The Toyota Production System (TPS) organizes manufacturing and logistics for manufacturing, which includes interaction with suppliers and customers. A forgotten pillar of TPS and Lean manufacturing is the concept of Jidoka. This principle is one of the most important tenets, which will help achieve true excellence. It is about quality at the source or built-in quality. There is no organization that can succeed without the highest quality of service or product.

Jidoka began as a concept by Sakichi Toyoda as a simple device which stopped a shuttle on an automatic loom if the thread broke. This prevented the machine from creating a defective product, along with alerting the operator to a problem. This simple but effective concept of autonomation (or automation with a human touch) enabled an operator to operate multiple machines instead of one operator for every machine. The sale of the patent for this innovation was sold to a UK textile mill, which subsequently funded the new family business called Toyota. The principle of Jidoka is not just confined to the automation process. One of the most crucial aspects of Jidoka is building quality into a process rather than inspecting at the end. This concept is applied in TPS and Lean manufacturing, which is still a most effective tool used to ensure defects do not reach the customer.

The key to success is the human touch. Every person in the TPS or a Lean manufacturing organization has the explicit authority to stop a process when and if a defect is detected. This is a firm requirement. However, in some western organizations, fear of stopping the line for minor issues adversely affects productivity. This fear is exactly what undermines the pillar of Jidoka. Painful at first, eventually errors are removed from the system, the number of stops reduced and productivity begins to improve.

Truly effective manufacturing organizations make this a way of life in an organization. When applied properly, this nearly lost pillar of quality is crucial to any Lean manufacturing organization.

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Lean manufacturing and principles have been around for years, so the ideas are not really new. However, the scope of lean and lean manufacturing principles have significantly shifted. Now, it is widely accepted beyond the factory floor and is expanding into hospitals, government agencies and service sectors. These trends are expected to continue as lean and lean manufacturing principles are put into places across a wide variety of businesses on a global scale. The problem becomes the long lasting success of new programs. Some experts estimate that the failure rate of lean implementations could be as high as 80%. Change is a difficult thing for organizations and sustaining that change can be problematic for most. For those enjoying the most success with lean and lean manufacturing principles, they have found that the main benefits are the effects it has on the people. Great people are the lifeblood of a successful lean organization because it is about keeping people first!

Keeping people first is all about changing the culture and that change starts with respect. Leaders have to be on board from the start. They have to actively engage in a way that demonstrates clearly they are engaged. Spending time with people is the best way to connect with each and every person in the organization. Listening is the key to this engagement. Manage by walking around, get to know the people and let them get to know you. Lean is about respect, and the best way to show it is by spending time together. You will find that the vast amount of people want to come to work and know they have some ownership and control over what they do. As these changes start to take hold in the organization, you will find that customer service reps take fewer angry calls, sales reps are having to explain problems less and less, and your shipping department is not rushing to complete their work at the end of the day. Simply, problems start working out over time and success becomes a real reward. We just have to keep in mind that lean and lean manufacturing principles take time. Leaders must have the focus, patience and determination to make changes over the long term. They must have a firm commitment to making sure people come first.

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No other industry places such a high a premium on quality of service as healthcare. Given the essential requirement of quality in the healthcare industry, consumers expect providers to lead the way in innovation and quality efforts in the services they provide. As a percentage of its gross domestic product (GDP), we spend more on healthcare than any nation in the world. In a study conducted by the Institute of Medicine, preventable medical errors are estimated to result in as many as 98,000 patient deaths each year, with a projected annual cost as high as $29 billion. These errors are believed to be one of the leading causes of death in the US. There has never been a more ripe environment for the innovative and quality improvement methods of lean practices.

Healthcare institutions are implementing lean principles and practices pioneered at Toyota and other industrial companies. The industry is currently undergoing an unprecedented change, as providers are engaged in efforts to bring their practices into compliance with the requirements of the 2011 Patient Care and Affordable Care Act. As a result, healthcare providers are under significant pressure to increase access and reduce costs while improving the quality of patient care. Because of these significant pressures, the industry is seeking innovative ways to improve quality of service and reduce costs. Lean principles and practices are now being implemented in medical environments. We know that Lean offers significant advantages over other quality improvement models by increasing efficiency and reducing waste while simultaneously improving quality of patient care.

Lean practices and principles have the potential to help balance the cost associated with healthcare, increase the job satisfaction of professionals, and fundamentally improve the health of our communities. In the current environment, there has never been a more crucial time for healthcare to operate in the most efficient manner possible, while delivering the highest quality care in a safe manner.

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Mark Graban is an internationally recognized leader in Lean healthcare and continuous improvement. His motivation is to apply Lean and Toyota Production System principles to improve quality of care and patient safety, to improve the customer-patient experience, to help the development of medical professionals and employees, and to help build strong organizations for the long term.

Lean management principles have been used effectively in manufacturing companies for decades. Those same principles can also be successfully applied to the delivery of healthcare. Lean  healthcare begins with driving out waste so that all work adds value and serves the customer-patient needs. Identifying value added and non-value added steps in every process is the beginning of the journey toward success.

Although Lean healthcare differs in many ways from manufacturing, there are also surprising similarities. Whether building a car or providing healthcare for a customer-patient, workers must rely on multiple, complex processes to accomplish their tasks and provide value to the customer or patient. Waste of money, time, supplies, or good will always decreases value.

Check out this educational video from Mark Graban.

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Understanding the Value of Capability Analysis

Understanding the true value of the variables in a process can be defined by the capability analysis. The capabilities and value of a process can be determined by comparing the width of the process spread to the width of the specification spread. When a process is capable, the process spread is smaller than the specification spread. When the process is centered and within the specifications, it is more capable of consistently producing product that meets customer expectations. The benefits is that it offers a key measure of performance that is easily translated in a visual representation that is applicable across all industries. Further value of the capability analysis is that it estimates the proportion of product that does not meet specifications. It provides calculations for the percentage of the time your process will fall above the upper specification, or below the lower specification. This can be compared to the yield, to determine how many failures are due to variation (common cause), and how many are due to outliers and mistakes (special cause). It also provides a summary number that explains how capable the process is of staying within the specification limits (known as Cpk and Ppk).

Here is an example:

If we are collecting data on the weight of cereal boxes, and we have to meet specifications between 85 and 92, then you can see below that we will not always meet those specifications. Sometimes the data falls below 85 (about 2.45%), and sometimes the data goes above 92 (about 7.1%). Therefore, this process is not capable. It will fail to meet specifications about 9.55% of the time. We should expect a yield of only 90% unless we reduce variation, shift the average, or work with our customers to define new specification limits.

If the process specifications were 80 and 100, then you can see below that the process would be capable. There is no chance that we will have data outside the specifications. This is performing close to a Six Sigma level (if the nearest specification is at least six standard deviations away).

Bottom line, it summarizes a significant amount of information in one chart.

Finding Value for Customers

Statistically speaking, you are assessing the capability to make this highest quality product by comparing the width of the variation in your process with the width of the specification limits. The capability analysis is crucial to achieve this with your project. By using this tool, you will be able turn your efforts from just meeting established requirements to applying change that reaps true quality improvements that are consistent. Ultimately, you will be able to offer the highest amount of quality and customer satisfaction from your process with the lowest amount of variation.

Capability Analysis is a valuable tool across the Lean Six Sigma practice.  If you would like to learn more about Capability Analysis, consider the following items we offer: Histogram Generator (free), Process Capability (Intro and Advanced) eBook (Shmula Pro members), and Six Sigma training videos (Shmula Pro members). You can also attend a Green Belt or Black Belt training program, or Minitab training class.

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Living the Fantasy

Voice of the Customer programs are crucial to the success of your business. The problem is so many think they know exactly what their customers think and feel. You have been in business for 30 years and do things the same way, that’s what your customers want. Are you sure about that? For many businesses, they are either disconnected from their customers or they live with rose colored glasses when it comes to the voice of the customer. Those same businesses are very quick to deal with a vocal, disgruntled customer. Immediately, they are showered with attention, promises and apologies, then a discount to make up for the upset. The customer walks out and everyone breathes a sigh of relief and pats each other on the back, thinking they have saved another customer. Truth be told, what you think just happened is probably not what the customer thinks just happened. This begs the question: do you really know what your customer thinks about you?

What They Really Think of You

Using a solid Voice of the Customer program, you are going to get to the core of what your customers really think of you. For some, it might just be a bit unsettling. Here are some facts you should keep in mind as you begin your journey down the road of truth:

• 78% of customers have walked out on a transaction because of a poor service.
• On average, loyal customers are worth more then 10 times as much as their first purchase.
• It takes up to 12 positive experiences to make up for one negative experience.
• 91% of frustrated customers will not continue to do business with you.
• 40% of customers expressed that if they could improve one thing, they would improve the human element of the service.

These facts are both enlightening and staggering to some. They should disturb organizations enough to happily engage in a viable Voice of the Customer program that is effective. The days of reactive customer service experiences are over. Your customers expect you to be proactive and anticipate their needs and exceed them!

Listening to the Voice of the Customer

The Voice of the Customer is a process used to capture customer expectations and opinions, then provide world class services and products. The key to a successful Voice of the Customer program is to be extremely proactive, not reactive. This will allow your business to grow with your customer base, anticipating their expectations. These expectations are both stated and unstated. A vibrant program will instill a sense of loyalty and satisfaction towards your brand, in a consistent manner.

Resources

Consider downloading our eBook titled Voice of the Customer and Critical to Quality. Shmula Pro membership provides access to 34 other eBooks and reference guides

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Lean was born out of manufacturing practices, but in recent times, has transformed the world of knowledge work and management. It encourages the practice of continuous improvement and is based on the fundamental idea of respect for people. Womack and Jones defined the five principles of Lean manufacturing in their book The Machine That Changed the World. Take some time and listen to Womack discuss the five principles of lean.

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