Step 5: Control

Step 5: Control - continued

Quality Tool: Control Spreadsheet Control Chart Audit the Controls Mistake Proofing Failure Mode and Effect Analysis

Control Spreadsheet

Control Spreadsheet

 A quality control spreadsheet summarizes the plan of action for a process out of control. It usually includes:

Control variable (what is measured) How measured Where and "when measured Standard Who analyzes Who acts What is done

Control Spreadsheet

Control Variable Minutes in waiting room

How Measured Difference between appointment time and time seen by Physician

Where Measured Reception area

Standard 7 (Seven) minutes maximum

Who Analyzes Receptionist

Who Acts Clinic administrator

What Done Check staff and equipment status. Check status of changing rooms. Advise technicians/ radiologists.

Control Charts

Audit the Controls

Effective audits answer two questions:

The intended results being achieved?

Are the quality controls being followed?

Audit the Controls - continued

To ensure that its work continues to be effective, a team needs to include the following in its remedy:
Routine reporting of results. Clear documentation of controls.

Audit the Controls - continued

Report Results
Routinely reported to a level of management prepared to monitor progress and respond if gains are not held. If admitting times from the Emergency Room have been improved, then performance-actual times for admissions from the ER-might be included in a monthly quality report delivered to the Quality Council and the management teams for Admitting and the ER.

Audit the Controls - continued

Document Controls
Cleary document all the critical elements of the control process so they can be effectively audited. One way to do this is to develop a quality control manual that documents all the organization's quality control systems in terms of goals, measurements, and feedback loop responsibilities.

Mistake Proofing

 To determine methods that will ensure that a process will not allow defects. To ensure that tasks can only be done the right way. A mistake is any wrong action or statement proceeding from faulty judgment, inadequate knowledge, or inattention. A mistake is an action; a defect is the result. You may have heard the term poka-yoke, which is Japanese for a mistake-proofing device.

Poka-yoke or mistake proofing helps operators (employees) work more easily and eliminates troubles associated with defects. Even if an operator makes a mistake, poka-yoke measures will prevent a defect from being passed on to the next step in the process.

 This will further reduce costs by eliminating inspection time. Were surrounded by mistake proofing.
Electric coffee pots have automatic shut-offs. bathroom or outside electric circuits have ground fault interrupter circuit breakers, medicines are sold in tamper-proof packaging and childproof containers, computers ask, Are you sure? after the user selects important operations such as to delete or to close a program

 When to use When a process step has been identified where human error can cause mistakes or defects to occur, especially in processes that rely on the workers attention, skill or experience. In a service process, where the customer can make an error which affects the output. At a hand-off step in a process, when output or (for service processes) the customer is transferred to another worker. When a minor error early in the process causes major problems later in the process. When the consequences of an error are expensive or dangerous

Failure Mode and Effects Analysis

Stage to Use:
Identify opportunities for Improvement and the most important control subjects.

Purpose:
To examine a prospective design for possible ways in which failure can occur so that actions can be taken to eliminate the possibility of failure, stop a failure before it reaches people, or minimize the consequences of a failure.

Failure Mode and Effects Analysis - continued

Steps in Failure Mode and Effects Analysis
1. Set up a process flow diagram. 2. Retrace the process flow diagram, assuming the worst, to figure out what could go wrong along the way. 3. Decide what the effects of failure might be on the reminder of the process. 4. Rank the estimated possibility of occurrence using the following scale: 1= remote possibility; 5 = possibility; and 10 = almost certain 5. Rank the estimated severity of the overall failure using the following scale: 1 = will not cause patient harm; 5 = may affect patient adversely; and 10 = injury or death will occur. 6. Rank the estimated like hood that failure will be detected before accident takes place: 1 = will always be detected; 5 = might be detected; and 10 = detection not possible. 7. Calculate the "Critical index" (multiplying numbers of steps 4, 5, and 6). 8. Decide on interventions to lower the criticality index. 9. Take action. 10. Assess.

Failure Mode and Effects Analysis - continued

Failure Mode and Effects Analysis Form Entry Explanation 1. Item - Item to which analysis applies. 2. Analysis Engineer - An engineer in charge of design project. 3. Function - Function of the item as user perceives it. This description should be as broad as possible. 4. Mode of Failure - A mode in which the item will fail as perceived by user. 5. Mechanism and Ca use of Failure - What causes failure to occur? 6. Effects of Failure - What effects will this failure have on the user or nearby person or nearby property?

Failure Mode and Effects Analysis - continued

7. Frequency of Occurrence (1-10) - How often is this failure
expected to occur? This column is subjectively rated on a 1 to 10 basis. 1 = Rare Occurrence 10 = Almost certain occurrence 8. Degree of Severity (1 -10) - How severe is the effect of this failure on the user or anything else? This column is subjectively rated on a 1 to 10 basis. 1 = Insignificant loss to user. 10 = Product inoperable or major replacement cost or safety hazard.

9.

Degree of Detection (1-10) - can problem be detected by the

user before it does the damage? This column is subjectively rated on a 1 to 10 basis. 1 = Certain detection before failure. 10 = No detection possible before failure. 10. Risk Priority Number (1-1,000) Order of problem solving priority is given by multiplying numbers in columns 7, 8, and 9. 11. Design Action - Action to reduce risk priority number. 12. Design Validation - Method to verify the design motion.