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Lean Tools and Methods: 5S

Erika Sundrud, M.A.Principal, Quality, Safety, and Performance Improvement

Master Black Belt in Lean Six Sigma

Judy Krempin, MS, CPHQManager

Quality, Safety, Performance Improvement


Objectives

State the key elements of 5S

Describe the value of implementing 5S

Obtain the knowledge needed to implement 5S in your organization


Wasted time spent searching for needed items

– anything missing?

Vascular Access Cart


Would you know if a supply needed re‐stocked?

How about This?




•A strategy that helps to keep our workplace safe and organized

Sort

Set/Simplify

Sweep

Standardize

Sustain/Self‐discipline

5S

5S is a foundational element of Lean hospitals


• Removes waste, including:

Excess inventory

Out‐of‐stock supplies

Searching for supplies

Walking for supplies

Wrong and outdated parts

Non‐value added setup and cycle time

Moving parts around workspaces

5S


•Assists in the elimination of waste

• Improves work flow

• Reduces employee stress

• Provides a systematic process for continuous improvement

• Focuses on the process and not the person

Benefits of 5S


5S at Work

Crash Cart Medications

Blood Sugar Supplies


1013

23

2730

47

51

58

62

79

40

Mark 1‐49


1013

23

2730

4740

Sorted / Mark 1‐49


10

13

23 27 30

47

40

Numbers from 1 to 49

Standardize/ Mark 1‐49


1013

23

2730

47

51

58

62

79

40

Find missing #s


10

13

23 27 30

47

40

Numbers from 1 to 49

Find missing #s


5S

1. Determine the space and scope for the 5S activity

2. Identify teams and team leaders

3. Involve as many team members as possible

4. Document the current state with photos

5. Measure current inventory levels

6. Use visuals/photos to describe current state to team

Implementation:


• Sorting separates necessary from unnecessary

Most critical of the 5S steps

Objective evaluation of all materials in the 5S area

Identifies additional required supplies

Identifies proper par levels

Document key information

• Consider:

Supplies are neat, but are par levels connected with use?

What do you do when there is excess inventory?

5S: Sort


5S : Sort


5S: Set/Simplify

Correlate location of supplies with their use

Place higher use items closer to the point of use

Makes unnecessary items visible

Enables the team to see what is out of place

Makes Places for Necessary Items

Place most frequently used items within reach

Ensure less frequently used items are still accessible

Label items that are mobile

Label items that are not familiar to all team members

Remove excess stock

Implement Set/Simplify


5S: Shine/Sweep

Remove and replace broken equipment

Replace missing equipment/ expired supplies

Clean area

Makes it obvious when things are out of place

Avoids the need for ‘cleanup’ events

Form of Inspection that Ensures Everything is Returned to its Proper

Place

Include scheduled sweeps with your eyes

Determine the appropriate sweep frequency

Determine the elements of a complete sweep

Implement Shine/Sweep


5S: Standardize

Define teams and roles for each team member

Specify training/ orientation expectations

Define standards for personal items

Specify standards for visual controls

Specify standards for disposing unneeded items

Creates a Standard Agreement and

Communicates it to the Team

Complete team agreement

Update kanbans to signal for replenishment

Document and post a visual map of the work area

Document and post pictures of new current state

Develop task sheet for each 5S area

Implement Standardize


5S: Sustain/Self Discipline

Often the most difficult of the 5S steps

Seeks to ingrain desirable behaviors

Consistency and repetition need to become habitual

Maintains Standards Through Training,

Empowerment, Commitment and Discipline

Managers should do visual 5S sweeps at least daily

Audit the area against the 5S achievement template regularly to maintain the gains & improve

All team members must participate ‐ Set time aside to ensure workspace is functional, orderly

Acknowledge gains

Implement Sustain/Self Discipline


5S Example

COLLEEN’S HARD WORK

Before After

http://runningahospital.blogspot.com/2009/10/5s‐projects‐are‐spreading.html?m=1


5S

S Cusanza, AONE 2010


5s


Level VContinuously Improve

Cleanliness problem areas are identified and mess prevention actions are in place

Map created for each item in storage room showing general location and layout of materials and can be retrieved quickly with minimal effort

Potential problems are identified an countermeasures are documented

Reliable methods and standards are shared throughout similar work areas

Root causes are eliminated and improvement actions focus on developing preventive methods

Level IVFocus on Reliability

Work area has documented housekeeping responsibilities and schedules, and the assignments are consistently followed

Items rotating from storage and use, create visual control to identify point of use

Inspection of area occurs daily and work areas and equipment are restocked and organized

Reliable methods and standards are adhered to by all members of the work group

Sources and frequency of problems are documented as part of routine work, root cause of non-compliance are identified and corrective action plans are developed

Level IIIMake it Visual

Initial cleaning has been completed; items disposed of accordingto auction disposition

Needed items are outlined, dedicatedlocations are properly labeled and required quantities are determined

Visual controls and indicators are established and marked for the work area equipment, files and supplies

Documentation for all visual controls exist

Work group routinely checks are to maintain 5S agreements

Level IIFocus on Basics

Needed and not-needed items are identified and those not needed are removed from work area

Needed items are stored and organized according to frequency of use

Work group has agreed on items to be checked and acceptable performance levels documented

Work group has documentedagreements for needed items, organization, and work area controls

Documentation of completed 5S is posted in work area; 5S is incorporated into new staff orientation

Level IJust Beginning

Necessary and unnecessary items are mixed together throughout the work area

Items needed are located in various places throughout the work area

Key work items are missing and current location is not known

Standards for workarea organization are not followed or documented

Work area checks are not done regularly and there is no visual measurement of 5S performance

Sorting Simplifying Sweeping Standardizing Self-Discipline


• Disorganization is a barrier to work flow!

• To “set” means to place higher use items closer to the point of use.

• 5S assists in the elimination of waste, improves work flow, reduces employee stress, and provides a systematic process for continuous improvement.

Summary of Key Points



• Executive Lean Training at Virginia Mason. 2013.

Resources and References


Lean Tools and Methods: Gemba Walk

Judy Krempin, MS, CPHQManager

Quality, Safety, Performance Improvement


Objectives

Be able to define Gemba

Describe the Gemba walk used to prepare for an RIE, and the Gemba walk for Kaizen

(Continuous Improvement)

Practice the role of gemba coach


The place where work is done

The place the truth is

found

What is the

Gemba?


Definition & Purpose of the Gemba Walk

Gemba means “the actual place”

Where work is done

The place of value creation

The place where the needs of the customer (the patient) meet the work of the system (the front line)

Purpose of the Gemba Walk is to:

See and understand the current situation

o Process (purpose, steps, reliability)

o Worker knowledge and experience

o Wastes/ Successes

Guide others to think critically, develop people

o Ask 1 or 2 coaching questions

o Let the person own the process

Encourage improvement & sustainment efforts


Get the Unbiased Facts at the Source

Management must be on the Gemba

See what is actually happening – get familiar

Familiarity facilitates one’s ability to ask the right questions about progress and barriers


Go See

Show Respect

Ask Why


Focus on:

The purpose of work

The effectiveness of the process

Engaging people who are part of the process

Walk from start to end of the value stream


RIE Team: To gemba before mapping the value stream & before

identifying solutions

When do I go to Gemba?


Who goes to Gemba as part of a Rapid Improvement Event (RIE)?

AllMembers of Improvement Team –before any solutions are suggested


Gemba Walk for RIE

Purpose: Understand the current state

Who does the work

Identify barriers to flow

See defects

Identify triggers for action


Gemba Walk for

RIE

Actions:

Observe

Draw/ time the current process

Listen to the people doing the work

Document cycle times, barriers and waste


Kaizen

A Leader goes to Gemba regularly

When do I go to Gemba?


Who goes to Gemba? How often?

CEO & Senior Team: weekly/ monthly

Quality/ PI Leaders: weekly

Managers and Directors: daily

Supervisors: every shift


Leader Standard Work: Regular Gemba Walks

Create capacity in your calendar•Routines are best•Consider a “no meeting” zone

The first several visits:

• Focus on observations• Learn the flow• 1‐2 questions to better understand the work


Gemba walk for Kaizen

Gemba Walk Purpose:

Be a keen observer – what questions can be asked to help people see barriers and improve the process

Force reflection among staff

Incrementally improve


Gemba walk for Kaizen

Actions:

Greet the staff

Review the PI Board

Observe the process

Understand the workflow

Discuss current improvement plan

Ask coaching questions


Learning from Toyota Gurus

Toyota managers should be sufficiently engaged on the factory floor that they have to wash their hands at least three

times a day.

‐‐Taiichi Ohno


Gemba Walk as Part of Kaizen

1 2 3 4 5

See the facts at the source.

Become familiar.

• What do we need to learn?

Learn the nature and cause of the

problem (before debating solutions).

Teach problem solving.

Why do you think that happened?

Why do you think those conditions exist?

Assess gap between

current and target state.

• If we are on target, what has helped us succeed?

• If we are not reaching our target, why?

Look for leadership

and cultivate.

• Does this person plan ahead strategically?

• Collaborate between departments?

Adapted from: Michael Balle’s “Go and See” presentation. Lean Enterprise Institute.


• “Wait! My staff do all their work on computers!”

Yes, a Gemba “walk” takes place wherever the work is done

• To prepare for desk Gemba walks:

1) As for all Gemba walks, schedule with staff and explain the purpose and approximate duration ahead of time

2) The first few Gemba walks, ask the front line person to explain the work (purpose of the work, data sets, decision making)

3) The next few Gemba walks: observe, listen, get familiar

4) Once familiar, coach the person that reports to you

Desk Gemba


Things to Avoid While Walking the Gemba

• Tampering with a process

Giving answers

“Management by walking around”

Going alone


Coaching at the Gemba

Traditional Coaching for Correction

Lean Coaching for Development

Specify the process deficiency

Get agreement that problem exists

Give feedback

Provide suggestions about how the process should go

Agree on next steps

Let the staff person own the problem

Let them think

Help them see

Force reflection


• Find a partner Partner should be someone you do NOT work with currently

• First person: Describe a process challenge at work Describe for 30 seconds

• Second person: Ask open ended questions to help the other person think through that problem

Do not use questions that can be answered with a “yes/ no”

Practice for 3 minutes

• Switch roles after 3 minutes

Practice Coaching


Gemba Observer Goals

Develop keen

observation skills

Develop better

engagement and

discussion skills


Effects of Showing Respect at the Gemba

Discretionary Effort

“You hire my time and are due a full day and good effort. You can define my responsibilities, program my activities, and evaluate my performance. You can control what you see.

But I can decide how far I go beyond that, and for what.”

From David Verble’s LEI presentation May 2013


Cheat Sheets Are At the End of the Section


• When the Gemba walks are introduced, observe the work for several weeks to become familiar with the process – no tampering with the process or asking questions except to understand the steps.

• When coaching at the Gemba, let the staff person own the problem, let them think, help them see, force reflection.

Summary of Key Points



•Michael Balle. “Go and See”. Lean Enterprise Institute.

•David Verble’s Coaching presentation at Lean Enterprise Institute. May 2013.

Resources and References


First Several Gemba Walks along a Value Stream: Observe & Reflect

Schedule Observe Say “Thanks!” Reflect

PI Board &

Process


Routine Gemba Walks:Observe, Reflect & Coach

Schedule Observe Thank Staff Coach & PI Board/ Reflect Process & Reflect


Manager Coaching Questions for Front Line Staff

How is this (process) going?

If it went well:• “How do we know we’re doing

the work the best way?”• “How do we know the outcome

was successful/ defect free?”

If it did not go as designed, “What is happening in the environment (that led to this outcome)?”

Ask the staff person to provide objective data/ evidence of success

If we don’t know why a process or interaction failed, “How might we learn more?”

Consider:• “How will we know when

we get it right?”• “What do you think you

would do next time?”

If remedial approach provided by the staff person is not going to be effective, ask further about the barriers or issues

Consider the follow up question:“What would you do if you had a problem with (xyz)?”


Senior Leader Coaching Questions for Managers/ Directors

How is this (process) going?

If it went well, “How do we know we were successful/ effective?”

If it did not go as designed, “What is happening in the environment?”

Ask the Manager to provide objective data/ evidence of effectiveness

If we don’t know why a process or interaction failed, “How might we learn more?”

Consider:• “How could we break that big change/

decision into smaller ones?”• “How might you coach staff differently

next time?”• “How would you coach someone to give

context to a problem next time?”

If remedial approach provided by the Manager/ Director is not going to be effective, ask further about the barriers or issues

Consider the follow up question:“What would you do if you had a problem?”




Intended for internal guidance only, and not as recommendations for specific situations. Readers should consult a qualified attorney for specific legal guidance.

Documents

Lean Tools and Methods - c.ymcdn.comc.ymcdn.com/.../D1_8_5S_and_Gemba_Walk_(FINA.pdf · Lean hospitals 8 Proprietary ... Form of Inspection that Ensures Everything is ... Lean Tools