DPMO or SIGMA LEVEL CALCULATION
How to find my process performance?
How to find my process Sigma Level?
How can I say whether to improve my process or not?
How will I find whether my process is improved or not?
What is DPMO?
DPMO stands for Defects per million opportunities. It means out of million opportunities how many defects does your process contains?
Consider n number of units from your process and assign some criteria or opportunities to check whether the output satisfies the opportunities .If it satisfies the criteria then there is no defect and if it fails to satisfy the criteria then it is said be a defect.
A product or service can have 1 or more than 1 defects.
Even though your process have less population, as a quality improvement person who follows DMAIC methodology will convert the data for million and perform the identification of defects.
The formula to calculate DPMO value is
Once after finding the DPMO value, compare the DPMO value to the nearest value in six sigma Conversion table and find the respective Sigma level
If a process follows at 6 sigma level, then the number of defects will be only 3.4 out of million opportunities.
For example: Number of units: 100
Number of defects: 10
Number of opportunities: 2
From this DPMO calculation, we can find our current performance, improved performance, and Sigma level value.
In DMAIC methodology, DPMO calculation is used in measure phase to understand the current performance and in improve phase to understand the improved performance.
Certified Professional in Healthcare Risk Management (CPHRM):
Definition of a Healthcare risk management professional primary duties include the prevention reduction, and control of loss to the healthcare organization, its patients, visitors, volunteers, physicians, other healthcare professionals and employees. Regardless of the healthcare delivery system in which the individual works, the Healthcare Risk Management Professional interfaces with a number of healthcare professionals in the accomplishment of these objectives. Duties may include incident investigation and analysis, tracking, trending and evaluation, risk financing and claims management.
CPHRM certification program administered by The American Hospital Association Certification Center (AHA-CC) and promotes healthcare risk management through certification of qualified individuals and the following program elements:
Recognizing formally those individuals who meet the eligibility requirements of the AHA-CC and pass the CPHRM Examination. Requiring certification renewal through continued personal and professional growth in the practice of healthcare risk management. Providing a national standard of requisite knowledge required for certification.
CPHRM course covers concepts of risk management in healthcare, employment practices, and general risk management strategies. It also goes over specific risk areas including medical malpractice, strategies to reduce liability, managing positions and litigation alternatives.
CPHRM course includes an emphasis on outpatient medicine and the risks associated with electronic medical records.
This course covers academic medical settings and the impact on healthcare delivery, ambulatory and outpatient surgery, risk management for infection control programs, telemedicine, risk management in ambulatory care settings, and risk management in office-based surgery.
CPHRM offers current information, regulatory and legal updates, and assessment tools that will prove invaluable to both new and professional healthcare risk managers.
The topics covered in this training includes, Clinical/Patient Safety, Risk Financing, Legal and Regulatory requirements, Healthcare Operations, Claims and Litigations.
Lean is a management technique which eliminates waste in any process resulting in improved efficiency, effectiveness & profitability.
In order to improve any process the primary task is to identify and eliminate the waste in it.
First of all let us understand what is waste?
Any step or operation that does not add value is waste. Hidden wastes in a process contribute to the increased prices of the products/services.
For any business to survive in today’s competitive world, the organization must strive continuously to reduce wastes in a process.
There are eight types of wastes:
- Motion: Unnecessary movement of personnel or information due to poor workspace layout, missing parts or tools.
- Transportation: Transporting items that is not required to perform the process from one location to another
- Waiting: Time waiting for parts, tools, supplies or the previous process step
- Overproduction: Producing more products than what is required to meet current demand
- Defects: Non-conforming products or services produced at the first time requiring resources to correct
- Inventory: Products or information that is being stored or not being utilized due to line imbalance or overproduction
- Unrecognized talent: Failure to effectively engage employees in the process and fully utilize their knowledge and skills
- Over processing: Activity that is not adding value or required to produce a functioning part, product or service
The five key Lean principles are:
- Value stream
Value is what the customer is willing to pay for. It is important to understand what actual needs of the customer are. Sometimes customers may not articulate the exact requirements. Therefore these requirements have to be captured by various methods such as interviews, surveys, customer complaints…etc. By using these techniques one can uncover what & how the customer wants, and the price that they are ready to afford.
Value stream mapping
In this step, the primary objective is to enhance the customer’s value by identifying all the activities that contribute to these values. Any non-value added activity in the process is considered as waste. The waste can be of two types: non-valued added but necessary and non-value & unnecessary. By reducing and eliminating unnecessary process steps, value of the product/service can be enhanced and can improve the customer satisfaction
Once all the wastes from the value stream are removed, the complex process steps has to be broken down in to simple steps, level out the workloads, redesign the process, train the employees for smooth flow of steps to avoid any delays and interruptions.
A pull-based system allows Just-in-time technique for manufacturing of products as per the customer requirement by time and quantity. Pull-based systems are always created from the needs of the end customers. By adopting all the above techniques we can ensure the needs of the customer are satisfied.
Though wastes can be prevented by implementing lean technique, perfection is the most important aspect in it. This drives Lean thinking and continuous process improvement a part of the organizational culture. Every employee should strive towards perfection while delivering products to the customer needs every time they are supplied.
Customer Service Excellence:
Customer service training refers to set of behaviors, which an organization undertakes during its interaction with its customers and how customers perceive the behaviors and teaching employees the knowledge, skills and competencies required to increase /fulfill customer satisfaction.
A customer is the one who interacts with us or the service we provide, either directly or indirectly, or is a affected by the quality of the product or service, whether they are paying for it or not, either indirectly or directly, whether they are internal to the organisation or not.
They do not have to be in a contractual (i.e. paying) relationship with us. The content of the training typically includes, how to greet the customer, questioning to understand the customer need or problem, listening, confirming understanding responding to customer using positive language, concluding the phone or face to face interaction, dealing with angry customers and unsatisfied customers and the importance of body language and tone of voice.
Employees who are trained properly and demonstrate professional customer service skills can improve customer satisfaction and loyalty. This helps the business retain customers and improve profits. It costs less to retain loyal customers than to get new ones. In addition, satisfied customers are more open to additional sale messages and are likely to refer to others.
Good listening skills and questioning techniques can shorten the interaction time with customers and this allows organization to serve more customers in less time possibly with less staff. However customers are intelligent and do not want to feel rushed, when they have questions, so be proactive and make sure every consumer feels they are being heard and not just listened to.
Training all employees using consistent customer service skills, allows them to have a common process language when assisting customers. This allows the business to brand their interaction of excellent service to customer, which adds value to the business.
Investing in employee training gives employees a feeling of value and improves confidence. When employee feels valued, they value their customers. This could be a result of effective customer service skills training which not only benefit employee but also enhance relationship with customer. These important factors can help increase employee loyalty; reduce employee turnover and lower productivity costs.
It is the absence of preventable harm to a patient during the process of healthcare.
There are six key areas of patient safety.
- Safe structure
- Safe environment
- Safe equipment
- Safe processes
- Effect of staff
- Effect of leadership and culture
Approaching patient safety within an organization requires a review in six key areas
- Safe structure: involves reviewing whether the facilities are designed to promote safety, right supplies are being ordered, and policies/ procedures address safety considerations.
- Safe Environment includes an assessment of lighting, temperature, noise levels. Surfaces, storage and ergonomics.
- Safe equipment/technologies include an examination of labels, instructions and safety features to be sure that potential errors can be avoided when using various devices.
- Safe Processes include an assessment of whether redesign would improve safety by looking at some factors: complexity, inconsistencies, and time constraints.
- The effect of people (i.e., staff) on patient safety requires attention to many factors. For example, employee attitudes, motivation, health, education, training and cognitive functioning can have an impact upon the likelihood of a medical error.
- The leadership/culture can drive safety issues when there is a willingness to allocate appropriate resources (e.g., staff equipment), analyze processes, implement changes, support non-punitive error reporting, and promote evidence-based practice.
Effective communication is essential for ensuring patient safety. The use fo effective communication among patients and healthcare professionals is critical for achieving patients optimal health outcome.
During complex situations, communication between healthcare professions must be at its best. The disclosure of adverse events is important in maintaining trust in the relationship between patient and healthcare provider. It is also important in learning how to avoid these mistakes in future by conducting quality improvement reviews or clinical peer review.
It is a process improvement tool which correlates all the variables in a process into five levels. The acronym for SIPOC stands for Supplier, Input, Process, Output & Customers.
It is a method that captures the transformation of the all the inputs into final Products/Services. It enables us to understand what factors influence the transformation and the people involved in each activity.
The supplier supplies the raw material, semi-finished material, knowledge as required by the organization to meet or exceed the expectations of the final customer These inputs are then processed through series of steps to transform them into finished goods. It helps anyone to understand the process who has little or no knowledge about the final Product/Service. The SIPOC model helps prevent that parts of the transformation process are overlooked.
The supplier supplies products or services to the process. Whatever necessary for the process the supplier supplies this Input in the form of materials, skills and information. All the inputs need to be gathered before the process can start.
The input of the process can be materials, service and information. Materials can be in the form of Raw material, Machines, tools, consumables…etc. and other form of inputs can be skills, knowledge and also required software’s.
At this stage all the set of activities that are performed in a sequence are briefly listed in the form of a flow chart to produce the required output. Only major steps (5-7 Steps) are captured just to understand the outline of the process. By following the steps as per the process the products/services are produced with consistent quality & at a lower cost.
The final outcome of the process is the end product. The net result of all the set of activities will be delivered to the customer by at least meeting or exceeding the customer expectations.
The end user of the product is called customer who can be an individual or a company. Customer requirements are important throughout the process. When the output doesn’t comply with the customer requirements, the business can’t be guaranteed.
Five phases of Six Sigma
Six sigma methodology follows a systematic approach .In order to complete a successful six sigma project we should travel through the following Five phases of Six Sigma:
The first phase in six sigma project is define phase, where we set the direction for our destination to travel throughout the project. We will define all the objectives of the project. The key points and deliverables in define phase are follows:
- Set objectives
- Form a team
- Define the project’s Problem statement and Goal statement
- List out the benefits of the project
- Design Project plan
- Map the Overview of process
- Identify the KPI
- Prepare the project charter document
The second phase of six sigma project travel is Measure phase. In measure phase, the focus should be towards on collecting the reliable data and measure the data to identify the current performance of the process. The key points and deliverable of Measure phase includes:
- Identify the data type
- Collect the data
- Measure the data location and variation
- Calculate the current sigma level or performance of the process
The third phase in six sigma project journey is Analyze Phase. Once the data is measured, Quality improvement person will focus on the root causes of the problem. Right from identifying all the causes and ends up with the major causes that contributes high weightage towards the problem. This can be done with the help of tolls like cause and effect diagram, Box plot, scatter plot, Pareto chart, etc.
The Key points and deliverables of Analyze phase includes:
- Identification of all the root causes
- Prioritization of the root causes
- Selection of High contributed causes
- Conformance of causes towards the problem
Improve Phase takes the fourth phase in six sigma project travel. The major contribution of improve phase is solutions. For the major root cause identified in analyse phase will be taken and discussed with team members for finding the solution. Tools like Brainstorming, Pugh Matrix, etc. can be utilised to generate ideas and select the best weighted solution. The key points and deliverables of Improve phase includes:
- Idea Generation
- Selection of suitable solution
- Implement the solutions
- Find the Improved sigma level or improved performance of the process
The fifth and final phase of six sigma project is control phase .Once after the implementation of solutions and with confirmation of improved process,Quality improvement person will not quit the project. Control phase deals with the monitoring of the process continously in daily basis to ensure that process is undercontrol without the occurrence of founded root causes in the project. Tools like control charts are used to control and monitor the process variation .The Keypoints to be noted with control phase follows:
- Selection of control charts
- Application of control charts
- Process variation with samples
- Immediate action for major variation of the process
With the above Five phases of Six Sigma, Anyone can improve the process and ensure the Quality improvement .
5S is a system for organizing work place so that the work can be performed efficiently, effectively, and safely. This system focuses on allocating the place for everything and ensuring everything in its place and also keeping the workplace clean, which makes it easier for people to do their jobs without wasting time or risking injury.
The term 5S comes from five Japanese words:
- Seiri (Sort)
- Seiton (Set in Order)
- Seiso (Shine)
- Seiketsu (Standardize)
- Shitsuke (Sustain)
The Origins of 5S
5S began as part of the Toyota Production System (TPS), the manufacturing method started at the Toyota Motor Company in the mid-20th century. This system, often referred to as Lean manufacturing, aims to increase the value of products or services for customers. This is often accomplished by finding and eliminating waste from production processes.
The workplace should be clean, organized, for achieving consistently good results. A messy, cluttered space can lead to mistakes, slowdowns in production, and even accidents, negatively impacting on a company.
By systematically organizing a facility, a company increases the productivity & quality while reducing the costs.
It is the first step of 5S, starts with segregating the material equipment’s, tools…etc in the work place what is useful & what can be removed by asking some questions which include:
- What is the purpose of this item?
- How often it is used?
- Do you really need this to be here?
The work space will be free from space taken up by the items which are unnecessary and are used infrequently.
After sorting the unnecessary items:
- Recycle/sell/throw away the items
- Put items into storage
Less frequently used items can be identified using a Red tag and placed in Red tag area along with other items. If the same is not used within the specified time period its worth to remove the item to free the space.
2. Set in Order
Once unnecessary items are removed, the useful items have to be arranged in a systematic & most convenient way to reduce unnecessary movements, by considering the following;
- What items are used?
- How frequently they are used?
- Who uses them?
The arrangements made are to be logical to the type of tasks handled, frequency of those tasks. The purpose of this step is to allocate a place for everything & ensuring everything in its place.
After arranging the useful items in the designated place focus to be given to cleaning your work space by mopping, dusting, sweeping, wiping the tools & equipment’s.
Shine apart from basic cleaning also includes regular maintenance of machineries, equipment’s in your work area which can prevent the breakdowns resulting in less process time and increased profits.
At this stage everyone takes the responsibility of cleaning & maintaining the work space on daily basis.
Standardize systemizes everything by just converting this one time activity into habits. This assigns tasks, plans schedules & develops instruction’s to convert the activities into routines.
This leads to initiation of SOP’s. Schedules to be developed indicating how frequently certain activities are to be performed and the personnel responsible for the activity to be done.
At this stage strictly adhering to the SOP’s and updating them regularly by involving everyone in the organization will effectively help in implementation of 5S.
With Sustain all the activities will become a long term project making it a part of the organization culture. Employees at all levels have to participate in order to motivate others and reap continuous benefits.
What is Quality?
Quality plays a significant role in progress of an organisation. Nobody can survive in the market by over sighting the quality.
Quality can be defined in many terms –
Quality can be measured as acceptance of all the requirements by the side of customer because customer comes for business but stay for quality.
Quality can be the cost or service of the product which customer be able to pay for. Product's performance is also essential for satisfied feedback.
Quality is an approach for making organizations or products performance better form service, system and process. Quality must be capable and effective.
Six sigma provides admirable quality of service by removing defects of the process. Make sure what your organisation provide is fit for target. Maintaining the quality is striving for the excellence. Product/service should be meeting the expectation and requirement of the customers.
Companies apply lean manufacturing processes to reduce an efficient business, you should focus on waste reduction method for increasing production, manufacturing and customer satisfaction. Lean involve in waste elimination for increasing the profitability in any organisation.
TIMWOOD can help in increasing the productivity, reducing the cost and better customer satisfaction. There are the 7 wastes of lean manufacturing.
Transport - Transportation of products between processes. Unnecessary motion of material which can cause to damage of material that might be waste.
Inventory - Inventory refers to purchasing and stocking raw material in workplace that might be waste in future.
Motion - Unnecessary movement of any employee or people.
Waiting - Waiting of a particular process while two processes are running. That is a kinds of waste.
Overproduction - producing something when it is not required or production before time of customer's demand.
Over processing - over processing is working on a feature that customer doesn’t demand for. Putting extra effort on something which doesn’t value.
Defects - Customers never expect any defects. It includes the defects in quality error that cannot be reworked.
A box plot, also known as box and whisker plot, is a good way to summarize large amounts of data.
It displays the data range and distribution of data along the number line
In 1977, John Tukey published an efficient method for displaying a five-number data summary. The graph is called a box plot and summarizes the following statistical measures
- Median (2nd Quartile)
- 1st Quartile
- 3rd Quartile
Correlation & Regression
Correlation is a statistical method used to determine if a relationship between variables exists.
Regression is the statistical method used to describe the nature of the relationship between variables - that is, positive or negative, linear or nonlinear.
Independent & Dependent Variable:
There are two types of variables in a regression analysis:
The independent variable is the variable in regression that can be controlled or manipulated.
The dependent variable is the variable that cannot be controlled or manipulated
A scatter plot is a graph of the ordered pairs (x, y) of numbers consisting of the
- independent variable, x,
- and the dependent variable, y.
The scatter plot is a visual way to describe the nature of the relationship between the independent and dependent variables.
After the plot is drawn, it should be analyzed to determine which type of relationship, if any exists.
A positive relationship exists when both variables increase or decrease
SPECIFIC - What details do you want to accomplish?
“I want to do better in Quality”
“I want to increase my Quality percentage from 95% to a 98%.
MEASURABLE – All goals should have a way to evaluate whether or not they were accomplished.
“I want to complete the file within 30 minutes.”
“I want to improve my processing time by 10 minutes.”
ATTAINABLE – Goals must be something you are capable of reaching.
Which one would be a better goal for an operator?
“I will help my team to achieve Production and Quality SLA”
“I will increase Efficiency and Utilization of team”.
RELEVANT – Make goals that are important to you and your working environment.
Which goal is better for Quality Analyst?
My goal is to discover a solution to improve quality
My goal is to inspire team members to become Performer of the Week/Month
TIME – BOUND – Make sure that you have a time set as a “dead line” so your goal is not unending.
My goal is to be achieve SLA within next one month.
My goal is to bring all processes in as per customer requirement
CTQ means Critical to quality, which is defined to be a measurable characteristics or feature of a product or process whose standard of performance must be maintained in order to satisfy the customer. CTQ concept is most widely used in Six sigma.
CTQ plays a key role in identifying the metrics which is required by customer and to make them happy for conformance of their expectation by understanding which characteristic of a product are critical in its overall quality.
CTQ can be accessed by collecting voice of the customer (VOC). VOC helps to express the needs of a customer. These needs are converted into measurable terms by identifying the feature of a product or process.
How to make a CTQ Tree?
- Identification of voice of the customer
- Understand the customer requirement criteria’s or parameters
- Prioritize the criteria’s or parameters
- Convert the customer requirements into CTQ s (Critical to quality) that are measurable
Identification of voice of the customer
The initial step in deriving CTQ is getting VOC (Voice of customer) and VOB (Voice of Business) as they are the base for of CTQs. They can be collected by surveys, direct interview, feedback form, complaint forms, social media forums, etc. It should be collected from all segments of customers.
Understand the customer requirement criteria’s or parameters
Though we collect different VOC from customers, there should be an expert team identify the parameters or criteria which is being preferred by the customer.
For example, in an x online shopping company, the IT helpdesk team collected VOC from their customers and one of the VOC is “It takes too long to receive the product from your company”. Then the customer requirement parameter is: Quick Delivery of product
Prioritize the criteria or parameters:
Prioritization of criteria or parameters is an important step even though it is not reflected anywhere in CTQ tree. It helps to identify the whether the requirement of the customer is must to have or pleased to have features. Tools like KANO model will be helpful
Convert the Customer Requirements into CTQs
From the above example the voice of the customer is “It takes too long to receive the product”, which by adding measuring term as delay and the respective CTQ is delivery time. If there is a delay in delivery time, it leads to critical to overall quality.
A Typical CTQ tree should identify all the VOC and convert all into measurable CTQ s.