Module 4 - Chapter 4 - Supportive Tools and Techniques PDF

# MODULE 4 | UNDERSTANDING AND ANALYSING PROCESSES ## CHAPTER 4: SUPPORTIVE TOOLS AND TECHNIQUES This chapter provides supportive tools and techniques to further understand and analyze work processes and eliminate wasteful activities in the hospital environment. The goal of the chapter is to find...

# MODULE 4 | UNDERSTANDING AND ANALYSING PROCESSES ## CHAPTER 4: SUPPORTIVE TOOLS AND TECHNIQUES This chapter provides supportive tools and techniques to further understand and analyze work processes and eliminate wasteful activities in the hospital environment. The goal of the chapter is to find best practices that will assist departments in their approach to understand their process, analyze and systematically improve it. ## 4.1 'STAND IN THE CIRCLE' OBSERVATIONS The 'stand in the circle' technique was introduced by Taiichi Ohno, who is considered to be the father of the Toyota Production System. He regularly used this technique in an effort to help managers understand and see the wasteful activities around them. The main focus of this exercise is to build awareness and rewire your brain to see many small problems. Although actual improvements are made, it is only seen as a resulting benefit. The more you are able to see the 'hidden' wasteful activities, the more you will be able to help your team members see the same. ### IMPORTANT INFORMATION Before starting, prepare the following: - Print a copy of the 'stand in the circle' observation sheet. - Get a pencil or pen and a clipboard (if there is no other firm writing surface). Put on comfortable shoes (you will be standing for 30 - 60 minutes). - Set aside just over an hour in your calendar. - You might want to keep a camera with you as it is sometimes necessary to take pictures or a short video clip. Note: Cameras are optional - always check if it is appropriate to use a camera in the area where you will perform this activity. ### Steps 1. Choose a spot in your work environment. It should be well located so that you can observe the area without obstruction. For 30 minutes, stand and observe - silently. 2. The key is to practice what the Japanese call 'kizuki' - the ability to notice. 3. Write down anything you notice that results in wasteful activities, that is a concern, abnormalities of any kind, even something that you notice that is not done as efficiently as could be. Indicate this on the observation sheet, next to each observation. 4. Your task is to make at least 30 observations - that is one every minute, including writing time. ### IMPORTANT INFORMATION - Just observe and write. No need to comment or discuss with others. - Describe what you see and why you see this results in wasteful activities. - Stay in one area and look deeply; it is easy to find 30 things if you flutter around like a butterfly and point out the large obvious wasteful activities instead, plant yourself like a tree and really see. - Sometimes wasteful activities can be hard to spot - if you need a place to begin. Look for issues pertaining to safety, quality, environment, or energy losses. Do lights need to be turned off? Perhaps you need better lighting? Is there a counter, carpet, wall, filing cabinet, desk area or storage area in need of cleaning? Are there any work positions with bad ergonomics or awkward access? ## What you see when you stand in the circle ### WASTED VALUE CONFUSION MIX-UPS POOR PLANNING ### POOR PROCEDURES WASTED MATERIALS RUSH AND HASTE BREAK-DOWNS ### SAFETY PROBLEMS REWORK WAITING IDLE EQUIPMENT ## 5. That's half of the exercise. Now take 30 minutes to do the following: - Choose one of the items you noted and make some type of improvement. - Create the next action for another of your observations. - The 'stand in the circle' observation sheet provides some basic categories. You are welcome to add your own to the list. The table below shows a few categories to consider: | Ergonomic issue | Complex processes | |------------------------------|---------------------| | Backsliding or letting systems deteriorate | Takes too long to process or complete | | Potential safety hazard | Too many steps to finish | | Environmental distraction | Cleanliness issues | | Excess or clutter | Excessive searching time | | Obsolete/outdated items | Lack of execution | | Non-functioning/broken items | Too hard to access (item or information)| | Backlog | Running out of supplies | | No clearly defined process | Unneeded items| | Not enough space, storage and shelving | Physical obstacles | | Energy inefficiencies | Planning issues | | Poor follow-through | Not getting a process right every time | ## OBSERVATIONS Stand in one place and do not move for a considerable period of time. | Number | Overproduction | Transportation | Motion | Waiting | Processing | Inventory | Defects | Walking | Waiting (People) | Talking | Checking | Telephone | Standing | Safety | Environmental | Space | Time | Energy | Direct money value | Housekeeping (58) | Machine condition | Work in Process | Layout | |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| | 1 | | | | | | | | | | | | | | | | | | | | | | | | | | | 2 | | | | | | | | | | | | | | | | | | | | | | | | | | | 3 | | | | | | | | | | | | | | | | | | | | | | | | | | | 4 | | | | | | | | | | | | | | | | | | | | | | | | | | | 5 | | | | | | | | | | | | | | | | | | | | | | | | | | | 6 | | | | | | | | | | | | | | | | | | | | | | | | | | | 7 | | | | | | | | | | | | | | | | | | | | | | | | | | | 8 | | | | | | | | | | | | | | | | | | | | | | | | | | | 9 | | | | | | | | | | | | | | | | | | | | | | | | | | | 10 | | | | | | | | | | | | | | | | | | | | | | | | | | | 11 | | | | | | | | | | | | | | | | | | | | | | | | | | | 12 | | | | | | | | | | | | | | | | | | | | | | | | | | | 13 | | | | | | | | | | | | | | | | | | | | | | | | | | | 14 | | | | | | | | | | | | | | | | | | | | | | | | | | | 15 | | | | | | | | | | | | | | | | | | | | | | | | | | | 16 | | | | | | | | | | | | | | | | | | | | | | | | | | | 17 | | | | | | | | | | | | | | | | | | | | | | | | | | | 18 | | | | | | | | | | | | | | | | | | | | | | | | | | | 19 | | | | | | | | | | | | | | | | | | | | | | | | | | | 20 | | | | | | | | | | | | | | | | | | | | | | | | | | | 21 | | | | | | | | | | | | | | | | | | | | | | | | | | | 22 | | | | | | | | | | | | | | | | | | | | | | | | | | | 23 | | | | | | | | | | | | | | | | | | | | | | | | | | | 24 | | | | | | | | | | | | | | | | | | | | | | | | | | | 25 | | | | | | | | | | | | | | | | | | | | | | | | | | | 26 | | | | | | | | | | | | | | | | | | | | | | | | | | | 27 | | | | | | | | | | | | | | | | | | | | | | | | | | | 28 | | | | | | | | | | | | | | | | | | | | | | | | | | | 29 | | | | | | | | | | | | | | | | | | | | | | | | | | | 30 | | | | | | | | | | | | | | | | | | | | | | | | | | ## THE ONE THING I WILL CORRECT - Within the next 30 minutes: - Within one week: - Within one month: ## ACTIVITY 5 [Image of a box with the number one in it] 1. Practise the observation technique by going to your workplace and completing the template provided. Summarise your learning here: ____ ____ ____ ____ ____ ____ ____ ____ ____ ## GLOSSARY ### 5W1H A method of asking initial questions about a process or a problem that was identified for improvement, to understand the current state. 5W1H stands for: ‘Who? What? Where? When? Why? How?' ### Continuous Improvement Team A small group of people that have been called together for a specific period of time to solve a specific problem or to come up with a specific solution. This group can be made up of about three to five people from one Performance Driven Team, or from different business areas and levels in the company. ### Performance-Driven Teams A group of people with specific roles and complementary talents and skills, aligned with and committed to a common purpose, who consistently show high levels of collaboration and innovation that produce superior results. ### Root Cause Analysis A method of problem-solving for identifying the root causes (main reasons) of faults or problems. ### Value Stream and Process Flow Map Techniques used to document, analyze and improve the flow of people, information or equipment or materials required to deliver a service to a patient. These are tools that help to visualise and understand the flow of people, information or equipment or materials through the value stream...