1st Edition
Utilizing the 3Ms of Process Improvement A Step-by-Step Guide to Better Outcomes Leading to Performance Excellence
Why is it that some improvement efforts succeed while others fail despite robust change management programs and the often do-or-die pressure to improve? Quite simply, there are three elements that separate those that succeed from those that fail. They are the 3Ms—Measure, Manage to Measure, and Make-it-Easy.
Complete with forms, templates, and case studies from the aviation and manufacturing industries, Utilizing the 3Ms of Process Improvement supplies step-by-step guidance on how to use the 3Ms to achieve performance excellence that lasts. Suitable for a wide audience—including suppliers, manufacturers, and those who work in service organizations, schools, healthcare, and government—it is as much about the science of process improvement as it is about how to lead process improvement utilizing the 3Ms.
Illustrating applications of the 3Ms across a range of industries, the book weaves stories throughout about role models who have succeeded, as well as those who have failed. It identifies the specific elements that were missing or defective in the failed attempts to provide a clear understanding of how the three elements work together. Arming you with a culture change method based on changing behaviors, it provides a leadership and management guide to achieving your objectives.
The 3Ms have worked for Ben Franklin, Abraham Lincoln, and the author’s teams across the globe. Now, with this book, you can put the power of the 3Ms to work for you in your quest towards improving processes and reducing costs.
The author encourages reader interaction and feedback on his website: www.rpmexec.com. He also provides you with access to the forms and templates described in the book.
Overview of Process Improvement and the 3Ms
Outcomes Are the Result of Processes
Performance Excellence
3Ms for Process Improvement
Measure
Manage to the Measure
Make it Easier
Science of Process Improvement
Change Leadership
We Need All Three Ms to Sustain the Improvements
Case Study in Process Improvement
Utilizing the 3Ms for Process Improvement
3Ms, Scientific Methodology, Change Leadership
Key Points
Endnotes
Change Leadership
The Need for Leadership in Change: A Case Study in Healthcare
Too Many Examples of Not Leading Change Well
Management and Leadership: Scientific Management
Perfect Example of Scientific Management
Definition of Manager and Leader
What Happens When There Is no Leader?
Leadership Principles
Abraham Lincoln on Leading Change
Leading Change to a Slave-Free America
Industry’s Change Leaders
Walking the Talk
Definition of Common Terms across Methodologies
Key Points
Endnotes
Resistance to Change and Process Improvement
A Quick Win against Resistance
Role of the Change Leader
A Policy of Change and Continuous Improvement
Piloting Changes
What Can Happen If Change Is Not Piloted First
Balancing Change and Continuity
The Emancipation Proclamation
What Happens When One or More of the Ms Is Missing?
Dr. Semmelweis and Washing Hands: The Right Change, but Why Is Change Needed In Healthcare?
Semmelweis’s Improvement Dies with Him
Forcing Doesn’t Always Work
The Force of Resistance
Benjamin Franklin, Electricity, and Change Leadership
Principles of Electricity Explain Resistance to Change
What You Can’t See Can Hurt You
Using Resistance to Help Lead Change
Electricity and Forcing Change Can Be Dangerous
Getting Change to Flow
Resistance to Change Can Vary within the Same Person
Resistance between Two Bodies
Resistance at Home
Key Points
Practicing Change Leadership
Endnotes
Process Improvement Methodologies
Work with Toyota and for Motorola
Motorola and Toyota Use Lean and Six Sigma Tools
PDSA and PDCA Compared to Six Sigma
All Good Methods Analyze for Root Causes before Solutions
Case Study of Late Shipments
Cross Reference of PDSA, Six Sigma, Lean, Change Leadership
Human Factors and Ergonomics in Process Improvement
Case Study: Human Factors Added to Lean Six Sigma
Hand Hygiene Change Leadership Issue
Failure to Engage Others with the Measure
Baseball and Managing to the Measure
Measures for Research Purposes
Measures for Process Improvement Purposes
Cedars–Sinai Using Measure and Manage to the Measure
Key Points
Endnotes
Roadmap for Process Improvement
Start the Journey on Main Street
Getting Started on Our Journey
Possible Shortcut
Prepare for Change
Train
Envision
Articulating a Vision
Elements in a Vision Statement
Try Out Your Vision Statement
How Does One Communicate the Vision?
Abraham Lincoln’s Vision
Advocate a Vision and Continually Reaffirm It
For Whom the Bell Tolls
Engage
Enable
Quality Circles
Enabling during the Recession of the Early 1980s
Assumptions and Decisions
Empower
Key Points
Endnotes
Chartering the Process Improvement Work
No Charter? Big Problem
Sharing Findings before Departing
Clear Definition of the Issue and What Was to Be Measured Are Key
The Final Report and Surprise
The Issue Statement
The Measures or Metrics
Outcome and Process Measures
Goals
Progressive Goals and Successive Successful Approximations
Measures and Goals to Build a Safer Culture
Hold Off on Financial Metrics Until
Scope the Work
Charter "Signatories"
Sponsor
Chartering Is Iterative
Sign the Charter
Key Points
Practicing Skills: Chartering
Endnotes
Stakeholder Analysis
Case Study in Stakeholder Analysis
Mission and Values of the Organization
Stakeholders
Overview of the SHA
Measuring the Gap: The Level of Resistance
Three SHA Scenarios to Know Your Strategy Upfront
Designing the "Circuit" to Achieve Flow and Manage Resistance
Difficult to Be Perfect
Them Is Us Eventually
Let’s Learn Stakeholder Analysis by Doing
Using the SHA Template
Time to Assess Each Stakeholder’s Buy-In
Key Points
Endnotes
Finding the Root Causes, Improving, and Controlling
Doctor Livingstone
Explore Together with Empathy and Patience
Building the Team
Case Study
Poor Service for a Major Customer and Its Customers
Work-Arounds in the "Factory of Hidden Defects"
Exploring Using the "Five Whys"
Explain
Experiment
Explore: Builds on Experimentation
Build Consensus
Train, Enable, Empower, Hold Accountable
Training in the Improvements
Enable
Empower
Hold Accountable
Key Points
Endnotes
Utilizing the 3Ms: Measure, Manage to the Measure, and Make It Easier
Measure
Practicing Measure
Manage to the Measure
Make It Easier
Visual Management
Measuring Example
Managing to the Measure Example
Make It Easier Example
Takt Time: A Measure of the Pace Needed to Meet Customer Demand
Measuring: The Most Important M
Apply the First of the Three Ms and See the Value
Setting Up Your Experiment
Measuring the Baseline
Statistical Process Control Charting: Turning Data into Information
Sample Size
Hand Hygiene and the 3Ms
Ready to Observe
Alternative Experiment
The Hawthorne Effect
Desire to Increase Productivity
Utilizing the 3Ms by Changing the Measure
Incentive Piecework as a Measure
More on the Perverse Incentive Measure
French Restaurant Dining
The Hawthorne Effect Revisited
Case Study in Timeliness in Sharing the Measure
Key Points
Endnotes
What to Measure
Hidden Factory of Rework and Swiss Cheese
Getting Started: Preparing for Change, Chartering, and Stakeholder Analysis (SHA)
Case Study: 3Ms Improving Surgical Safety
The Measure Is Invented
Measuring the Errors to Reduce the Risk of Wrong-Site Surgery
Measuring the Quality of a Decision
Practicing Measuring
Setup
A Change In One Area May Affect Other Areas
Inventory Management
Measure What the Customer Measures
Base the Measure on Correlation with the Outcome
High Reliability Organizations: What Do They Measure?
A Safety Culture and How to Measure
Measuring the Inputs versus Just the Outcomes
Measuring the Culture
President Franklin D. Roosevelt’s First Inaugural Address
Key Points
Endnotes
Measure Risk to Achieve High Reliability
The FMEA Form
The Process Step or Design Function
Input, Failure Modes, Effects, Causes, and Scoring of Risk
Existing Controls
Risk Priority Number (RPN)
FMEA for IT
Data Can Be a Component In Today’s High Tech Equipment
FMEAs Don’t Always Prevent Catastrophic Failure
3Ms Lesson: Must Manage to the Measure, Not Just Measure
Facilitating a FMEA
Key Points
Endnotes
Measurement as a System
Measurement as a System
Measurement System Analysis (MSA) Critical in Utilizing the 3Ms
Analyzing a Measurement System
Qualities of an Acceptable Measurement System
Attributes of a Measurement System
Accuracy
Bias
Precision
Repeatability
Reproducibility
Designing a Measurement System
Performing a Measurement System Analysis (MSA)
MSAs Can Be Really Easy
Inaccurate Measurement Systems Can Lose Customers
A Measurement System Using Actual Data by Surgeon and by Procedure
Drawdown
Measurement Systems That Add No Value to the Client
Calibrating a Measurement System
Statistical MSA Methods
Categories and Types of Data
Checklists as Measurement Systems
Granularity
Discrimination
Overview of Performing a Gage R&R
MSA for Blood Pressure Reading
MSA for Attribute Data
Attribute Agreement Analysis
Moderate Risk of Harm
The Soft Drink Challenge with AAA
Stability
Linearity
Overview of MSA for Continuous Data and High Granularity
Gage Repeatability and Reproducibility (Gage R&R)
Precision to Tolerance: (%P/T)
Knowing Good from Bad
Percent to Total Variation %P/TV
% Contribution
Using Minitab in Measurement System Analysis for Gage R&R
Sampling
Should I Measure 100% or Sample?
Sampling Quality
Key Points
Endnotes
How to Share and Communicate Measurements
Charting
Pareto Charts
Pareto to Reduce Resistance
Statistical Process Control Charts (SPC)
First SPC Chart: May 1924
High Reliability Organizations (HROs) and SPC
The "Swiss Army Knife" for Process Improvement
Components of the SPC Control Chart
Control and Out of Control
Case Study
Call Center Wait Times
Using a Simple Histogram to Create SPC Chart Parameters
Reliability and SPC
SPC Is Often Preferred in Managing to the Measure
Prove Change Really Occurred
Change Management without SPC?
Frontline Workers Have Been Using SPC Since the 1920s
Run Charts
Key Points
Endnotes
3Ms: Manage to the Measure
Visual Management
What to Expect Short Term and Long Term from Measuring
Instructing and Coaching
Training within Industry
Job Instructions
Job Methods
Job Relations
Program Development
Standard Work to Manage to the Measure
Coaching is Key in Managing to the Measure
Coach’s Playbook
Key Points
Endnotes
3Ms: Make It Easier
Case Study
Store Staff Spending Time with Customers
Job Satisfaction
Making Change Easier Is What We Need to Do
Prepare Stakeholders for the Change
Train
Envision
Engage
Enable
Empower
Explore Together
Satisfaction and Loyalty Measurement
Explain
Experiment, Explore, Build Consensus
Choosing the Best Countermeasures
Piloting and Choosing the Best Countermeasures
Piloting to See if the Measure Moves
Train, Enable, Empower, and Hold Accountable
Mindfulness and Control
Mindfulness
Commitment to Resilience
Case Study
University of Pennsylvania, Penn Medicine Utilizing the 3Ms
SPC Making It Easier
The 3Ms Are the Most Important Tool for Leadership and Process
Improvement Leaders Including Change Leaders to Sustain the Gains
Key Points
Endnotes
High Reliability
Case Study: SKF
High Reliability Program Number 1
High Reliability Program Number 2
The Products Surrounding the Variation
Scrapping versus Inspecting
Utilizing the 3Ms in Zero Defects and SWOC
High Reliability Program Number 3: Building a Safety Culture
A Story of a Seal and Its Grease
Change Isn’t Always Easy, Except
Stakeholder Analysis Revisited for Making It Easier
Designing an Experiment Should Start with the People Doing the Work
Key Points
Endnotes
Summary
Mistake-Proofing Promotes Defect Prevention versus Detection
Types and Levels of Mistake-Proofing Devices
Human Error Drives Need for Mistake-Proofing
Mistake-Proof Approaches
Train, Engage, Enable, and Empower the People Doing the Work
Reinforcing Continuous Process Improvement
Key Points
Endnotes
Appendices:
Roadmap for Performance Excellence™
Process Improvement Foundational Tools
The Emancipation Proclamation
Charter Template
Stakeholder Analysis Template
Hand Hygiene Data Collection Sheet
Hand Hygiene Compliance Chart for Posting
Measure: Data Collection Tool
FMEA Severity, Occurrence, Detection Tables
Gage Repeatability and Reproducibility Measurement System Analysis
Index
Biography
Richard Morrow
In this book, Rick Morrow provides a clear, structured, and disciplined approach to improving processes and systems in any industry or organization in need of improvement. He gives readers great insight into how all the tools of improvement can indeed be used in an integrated approach to improve service or product reliability, quality, safety, utilization, and efficiency. He wraps this around straightforward steps and the management systems required to sustain improvements. A must read for all looking to improve an organization and delivery system.
—Charles Hagood, Founder & Past President of The Access Group, International Industrial and Business Services ConsultingAs an international expert in quality and safety, Utilizing the 3Ms of Process Improvement is my go-to-guide for practical applications in process improvement. This is a must read for all professionals looking to create sustainable processes and improve outcomes.
—David Jaimovich, MD, President of Quality Resources International