KAIZEN Theme selection

KAIZEN Theme selection
Prepared by Francisco M. Chibunda QIT SECRETARY

Introduction KAIZEN-Theme selection is the first step, among the seven steps of KAIZEN process of solving the problems that exist in a workplace which need to be taken by staffs who want/wish to improve their Quality of Services for clients. Prepared by Raymond Dibogo

Definition of different terms
Theme is Synonymous to subject, topic, idea, or subject matter. It is usually a broad statement of the problem. It’s usually encompassing statement. Problem is the gape between ideal condition and current condition, knowing what should be but actually is not.

KAIZEN Process KAIZEN process has seven steps called “Quality Control story” which established in a sequential manner, named; Step 7: Standardization of effective countermeasures Step 6: Check effectiveness of the countermeasures Step 5: Implementation of identified countermeasures Step 4: Identification of countermeasure Step 3 Root cause analysis Step 2: Situation analysis Step 1: Selection of KAIZEN Theme

How to select KAIZEN theme
There are four main steps of KAIZEN them selection:- Staff discussion on difficulties that staffs &clients are facing at work place daily . Identifying some problems raised on the discussion based on data that shows the gravity/seriousness of the problem to both internal and external clients. - .

Collect the possible suggestion aroused in the discussion based on;
- Claims from internal & internal clients. - Mistakes which are often happening. - Un availability of material resource that disturbing smooth practice of daily routine work. -Working process that takes time & hard to do or finish. Evaluating feasibility of each KAIZEN theme suggested, based on given criteria's as follows.

Evaluation of feasibility of KAIZEN them
Criteria for suggested KAIZEN are, Impact Examine the degree of impact when problem reduced or solved. Urgency Examine if a theme has to be tackled immediate or not. Realization. Examine if the suggested theme if is possible to be tackled with the available and existing resources or not. Burden to service users. Examine if it is of less burden to service users.

Key point need to be set and agreed upon, that the suggested KAIZEN theme/ idea with high points will be selected. Key O stand for 2 points, + stand for 1 point, X stand for 0 point. Observe an example of matrix table for KAIZEN theme selected in certain ward.

KAIZEN theme selection matrix
Possible theme Immediate effect Urgency Realization Burden to service users Score ward space expanded + X 2 giving wrong medication to patients is reduced O 7 sampling mistake of laboratory test is reduced 6 medicine wastage volume is reduced 5 7

Key points KAIZEN-Theme selection need to be established on positive wishes of staffs-example we would like to do…./to be…. KAIZEN theme is not a permanent theme, should be implemented within a short period of time, (approx 6 months). Should have grate impact. Does not require many resources and possible to realized. Presence of data's on all process done for selection of the theme. Availability of the explanation on why, and how KAIZEN theme chosen.

Did you select good KAIZEN theme?
Impact What is the impact, when it is implemented？ Is it possible to get impact with little inputs? Urgency Do we have to do it immediately? Possibility Is it possible to complete whole KAIZEN process in 6 months? Is it possible to carry out KAIZEN process within your department? Are we not giving a burden to service users?

Resources Possible to implement with existing resources？
Require involvement of many sections？ Is data and information available for situation analysis? If not available, is it possible to collect？ Who and how many staff are going be involved?

KAIZEN Step 2: “Situation Analysis”

Objectives of the session
At the end of the session, trainees are able to: Define what is situation analysis in KAIZEN process Describe process of situation analysis Describe how to develop and utilize Pareto chart properly Demonstrate the process of situation analysis

KAIZEN Process 7 6 5 4 3 2 Situation Analysis 1 Standardization
STEP 7 Standardization STEP 6 Check effectiveness of countermeasure STEP 5 Implementation of countermeasure STEP 4 Identification of countermeasure STEP 3 Root Cause Analysis STEP 2 Situation Analysis STEP 1 Selection of KAIZEN theme

Steps of situation analysis in KAIZEN process
Identify contributing factors Identify measurable data and information Define methodologies for data collection Conduct data collection Develop a calculation table Develop Pareto chart Set target 1 2 3 4 5 6 7

Steps of situation analysis (1)
Brainstorm to identify contributing factors of the problem (KAIZEN theme) Contributing factor 1 Contributing factor 2 Contributing factor 4 Contributing factor 3 “Large problem” is composed of several contributing factors (composing elements). Large Problem

Steps for Situation analysis (2)
Identify measurable data and information of each identified contributing factor Identify methodologies of the data collection; Period of data collection (maximum 1 months) Kinds and number of data source: retrospective data or prospective data Collection method

Conduct data or information collection according to the methodologies Develop a calculation table of frequency and its accumulation ratio to compile the data

Example of calculation table
KAIZEN Theme is “Giving wrong medication is reduced” SQ# Contributing factors Before KAIZEN Frequency Cumulative frequency Accumulation ratio 1 Number of giving wrong injectable medicines 25 46% 2 Number of giving wrong inhale medicines 16 41 76% 3 Giving wrong oral medicines 6 47 87% 4 Giving wrong volume of insulin 5 52 96% Number of giving wrong ointment 54 100% Total - Descending order Calculation formulas will be explained on the next slide

Points of development of calculation table
Contributing factors will be put in descending order of its frequency Cumulative frequency = (its frequency) + (the previous cumulative frequency) Accumulation ratio = (each cumulative frequency) ÷ (Grand total of frequency) × 100 Please see next slide!!

Develop “Pareto chart” based on the data table, to identify prior contributing factor(s) to be solved “Calculation table” “Pareto chart”

What is Pareto chart? Cut off line is 80% It is a type of chart that contains both bars and a line graph, where individual values are represented in descending order by bars, and the cumulative total is represented by the line One of the seven basic tools of quality control 80.0 Example of Pareto chart

Pareto principle It is also called as “80:20 rule”
It is a technique helps to identify the top 20% that needs to be addressed to resolve the 80% of the problems Vilfredo Federico Damaso Pareto, Italian economist, developed this concept

Necessity of Pareto chart in KAIZEN Process
To identify “large contributing factors” If the large contributing factor(s) is solved, the situation with the problems will be improved effectively and easily Reduced by eliminated the contributing factor “1” Problem Contributing factors Situation with problems before KAIZEN (100% of the problem) Situation with problems after KAIZEN (reduced problem)

(Example) Data table and Pareto Chart
Maximum number of the axis shall match with the frequency of the first faactor SQ# Contributing factors Before KAIZEN Frequency Cumulative frequency Accumulation ratio 1 Number of giving wrong injectable medicines 25 46% 2 Number of giving wrong inhale medicines 16 41 76% 3 Giving wrong oral medicines 6 47 87% 4 Giving wrong volume of insulin 5 52 96% Number of giving wrong ointment 54 100% Total - Cut off line is 80% 80.0 Period of data collection: 31st January 2014 to 30th February 2014 (30 days) Data source: medication and treatment chart Number of investigated patient (chart): 50 Methodologies of data collection need to be described clearly.

Target setting The last step of KAIZEN Step 2 is “target setting”
“Desire” and “target” is different We want to reduce 70% of the problem! This is our “target of KAIZEN” What is the reason of 70% reduction of the problem?? ……… We just want… Is it just your desire? It is important to explain the reasons of your target setting.

Pareto rule can be useful for target setting
Ideally, 80% of the problem (vital few) is the target of the KAIZEN based on Pareto rule. But it is difficult…?! In the example above, if your target is: “46% reduction of KAIZEN theme” it means to solve all of the 1st contributing factor “87% reduction of KAIZEN theme” it means to solve all of the 1st, 2nd and 3rd contributing factors)

Our target is to make “wrong medication” zero by April 2016.
Cont. Our target is to make “wrong medication” zero by April 2016. Target setting By when? By April 2016 What? Number of wrong medication How? 46% reduction * Do not forget: Need to consider “the problem is still remained even if you achieve your target

STEP 3: ROOT CAUSE ANALYSIS

KAIZEN Process 7 6 5 4 3 Root Cause Analysis 2 1 Standardization

KAIZEN Step 2 and Step 3 1 1 KAIZEN Step 2 KAIZEN Step 3 2 3 2 4 5
Find root causes of the contributing factor(s) Identify the contributing factors Prioritize the contributing factor(s) to be solved KAIZEN Step 2 KAIZEN Step 3

Cause-Effect diagram (Fishbone diagram)
It is developed by Prof. Kaoru Ishikawa It connects “effect” and “cause(s)” systematically with line Clarification of relations between effect and cause(s)

Steps of root cause analysis (1)
Put effect (= the major contributing factor) in the step 2 as ”head of fish”; “Why (the contributing factor) happened?” Draw heavy line from left to the effect on the center; ”Backbone of fish” Why (the contributing factor) happened?

Seek and list up all possible causes for the effect (the primary cause) Avoid to mention to things in terms of “recourse shortage”: No money, No human resources, No materials etc. List of the possible causes Why (the contributing factor) happened? Because ….

Grouping of causes Human: knowledge, skills health conditions, physical conditions etc. Soft: system, methodologies, mechanism etc. Hard: material, equipment, furniture, tools etc. Environment: facility environment (water supply, electricity, smell, humidity etc.), working environment (work space, accessibility of materials, arrangement etc.)

Narrow down cause(s) of each primary cause (the secondary cause) Avoid to mention to things in terms of “resource shortage” Environment Human Why (the contributing factor) happened? Hard (machine/equipment) Soft (System and methodology)

Find out “root causes” by asking “Why it is happening?” in enough time (recommended 5 times) for each possible causes listed on primary branch, and branch them into secondary, tertiary. One Human Two Three Make circle clearly on it! Why (the contributing factor) happened? This is Root cause Four Five times!!

Tips for developing Fishbone analysis
Effect = Major contributing factor, which was identified in Step 2 Effect is not equals to “KAIZEN Theme” If two contributing factors account for 80% (Pareto rule) in Step 2, you need to develop two fishbone diagrams

Cont. Repeat “Why~? – Because~.” in 5 times
Consider “your own work / work place” before searching a cause of others Avoid blaming other sections; KAIZEN is for own Do not deny the opinions from other group members

Cont. Avoid mentioning “shortage of resources”; “No money”, “No human resource”, “No material” etc. Your analysis is stopped Avoid to guess and assume the causes Use your experiences, knowledge and existing information in your working place

The problem will never be solved!!
If root cause(s) are not identified properly, any countermeasures could not be come up… The problem will never be solved!!

KAIZEN Step 4: “Identification of countermeasure”

KAIZEN Process 7 6 5 4 Identification of countermeasure 3 2 1

KAIZEN Step 3 and Step 4 KAIZEN Step 3 KAIZEN Step 4
Find out root causes of the contributing factor(s) Find out countermeasures to solve the root causes Identify realistic countermeasures in our working situation/condition QC tool: Tree diagram QC tool: Matrix diagram KAIZEN Step 3 KAIZEN Step 4

Outline of how to make Tree Diagram
Put all the identified root causes in Step 3 on left end Brainstorm countermeasures with team members against identified each root cause 1st line countermeasure Clarify ideal situation towards root cause Connect the line with each route cause systematically 2nd line countermeasure Discuss detailed activities to realize the 1st line countermeasure(s) If identified countermeasures are not clear, we can break them to 3rd line countermeasures

Primary countermeasures (1st line countermeasures) Root causes
Primary countermeasures for Root Cause 1 (a) Root cause 1 Primary countermeasures for Route Cause 1 (b) More than one primary countermeasure can be come up with for one root cause Primary countermeasures for Root Cause 2 (a) Root cause 2 Primary countermeasures for Route Cause 2 (b) Root cause 3 Primary countermeasures for Root Cause 3 (a)

Primary (1st line) countermeasures Secondary (2nd line)
Root causes Root cause 1 Primary countermeasures for Root cause 1 (a) Secondary countermeasure (a) for primary countermeasure（a) Secondary countermeasure (b) for primary countermeasure（a) Primary countermeasures for Root cause 1 (b) Secondary countermeasure (a) for primary countermeasure（b) Root cause 2 Primary countermeasures for Root cause 2(a) Secondary countermeasure (a) for primary countermeasure（a) Secondary countermeasure (b) for primary countermeasure（a) Primary countermeasures for Root cause 2 (b) Secondary countermeasure (c) for primary countermeasure（a) Secondary countermeasure (b) for primary countermeasure（a)

Primary (1st line) countermeasures Secondary (2nd line)
Root causes Tertiary … Root cause 1 Primary countermeasures for Root cause 1 (a) Secondary countermeasure (a) for primary countermeasure（a) Secondary countermeasure (b) for primary countermeasure（a) Primary countermeasures for Root cause 1 (b) Secondary countermeasure (a) for primary countermeasure（b) Root cause 2 Primary countermeasures for Root cause 2(a) Secondary countermeasure (a) for primary countermeasure（a) Secondary countermeasure (b) for primary countermeasure（a) Primary countermeasures for Root cause 2 (b) Secondary countermeasure (c) for primary countermeasure（a) Secondary countermeasure (b) for primary countermeasure（a)

Matrix Diagram Matrix diagram is useful to check feasibility of all the final-line countermeasures “Feasibility check” ……? Can we implement the countermeasures with our available resources? Impact by the interventions?

Items for feasibility check Scales for feasibility check
What should be checked Importance How is the positive impact of solving the problem? No negative impact? Urgency How soon the problem need to be tackled? Difficulty Is it possible to implement the countermeasures technically easy or not? Time consumption How long does it take to solve the problem? Resources availability Are resources (human, materials, financial ) available for implementation of countermeasures? Scale Meanings 3 High priority, Easy to do 2 Moderate 1 Low priority, Difficult to do

Example of Matrix Diagram
Countermeasures Importance Urgency Difficultly Time Consumption Resource availability Feasibility Develop training material 3 1 9 Conduct TOT 2 Sort and Set 12 Develop M&E tool 13 Develop storage rules 11 Weekly monitoring Weekly inventory Make a circle on the score of identified feasible countermeasures Scale Meanings Countermeasures get “11 points and/above in total out of 15 (>70%)” are selected for implementation 3 High priority, Easy to do 2 Moderate 1 Low priority, Difficult to do

It is necessary to clarify the scale and cut off point for feasibility check
3= high priority, easy to implement 2= middle level priority 1= low priority, difficult to implement Importance Urgency difficulty Time consumption Resource availability Feasibility 3 1 9 2 12 10 11 13 Root cause Primary Countermeasures Secondary Countermeasures Teaching material development Staff is not trained Training on handling injectable Conduct training Conduct sort and set of store No proper storage place Use labeling and color coding for setting of injectable store Develop M&E tool No clear regulation of storage of injectable Develop regulation Develop regulation of injectable store Sensitize the regulation No instructing from pharmacy Instruction from pharmacy Coordinate with pharmacy and develop check sheet Training and dissemination No clear hand over of medicine Change system of handing over Develop handing over note and checklist Un clear order sheet design Redesign of order sheet Improve order sheet with other department

Tips for identification of countermeasures
Reflect all identified root causes in Step 3 to Tree Diagram Check whether detailed countermeasures are identified or not; breakdown of countermeasures by the level of countermeasures

Cont. Consider effective usage of available resources;
Avoid identifying countermeasures with “increase / put something resources” Discuss countermeasures that can be implemented by your section itself Check conflict of activities among identified countermeasures

KAIZEN Step 5: “Implementation of countermeasure”

KAIZEN Process 7 6 5 Implementation of countermeasure 4 3 2 1

Process of Step 5: Countermeasures Implementation
Importance Urgent Difficulty Total CM 1 ◎ ○ 13 CM 2 ▲ 9 CM 3 11 Action plan development with 5W1H Sharing action plan with section staff Sharing action plan with QIT Implement countermeasures Monitoring progress of intervention Check effectiveness Step 6

Cont. Implement ALL the countermeasures identified as feasible measures in Step 4 Develop an action plan and possible to complete the countermeasures within one to three months Share the action plan with: All section staff (Participatory implementation) QIT (Seek technical inputs) Monitor progress of implementation of the countermeasures

Time allocation for Step 5
Remember “proper time allocation” for whole process of KAIZEN is maximum６months Implementation of countermeasure must be done within 2-3 months KAIZEN Process Step 1 Step 2 KAIZEN Process Step 3 Step 4 KAIZEN Process Step 5 KAIZEN Process Step 5 KAIZEN Process Step 5 KAIZEN Process Step 6 Step 7 2 months 2 - 3 months 1 month

Benefit of development of action plan
Developing a action plan with “5W1H” will be of benefit to; Define detailed actions to implement the countermeasures with “5W1H” Improve communication among section staff Unify the sense of purpose of the staff in implementation of KAIZEN Simplify a progress monitoring

Clarification of “5W1H” Why? Who? When? Where? What? How? “5W1H”
Example Why? Why we need to take this countermeasure To strengthen stock management of medicines Who? Who is the responsible person of the countermeasure Ward in-charge and KAIEN team When? Timing or period (deadline) of the countermeasure By 27th of October 2015 Where? Place where the countermeasure taken At the ward What? What is objective of the countermeasure Rules and regulation of storage of the medicines How? How do you do for the countermeasure (action, verb) Develop

Example of Action plan format
Counter measure Who What Where When Why How 1 Develop of storage rules with pharmacists Ward In-charge, ward pharmacist Storage rules and regulations At the ward By Dec. 01 Strengthen stock management of the medicines Develop 2 Develop checklist and handing over note WIT, Ward In-charge Checklist and handing over note By Dec. 15 Reduce miscommunication among shifts 3 …… 4

Monitoring a progress of the implementation
Develop a monitoring checklist by clarifying: Date of monitoring Responsible person(s) of the monitoring Progress of monitoring Utilize the checklist Utilize the results of the monitoring Proper implementation: continue Delay of the implementation: re-plan and implement Impossible to implement: clarify the reasons of why not implemented

Example of action plan with progress checklist
Counter measures Who What Where When Why How Date of monitoring Who checked Progress 1 ………… ／ 2 ……………… 3 ………. 4 ……………. 5 Keys for progress check G: According the plan D: Delay N: Not implemented

Tips for successful implementation
It needs to check again whether all countermeasures are possible to be carried out within the section or not Remember “KAIZEN is participatory activities” “WHO” in your plan is not only “in-charge” Sharing the plan with all section staff

Cont. Action plan must be displayed on the notice board for staff
To remind staff of implementation of KAIZEN To promote participatory implementation of KAIZEN Conduct periodical monitoring with progress checklist

KAIZEN Step 6 : “Check effectiveness of countermeasure”

KAIZEN Process 7 6 Check effectiveness of countermeasure 5 4 3 2 1

Outline of effectiveness check
1 Situation analysis 2 3 Effectiveness check Reduction rate Comparison Pareto chart Relation between countermeasures and effectiveness Implemented・ Not effective Not implemented・ Not effective Not implemented・ But effective Implemented・Effective 4 Go to Step 7: Standardization

How to check effectiveness of KAIZEN
Compare frequency and reduction rate of frequency between before and after KAIZEN Check achievement to your target set in Step 2 (reduction rate) Compare other information in terms of: Cost Work labor cost effectiveness Quality Work process Human resource etc.

Data collection (Situation analysis after KAIZEN)
Review methods of situation analysis done in KAIZEN Step 2 Conduct situation analysis in the same methods: Same data Same period of data collection Same methodologies of data collection

Development of a comparison calculation table
SQ# Contributing factors Before KAIZEN After KAIZEN Reduction of frequency Reduction rate (%) Frequency Cumulative frequency Accumulation ratio (%) 1 Number of giving wrong injectable medicines 25 46.3 7 46.7 18 72.0 2 Number of giving wrong inhale medicines 16 41 75.9 4 11 73.3 12 75.0 3 Giving wrong oral medicines 6 47 87.0 14 93.3 50.0 Giving wrong volume of insulin 5 52 96.3 15 100 80.0 Number of giving wrong ointment 54 100.0 Total - 39 72.2 Data of before KAIZEN Data of after KAIZEN Reduction between before and after KAIZEN Formula of reduction rate

Development of comparison Pareto chart
Adjusting scale as same level of before KAIZEN Before KAIZEN After KAIZEN 80.0 80.0 Same order of “the contributing factors” between before and after KAIZEN even if the order of contributing factors is changed.

(Example) Comparison results between before and after KAIZEN
SQ# Contributing factors Before KAIZEN After KAIZEN Reduction of frequency Reduction rate (%) Frequency Cumulative frequency Accumulation ratio (%) 1 Number of giving wrong injectable medicines 25 46.3 7 46.7 18 72.0 2 Number of giving wrong inhale medicines 16 41 75.9 4 11 73.3 12 75.0 3 Giving wrong oral medicines 6 47 87.0 14 93.3 50.0 Giving wrong volume of insulin 5 52 96.3 15 100 80.0 Number of giving wrong ointment 54 100.0 Total - 39 72.2

Breaking down your effectiveness
Clarify whether each countermeasures were effective or not Relation between countermeasures and effectiveness can be categorized into 4 groups Effectiveness Effective Not effective Implementation Countermeasure implemented ①　 It is effective and need to be standardized ② It is not effective and need to review measures Countermeasure not implemented ③ Need to clarity why it is effective ④ Implement some measures (DO something)

Cont. Effectiveness should be measured by each countermeasure
The countermeasure that is not implemented but show good effects need to be investigated the reason The countermeasure that is not implemented and cannot measure effectiveness need to be implemented

Cont. It is necessary to review countermeasures if the countermeasures were not effective The countermeasures that were implemented and judged as “effective” will be standardized in Step 7 The countermeasures may cause bad effects. If bad effects are greater than effectiveness, it is necessary to review the countermeasures

Identify effective countermeasures
Which countermeasure was leading?? Your target Move to KAIZEN Step 7 Achieved Expected outcome Partially achieved By doing the countermeasures Got worse Review KAIZEN Step 3, 4, 5, 6 Good effect Stop doing the countermeasure(s) Unexpected outcome Bad effect * Tangible effect, Intangible effect and Ripple effect will be also recognized while Step 6.

KAIZEN Step 7 : “Standardization”

KAIZEN Process 7 Standardization 6 5 4 3 2 1

KAIZEN Step 7: Standardization
Prevent recurrence of the problem Sustain “improved situation” Situation after KAIZEN Situation before KAIZEN Standardize effective countermeasures Improvement By effective countermeasures KAIZEN Step 1 - 5 KAIZEN Step 6 KAIZEN Step 7

Standardization of effective countermeasures
It is a part of the final step of KAIZEN process Two parts of standardization: Development of a implementation plan and its checklist Practice standardized activities sustainability Standardization measures must be able to Maintain the “good effects” by anyone in the workplace Eliminate waste continuously in costs and workloads

Benefits of standardization
Reductions in variability Easier training of new operators Reductions in injuries and strain (ensuring safety for internal / external clients) Baseline for improvement activities Reference:

“Recurrence prevention” and “Standardization”
“Prevention of recurrence” is not equals to “standardization” Prevention of recurrence is to prevent fallback of the improved situation “Standardization” is very important for proper recurrence prevention

Process of standardization
List-up all effective countermeasures identified in the previous step 6 Develop standardized procedure table by utilizing “5W1H” Develop “progress checklist” for standardized implementation plan Share the plan and checklist with all the staff in the section

“5W1H” for standardization
Description Why? Necessity of the standardized activity Who? In-charge of the standardized activity When? Period / Frequency of implementation of the standardized activity Where? Place at where the standardized activity is taken place What? Objectives of the implementation (verbs) or tools used for the standardized activity How? Methodology to carry out the standardized activity (verbs) Note that the standardized procedure table is similar with implementation plan in KAIZEN Step 5, however, there are different

Standardized procedure table
Standardized activities Why Who When Where What How Check stock condition of all medicines in our section To ensure stock management of sampling container In-charge of stock management of the day Daily Ward Inventory checklist Use properly Check handing over between shifts To reduce miscommunication between staff on reduction wrong medication All staff working at the ward Before taking over next shift Handing over note and checklist

Progress checklist Standardized action Progress Date of checking
Checked by Remarks Check stock condition of all medicines in our section Sustained Not sustained Following STD Not following STD Check handing over between shifts

Example of KAIZEN Step 7 Standardized activities Why Who When Where
What How Progress check Date of checking Checked by Remarks Check stock condition of all medicines in our section To ensure stock management of sampling container In-charge of stock management of the day Daily Ward Inventory checklist Use properly o Sustained o Following STD o Not sustained o Not following STD Check handing over between shifts To reduce miscommunication between staff on reduction wrong medication All staff working at the ward Before taking over next shift Handing over note and checklist

How to develop progress checklist
Establishing standardized methodology only does not make sense It must be practiced by everyone in the workplace The checklist is important and useful tool to monitor how staff are practicing, and the method is sustainable Progress check must be done frequently Period of monitoring must be agreed with the workplace and shared with everyone

Tips for successful standardization
Remember that KAIZEN should not be “individual issue”, it should be “section issue” Try to avoided the situation of “only in-charge knows” Clarify roles and responsibilities of all the section staff in the implementation plan Emphasize benefits by the standardized work process

Cont. Share the standardized procedures and its checklist with all the staff in the section Consider and select effective ways for the sharing Display the standardized procedures on common place in the section (eg. notice board) Disseminate how to use the checklist Put proper documents (ex. SOPs) in the place which the procedures are practiced Remind the staff of the standardized procedure periodically (ex. while morning meeting) Train the standardized procedures to newly employed staff and students

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KAIZEN Theme selection

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