Posts Tagged ‘methodologies’

The Seven Types of Waste a Summary

Thursday, March 18th, 2010

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You may have seen a couple of posts I have done on the seven types of waste. I have completed seven articles on all seven types of waste you might find in your organization. Below is a listing and a short description for each of the seven types of waste plus a link to the full article. I believe if you read these articles you will have a new way of looking at your business.


The Seven Types of Waste:


Correction – Corrections are and time you redo, rewrite, rework, repair, or scrap something. This can be as simple as rewriting a grocery list. Say you have a grocery list but you want to rearrange the items on it in the order you will encounter them in the store. Even though it will speed things for you shopping it had to be redone instead of thinking of making the list ordered in the first place. Redoing the list did not add any value to you; it took longer to write it a second time instead of doing it right the first time.


Overproduction – Overproduction is when you make too much of something or you perform too much of a service for some one. Have you ever held a meeting and made copies for that meeting? Most people make a few extra, do you? That is overproduction they will end up in the trash. Or have you every as a question about something in a store and the salesman goes on an on answering your question when all you wanted was the simple answer? That salesman was overproducing


Movement of material or information – This type of waste is when you take any material for information and have to move it from one place to another. You may ship it or carry it your self but that movement does not create any value for the customer in fact it is lost time because it delays your product or service from getting to your customer


Motion of employees – This type of waste is when you or an operator has get up and walk or travel to get something to do their job.  Just like movement of materials and information, motion of the operator does not create value. In fact the “thing” in the process is not changing at all


Waiting – This type of waste is when you, other employees, customer, material, or equipment sits idle waiting. Think about all the waiting rooms there are. As a customer do you want to wait? No but we sometime have come to expect the wait. I have been to doctor’s office where the waiting room is empty or full did not matter but in some I was seen on time and other I have waited over an hour.


Inventory or other resources - This type of waste is not just supplies and materials on shelves but also any recourse your company has that is not being utilized. We normal see inventory as parts and supplies sitting on a shelf like boxes of cereal in the grocery store. But here inventory also include equipment that is standing idle or in storage and employees that have skill that are not being used to their fullest.


Processes - This type of waste is when you are doing more than required by the customer. This is a hard one to understand because sometimes doing more for free has a WOW factor for your customers. That is why it is important to know what is of value and what is not. You see sometime you do sometime more that you think the customer wants and they do not care. That is when it becomes a waste.

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Human Metrics

Monday, July 6th, 2009

Six Sigma teaches us to view everything as a process. We should take an objective look at the system, measure the values, form a model, enact changes on the process, and observe the effects of these changes. However, we sometimes want to measure objectively something that is intrinsically subjective, the opinions of people. These fall under the category of what I like to call “Human Metrics.” Some common examples of these metrics are customer satisfaction, perception of quality, and ease of use. How do we accurately measure these values?

Surveys are regularly used as the catchall for human metrics. This has several flaws, though. First, people are not consistent graders, and a 7/10 for one person may be an 8/10 for another. Ultimately, though, this is not a problem because it represents the same sort of variation you will see in any measurement. The second problem is self-selection of responders. This is well documented, and can create extreme disparities between real and actual numbers. A good example of this can be found with call-in surveys. In many cases, only those with a chip on their shoulder will be compelled to call, creating a clearly biased sample. To counter this, sometimes incentives are offered to get a higher response rate, but this brings us to the third problem with surveys, non-response. Where some people may choose to simply not respond to a survey, others will purposely subvert the survey itself by ignoring the questions and answering in some sort of pattern. This is common with incentives, like contests for surveys, because it is so easy to simply hit the number one repeatedly without hearing the questions being asked. It can be hard to pick out this group, and one can only hope that over the long term the collective contributions of these unresponders will balance each other out.

How do you deal with these problems? A common solution is to try to address and eliminate the issues inherent to surveys. Select the sample by hand, normalize the scores across respondents, and remove surveys with obvious patterns or very unusual scoring habits. Ultimately though, even if these methods were perfect at eliminating their respective flaws, you would still be left with the fact that people are bad judges of their own opinions. Thus, you cannot use the responses to predict future behavior. This brings us to the best method for retrieving human metrics, using a proxy.

Measurement by proxy is a method that has existed for millennia. If you know the angle of the sun, you can measure the height of a flagpole by measuring the length of its shadow. You can apply this to human metrics and find values from behaviors that reflect certain opinions. Often, these are the values you care about most. Repeat sales, for example, is a good measurement of customer satisfaction. However, while repeat sales a metric that you can find using existing data, some require testing. For example, if you want a metric for ease of use, then you can look at the time taken to use the product. To test this, one might take a group of people with little or no familiarity with a product and ask them to use it. The time taken does not exactly demonstrate ease of use, but the two are related enough to make this a reasonable proxy in certain situations.

That is not to say that surveys cannot be useful, or don’t have a place. Simply put, they are very easy to implement, and consistent surveys allow the tracking of trends in user opinions. Additionally, measurement by proxy is far from perfect. Other factors in your system can seep into your measurement and taint the values. For example, the number of repeat sales may be artificially increased by having a product with a short lifespan. Naturally, the short lifespan is bad for customer satisfaction, but the proxy would insist otherwise.

In conclusion, as a Six Sigma expert, you should look to be quantitative in your assessment of systems. Human metrics are no exception to this rule. You cannot abandon the Six Sigma philosophy just because “Everyone is different.” Instead, look to measure how they are different.

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One in Three Medicare Patient Readmitted Within 90 Days

Monday, April 6th, 2009

A study reported in the April 2, 2009 New England Journal of Medicine discovered that one in five Medicare patients are readmitted to the hospital within 30 days of being discharged—and one in three are back within 90 days—in large part because they lacked a primary care provider, according to a new national study released Wednesday. More than half of the nonsurgical patients in the study had not seen a doctor prior to being re-hospitalized.

I don’t doubt the reported numbers, which are absolutely horrific, but I have my doubts about the causes and the proposed fixes. Healthcare has seriously lagged behind other segments of the economy in its adoption of quality, Lean and Six Sigma methodologies. The healthcare sector’s costs continue to skyrocket and consume an ever larger share of GDP, and patients continue to suffer the consequences. Readmissions are the healthcare equivalent of field failures. If any manufacturer had numbers like this, they’d be out of business within months.

An earlier post on this site reported that hospitals kill an estimated 98,000 patients per year, with some estimates double that number. That’s like a jumbo jet crashing and killing 400 people every day. Now we learn that even those patients who escape the hospital alive will very likely need to return soon after their discharge. Apparently the healthcare system’s failures extend to so-called “care” of patients outside the hospital walls as well as inside. In the meantime, healthcare providers continue to make money fixing problems they either caused or could have prevented. If things don’t change soon, the price of all of this may become more than society can bear.

Six Sigma and other quality improvement tools have the potential to change this bleak situation. I have data from a study where a very simple process change reduced the readmission rate for Medicare Med Surg patients from 28% to 10% in less than one year. As a result the admissions per thousand insured members dropped from nearly 230 to around 120. The question is: do hospitals view this as an incredible accomplishment, or lost revenue? We owe it to ourselves to design a system that assures the former conclusion.

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