What do you like? What can be done better? Windows Sign What do you like? What can be done better?

Eye on Safety First – Forklift routing (yellow pillars) Color, & shut out Sign First – Forklift routing (yellow pillars) Concrete barriers preventing building damage Second - Location of trash can 2) Sign

Train your Brain ! (and ear …) Eye on Safety Train your Brain ! (and ear …) ASK: What safety issues pertain to this part of the organization? When was the last audit conducted by an outside expert? What data does the safety committee provide? What is the process for collecting and sorting information about accidents, incidents and close calls? Are systems and standards adequate to sustain a safe environment? Are safety rules followed?

Are Safety Rules Followed …

Feeling lucky? Well, are you . . . . Punk

START THE DISCUSSION ASK: If there were a safety incident, injury, illness, close call, or accident caused by working here, what would it be?

Prevention is Key #1 Heart disease: 614,348 • Cancer: 591,699 • Chronic lower respiratory diseases: 147,101 • Accidents (unintentional injuries): 136,053 • Stroke (cerebrovascular diseases): 133,103 IN THE TOP 5 !! Source: Health United States 2015 Table 19

What is the Purpose of Mistake Proofing? Prevent a “foolish action” through 3 functions: SHUT DOWN a step, process, machine or operation CONTROL a step, process, machine or operation WARN that a mis-step/ defect* (is about to occur or) has occurred * aka - unintended consequence

What do you say ?

Guidelines for Mistake Proofing In general, the approach should meet the following guidelines: Inexpensive Based on common sense and obvious to the person involved in the process It MUST eliminate Occurrence and Detection of the problem at the root cause

A Better Practice … Slotted metal guard (“stand-off”) to prevent accidently stopping luggage conveyor at the airport.

A Better Practice … Safety and equipment start-up procedures have lots of pictures, diagrams, schematics and drawings.

Almost !! So many signs! Maybe the pit fell in the void after catching fire??

Q) Why a Mistake-proof Hierarchy? Full Automation Most Desired No Manual Intervention Impossible to Fail Eliminate Activity Certification and Audits Notification Fail-Proof The process is changed to be less dependent upon people Simplification Training HERE Awareness Behavior typically reverts back Least Desired A) So you don’t have to “fix” the problem again!

What in the World ?!? (Notification…) Alert the operator at the point of mistake… Four xample, when one makes a misteak, an effective Poko-Yoke system will alert the operotor that a misteak was made, where it was made, and even how the misteak was made

What in the World ?!?

What in the World ?!? Who keeps leaving the coffee pot on? Hint: the cleaning crew …

Top Causes Processing omissions: leaving out one or more process steps Processing errors: process operation not performed according to the standard Error in setting up: using wrong tooling or incorrect setting/ adjustment Missing parts: not all parts are included in assembly/ process Improper part/ item: wrong part installed in assembly

Top Causes Processing wrong work piece: wrong part machined/ processed Operations errors: incorrect revision or specification sheet Errors in equipment, maintenance or repair: Defects caused by incorrect repairs or component replacement Error in preparation of inspection equipment, fixtures or tools: Damaged inspection tooling; poorly designed fixtures or wrong tools; mis-measurement

Leaving out one or more process steps … IS GAS CAP SECURE? Tighten till you hear the “click” What do you like? What can be done better?

Try It ! Mistake-Proof This: A local countertop company makes and then loads the countertop pieces on to a truck and goes to the customer’s home and installs the countertop. More than 15% of all installation jobs have to be done with more than one trip to the customer’s home because one or more pieces of the countertop was not loaded on the truck. Propose a change that will ensure all the material is loaded on the installation truck.

Try It ! Mistake-Proof This: The far-sighted instructor in a rush to get to work on time often forgot and left his glasses at home. Propose a change that will ensure the instructor does not forget his glasses.

Try It ! Mistake-Proof This: Mechanics in the instrument lab have to calibrate instruments in accordance with a procedure that has several steps. They sometimes inadvertently skip a step in the procedure. Propose a change that will ensure no steps are skipped.

What can we LOOK for? (Human Factors)

Under what Conditions? (Operating Factors) Adjustments Multiple handoffs Unclear or no instructions Hand processing Undefined process Rapid repetition Many units/mixed units High volume demand or deadline pressures Multiple steps Environmental conditions Infrequent production Ineffective or lack of standards

Go Forth Identify what your impediments to improvement are Work on those and you will be on the right track In particular, what are barriers to higher equipment uptime higher process capability safer environment or equipment higher capital and labor productivity without adding cost or more highly trained personnel I call this building better process stability

Better Practice Sharing Implement One Idea Surfin’ for Ideas?

A Better Practice … This rental truck has a door latch that will not allow the loading ramp to slide out while the latch is in the closed position.

A Better Practice … Automatic flush, soap, and water. A locked trash receptacle. Also, a touch-less motion sensor on paper towels… (consider hand dryer /hot air blower ??)

Place sign above (or below) the Fire Extinguisher A Better Practice … Place sign above (or below) the Fire Extinguisher

A Better Practice … HEAT INDEX ALERT (signage) for outside operations. Cool down stations / water identified (in blue) …

A Better Practice … P.P.E. REQUIREMENTS to enter into the operation. Steel toe shoes, reflective vest, hard hat, etc.

Green tag for “Carry On” bags that had to be checked. A Better Practice … Green tag for “Carry On” bags that had to be checked.

Child-proof safety lock on cabinets. A Better Practice … Child-proof safety lock on cabinets.

A Better Practice … Bags contain a super absorbent powder that gels

Innovative Designs, Solar powered, Second Train Warning, Shut Out Gate A Better Practice … Innovative Designs, Solar powered, Second Train Warning, Shut Out Gate

A Better Practice … Cap Tethered Cap Eliminated

A Better Practice … Specialized tool for Heavy Cover removal (1 operator)

A Better Practice … Specialized tools Safety, Communications, Legal, et al

What Did We Cover Today? Generally speaking, mistake-proofing measures should ultimately be to prevent a foolish action: Common Guidelines (inexpensive, common sense, attack the root cause) Purpose of these Measures (S, C, W) (V I S U A L S are only the first level) Visual Display vs. Visual Control Evaluate ‘Conditions’ in which they (opportunities for mistakes) may breed … (multiple handoffs, undefined processes, adjustments, etc) (human factors – Mental, Speed/Skill, Perception, Communication, etc.) SOURCE: www.freeleansite.com

Visuals go so far …

Oops !! [Mistakes, - some are obvious]

Oops !! [… some recover well!]

Oops !! [And… some, don’t recover so well!]

And, NOW – What is Your Mistake Proofing Measure ? An idea you can put into practice… WHAT is your mistake proofing measure?? And… what foolish action does it prevent??

Don’t have one… sleep on it !

Look for these Conditions: Key Points about Mistake Proofing SHUT DOWN a process, machine or operation CONTROL a process, machine or operation WARN that a defect (is about to) or has happened Look for these Conditions: Adjustments Unclear or no instructions Undefined process Many units/mixed units Multiple steps Infrequent production Ineffective or lack of standards Multiple handoffs Hand processing Rapid repetition High volume demand or deadline pressures Environmental conditions

What is Your Mistake-Proofing Measure? ? An idea you can put into practice … Process / Step: _________________________ Describe the Error: ______________________ Mistake-proofing Measure: _________________ _____________________________________ What foolish action does it prevent? ---------------------------------------------------- WHAT is your mistake proofing measure?? And… what foolish action does it prevent??