1. 1 Let’s take a minute for SAFETY: Who has a safety concern/ contact or tip? A ship is safe in harbor, but that's not what ships are for … Learn more about mistake-proofing at: www.freesixsigmasite.com

2. 2 SMILE !! It’s Contagious! Sustain the Gain

3. Where in the World are Poka-yoke? They exist in the world around us… (they’re out there)

4. Mistake-Proofing Devices On Your Car Can’t start the car unless it’s in park or clutched Can’t fit a diesel nozzle in the gas tank Doors lock when speed is greater than 5 miles per hour Bell chimes when headlights left on Headlights automatically burn & extinguish Bell chimes when seatbelt not worn Indicator lights when fuel is low Gas cap is attached to car by a lanyard Oil and fuel specs are listed on caps or tanks Bell chimes when turn signal left on Light indicates that parking brake is engaged

5. What Are Guidelines for Poka-Yoke ?

6. BTW, Don’t Do “Fake” Poka-Yoke! aka: “You had one job” Just for fun!! Let’s examine a couple …

7. Almost !!

9. Do … Careful pedestrians need to stop??

10. Almost !! There are 2 Parts to this one… Now - notice how far away sign is from hospital bed

11. Almost !! “falls program…” Really ??!??!!

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

13. Almost !!

14. At least they had a little fun with this one!

15. What is the Purpose of Poka-yoke?

16. Top Causes of Errors Look for these in your processes… 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

17. Top Causes of Errors (con’t) 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

18. Q) Why a Mistake-proof Hierarchy? 18 A) So you don’t have to “fix” the problem again! Full Automation Awareness Fail-Proof Simplification Training Behavior typically reverts back The process is changed to be less impacted upon variation caused by people Most Desired Least Desired No Manual Intervention Impossible to Fail Eliminate Activity Certification and Audits Notification

19. 2 states for Poka-Yoke

21. Example Why did you “pop open” the trunk to gas up?

22. Example 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

23. Example IS GAS CAP SECURE? – Tighten till you hear the “click”

24. Example Computer Start-up Routines – [password/log-in/pin etc] Computer Shut-down Routines [series of low battery warnings/ actions taken]

25. What are the Conditions? (ripe for poka-yoke) 1.Adjustments 2.Unclear or no instructions 3.Undefined process 4.Many units/mixed units 5.Multiple steps 6.Infrequent production 7.Ineffective or lack of standards 8.Multiple handoffs 9.Hand processing 10.Rapid repetition 11.High volume demand or deadline pressures 12.Environmental conditions

26. 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.

27. 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.

28. 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.

29. 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 environments or equipment – higher capital and labor productivity without adding cost or more highly trained personnel I call this building better process stability

30. Surfin’ for Ideas? Better Practice Sharing

31. A Better Practice … Use CAPS: (Action Verb) then, the event … In your Outlook Calendar

32. A Better Practice … Label, Label, Label Color code …

33. A Better Practice … Which side is gas cap on?… Points to left side (see white arrow)

34. A Better Practice … Sign (Warning)Metal tabs (Shut-out)

35. 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.

36. Countdown to Takeoff – Get on the plane, people !! A Better Practice …

37. Green tag for “Carry On” bags that had to be checked.

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

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

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

41. A Better Practice … COFFEE/ SINK AREA (signage) for galley operations. Considerate but firm…

42. A Better Practice … TIME ALERT (signage) for coffee operations. Denotes type and how long coffee has been sitting…

43. What Did We Cover Today?

44. Oops !! [Mistakes, - some are obvious]

45. [… some recover well!] Story on back of each bag of chips…

46. [And… some, not so much!]

47. Lot’s O’ Reasons… to address Focus your analysis on those causes…

48. An idea you can put into practice…

49. Look for these Conditions: 1.Adjustments 2.Unclear or no instructions 3.Undefined process 4.Many units/mixed units 5.Multiple steps 6.Infrequent production 7.Ineffective or lack of standards 8.Multiple handoffs 9.Hand processing 10.Rapid repetition 11.High volume demand or deadline pressures 12.Environmental conditions Key Points about Mistake Proofing

50. Mistake Proof This! A great idea you can put into everyday practice … Process / Step: _________________________ Describe the Error: ______________________ Mistake-proofing Measure: _________________ _____________________________________ What foolish action does it prevent? ---------------------------------------------------