Module 1 Outline of KAIZEN improvement V.pptx

Kaizen

1. Module 1 Outline of KAIZEN Applied course 2: Improvement methods EH-QIPS MOHP / JICA

2. Objectives of the module After the module, trainees will be able to; Understand what is KAIZEN Understand what is “problem” and levels of problem Understand “Quick KAIZEN” and “KAIZEN with QC story” Understand how to practice “Quick KAIZEN” and “KAIZEN with QC story” 2

3. “Problems” Before talking about “KAIZEN”, we had better know more about “problem” … ..

4. What is “KAIZEN”? “KAIZEN” is a “ problem” solving process with continual improvement of working practices and management for departmental optimization, towards to Total Quality Managed Organization (hospital). 4 “Change” & “Improvement” It means “ Change for the better” 改善 KAI ZEN

5. What is the concept of “KAIZEN”? 5 KAIZEN is to filling the gap (solving problems) with your wisdom and try to achieve ideal situation Ideal situation Current situation GAP

6. “Problem” can be categorized into 3 levels 6 Large size problems Middle size problems Small size problems 10 ％ of all 30 ％ of all 60 ％ of all Beyond control Health financing HRH shortage Many expired medicines Long waiting time Facility level Cleaning is not done regularly Improper waste segregation Disorganized working desk

7. “Problem” is not that simple … ① ② ③ ④ ⑤ ⑥ Complicated problem Non-Complicated problem ① It is composed by multiple factors and it is complicated to solve It is composed by single factor; thus, it is not complicated and easy to solve the problem

8. ① ② ③ ④ ⑤ ⑥ Complicated problem Non-Complicated problem ① ① ② ③ ④ ⑤ ⑥ Dissect ”problem” to identify composing factors Quick decision making to improve the solution Quick KAIZEN KAIZEN Process with QC story Follow QC story and try to eliminate the composing Factors step by step

9. Two types of KAIZEN Quick KAIZEN It is for solving non - complicated issue/problem “Solutions” can be implemented within short period of time (1~2 days), and improvement of work environment and healthcare services can be seen rapidly Very little investment of resources KAIZEN with QC story It is for solving complicated issue/problem It is necessary to use some quality control tools carry out the KAIZEN process It is necessary to conduct situation analysis with evidences (data and information) Whole process takes 4 to 6 months Some resources for interventions are necessary 9

10. What is Quick KAIZEN?

11. What is Quick KAIZEN? An improvement activity that can be implemented within short period of time and effects can be seen immediately A very little investment of resources is necessary Maximum of 1~ 2 days for completion of implementation Costs: use of available resources Human resources: Person who suggested Implementing Hospital staff’s ideas as small changes can be done by the staff him/herself with very little investment of resources 11

12. Benefit of Quick KAIZEN It can improve work environment and healthcare services rapidly It can grow the confidence among hospital staff (by pilling small and continuous successful experiences) It can cultivate positive mindset among staff It can strengthen record keeping habit among staff 12

13. Quick KAIZEN Everyday a little bit higher Unit/Ward/Department : ………………………… … Date of implementation : …......... / ............ / 20 …...... Head of WIT : …………………………………… …... Member of WIT: Before KAIZEN After KAIZEN (Picture of situation before KAIZEN) (Picture of situation after KAIZEN) Description of the situation before: Description of the situation after: Benefits from this Quick KAIZEN: Improve movement/transportation Reduce staffs’ work burden Improve workers’ safety Improve productivity Improve patients’ safety Others: Need to record Quick KAIZEN on “good practice sheet” 13

14. Quick KAIZEN Everyday a little bit higher Unit/Ward/Department : Maternity Date of implementation : January 2016 Head of WIT : XXXXXXXX Member of WIT : XXX, XXX, XXX, XXX, XXX, XXX Before KAIZEN After KAIZEN Description of the situation before: Previously, we used screens only between the beds, and it cannot ensure the clients’ privacy. Also, this disturbed the staff movements. Description of the situation after: Put the curtains between beds and in front of the beds. Benefits from this Quick KAIZEN: ☑ Improve movement/transportation Reduce staffs’ work burden Improve workers’ safety ☑ Improve productivity Improve patients’ safety ☑ Others: Improve client’s privacy Example 14

15. Quick KAIZEN Everyday a little bit higher Unit/Ward/Department : Ward XX Date of implementation : January 2016 Head of WIT : XXXXXXXX Member of WIT : XXX, XXX, XXX, XXX, XXX, XXX Before KAIZEN After KAIZEN Description of the situation before: Although we had the place for keeping our home clothes and uniforms, we had risks for transmitting infections among clothes, also did not have individual space for own clothes. Description of the situation after: We separated clearly the places for home clothes and uniforms. We are also given individual hanger to keep own clothes. Benefits from this Quick KAIZEN: Improve movement/transportation Reduce staffs’ work burden ☑ Improve workers’ safety Improve productivity Improve patients’ safety ☑ Others: Improve IPC, Improve staff satisfaction Example 15

16. Quick KAIZEN and 5S activities 　 We were often asked “what is different between 5S and Quick KAIZEN. There is NO clear demarcation between Quick KAIZEN and 5S activities. “Quick KAIZEN” is often practiced thorough 5S activities without notice. It means that Quick KAIZEN is overlapped with 5S activities. 16

17. KAIZEN with QC story

18. KAIZEN with QC story KAIZEN with QC story is a continuous improvement process, based on the following principles: Target of KAIZEN is in our work, not in the others Good processes bring good results Look by ourself to grasp the current situation Speak with data, manage by facts Take action to contain and correct root causes of problems Work as a team KAIZEN is everybody’s business 18 https:// www.kaizen.com /about-us/definition-of- kaizen.html

19. Two types of QC story Problem solving type QC story To reduce/solve problem and make the situation closer to setting standards (what and how it should be) It is often applied on the on-going activities Task-achieving type QC story To make an effort for achieving task or challenge and closer to the ideal situation It is often applied on the newly starting activities

20. Comparison between two types of QC story Problem solving type QC story Task-achieving type QC story Theme selection １ Theme selection Situation analysis ２ Situation analysis Prioritization Target setting Root cause analysis ３ Development of countermeasures Development of countermeasures ４ Development of successful scenario Implementation of countermeasures ５ Implementation of successful scenario Measure effectiveness ６ Measure effectiveness Standardization ７ Standardization

21. Logical thinking in problem-solving QC story 21 What are the problem in our workplace? What is the current situation of the problem ? What are the causes of the problem? What are the solutions for the problem? What will happen the solutions are implemented? What are changes after the implementation of the solutions? What should be done to sustain the good changes? Usually, staff will think and take action like the diagram, when problem occured in their workplace.

22. QC tools Each step of QC story utilizes one or two QC tool(s) 22

23. QC story and QC tools QC story is a method for illustrating the quality control process, which is used for systematic and permanent problem solving. QC tools are very important to proceed and process of QC story with evidences. 23

24. Two groups of QC tools Basic seven QC tools are used for Quantitative data analysis They are basic statistical approaches to analyze information correctly They are also useful for evidence-based management of work New seven QC tools are used for Qualitative data analysis Qualitative data can be organized and reveal problems They are useful for organizing complicated and intertwined problems Narrow down problems and make planning easier 24

25. QC tools Seven QC tools Pareto Chart Histogram Graph Scatter Diagram Cause-and-Effect Diagram Check Sheet Control Chart New seven QC tools Affinity Diagram Relation Diagram Tree Diagram Matrix Diagram Arrow Diagram Process Decision Program Chart (PDPC) Matrix Data Analysis 25

26. Plan Do Check Act Step 5: Implement countermeasures Step 6: Check effectiveness PDCA cycle and “KAIZEN with QC story” Step 2: Situation analysis Step 3: Root cause analysis Step 4: Identification of countermeasures Step 1: KAIZEN theme selection Step 7: Standardization Important is “continuous improvement“ Do not stop here after ACT. 26

27. Open Quality Improvement Spiral 27 Next KAIZEN should be better than the previous one

28. Wrap-up: Types of KAIZEN 28 KAIZEN Quick KAIZEN KAIZEN with QC story Task achieving type Problem Solving type For Non complicated issue For complicated issue Focusing on achieving tasks given to clarify or improve the situation Focusing for solving the problem and learning from mistakes for further improvement

29. Wrap-up : Tips for KAIZEN The target of “KAIZEN” is in your work , not in the others’ Dissatisfaction, complains to the current situation, and complains about people are not fit to be the KAIZEN theme because it is based on “negative attitude” KAIZEN theme must be based on positive wishes of workers such as “we would like to be/do……” KAIZEN starts from recognition of problem Better not to tackle with a problem that you cannot solve within your power and resources Begin what you can do with maximum utilization of existing resources 29

30. KAIZEN is to optimize departmental function for TQM Connecting optimized departments makes whole hospital will be optimized

31. The end of module