corrective action plan
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CJ Kurtz & Associates LLC 1
Corrective ActionProblem Solving
Carol KurtzCJ Kurtz & Associates LLC
CJ Kurtz & Associates LLC 2
Trainer: Carol Kurtz
American Society for Quality (ASQ) Certified Quality Engineer Certified Quality Auditor Certified Quality Manager Certified Mechanical Inspector
20+ years of Quality & Manufacturing Experience
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Course Objectives
Understand 8D Corrective Action & Problem Process
Identify and Use Tools for Each 8D Process Step
Understand Vocabulary & PrinciplesCompare to Other Fact Based Problem
Solving Methods
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Corrective Action
Action to eliminate the cause of a detected nonconformity.
Action to protect the customer from receiving or using nonconforming product.
Corrective action is taken to prevent recurrence.
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Problem Solving
Problem Solving: Typically involves a methodology of clarifying the description of the problem, analyzing causes, identifying alternatives, assessing each alternative, choosing one, implementing it, and evaluating whether the problem was solved or not.
8D, PDCA, DMAIC (du-may-ic)
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Corrective Action Origins The origins of the 8-D system
actually goes back many years.
The US Government first ‘standardized’ the system in Mil-Std-1520 “Corrective Action and Disposition System for Nonconforming Material”
Mil-Std-1520 - First released: 1974
Last Revision was C of 1986 Cancelled in 1995
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What is 8D?
8D means Eight DisciplinesIt is a methodology used for solving
problems8D also refers to the form that is used to
document the problem and resolutionAlso called 8-D ReportCorrective Action ReportEW8D Report – East-West-8D
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Why 8D?
8D is a structured approach to solving problems
Fact Based Data Collection & Analysis
Tests progress and results Verify & Validate
Documented History – An information database Anticipate future problems Prevent recurrence
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8D Corrective Action
D0: Recognize the Problem
D1: Establish the Team
D3: Determine and Implement
Containment Actions
D2: Describe the Problem
Identify Potential Causes
Select Likely Causes
Identify Possible Corrective Actions
Root Cause?
D5: Choose & Verify Corrective
Actions
D6: Implement & Validate
Corrective Actions
D7: Prevent Recurrence
D8: Congratulate the Team
Yes
No
D4:
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Six Sigma DMAIC
Define
Measure
Analyze
Improve
Control
D1: Team ApproachD0: Recognize ProblemD2: Describe ProblemD3: Containment
D4: Define & Verify Root Causes
D5: Select & Validate Corrective ActionsD6: Implement Corrective Actions
D7: Prevent Recurrence
D8: Congratulate Team
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Plan Do Check Act - PDCA
Plan:Identify the Problem Analyze The Problem
Do:Develop Solutions
Implement Solutions
Check:Evaluate Results
Achieve Desired Results?
Act:Standardize Solution
D1: Team Approach
D0: Recognize ProblemD2: Describe ProblemD3: Containment
D4: Define & Verify Root CausesD5: Select & Validate Corrective ActionsD6: Implement Corrective Actions
D7: Prevent Recurrence
D8: Congratulate Team
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Some Vocabulary
Problem Symptom Concern Root Problem Failure Mode
Effect Cause Special Cause Common Cause Root Cause
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Verification & Validation
Verification and Validation are often not well understood. Verification and Validation work together as a sort of ‘before’ (Verification) and ‘after’ (Validation) proof.
Verification provides ‘insurance’ at a point in time that the action will do what it is intended to do without causing another problem. Predictive.
Validation provides measurable ‘evidence’ over time that the action worked properly.
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Verification & Validation
Step Process PurposeD3 Verification That the containment action will stop the symptom from
reaching the customer.
ValidationThat the containment action has satisfactorily stopped the symptom from reaching the customer according to the same indicator that made it apparent.
D4 Verification That the real Root Cause is identified.D5 Verification That the corrective action will eliminate the problem.
D6 Validation That the corrective action has eliminated the problem according to the same indicator that made it apparent.
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Structure of a Problem
Determining the structure of a problem assists in the selection of the correct tools to use.
It may give clues to the nature of the root causes.
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Structure of a Problem
TimeEstablished Performance
Sudden change, catastrophic change from standard:
TimeEstablished Performance
Gradual change, deteriorating performance over time:
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Structure of a Problem (continued)
TimeExpected Performance
Start-up, gap between expected and actual performance:
Actual Performance
TimeEstablished Performance
Recurring change, comes and goes with unknown causes:
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Structure of a Problem (continued)
TimeEstablished Performance
Positive change:
Sometimes we experience positive changes that need to be investigated so that processes and products may be improved.
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Classifying Problems
Correctly categorizing and classifying a problem precedes any problem solving effort.
Ensures proper methods and tools are selected.
If not done, wasted time and effort may occur and wrong solutions may be implemented.
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Classifying Problems – Type I
Plant Floor Problems Rapid response is needed Usually have discernable root causes Usually require less data collection and analysis Usually can be solved by local experts Usually gradual or sudden problem structures Special causes Specific problem requiring Problem Analysis 8D methodology applies
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Classifying Problems – Type II
Technical Problems Permanent corrective actions are needed Usually have difficult to discern root causes Usually require more data collection and analysis Usually require some technical expertise to solve May be any problem structure Special Causes Specific problem requiring Problem Analysis 8D methodology applies
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Classifying Problems – Type III
Process Improvement Major systemic fixes needed Multiple causes and effects May require data collection and analysis May need “systems thinking” to solve Usually requires process owner’s involvement Common cause problem Structures include startup and positive. Others may apply. Broad problems requiring a Situation Analysis Quality Improvement Projects, Continual Improvement
Projects or other methodologies apply.
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Problem Solving Tools
Trend Chart Control Chart Pareto Chart Brainstorm Checksheet Histogram Nominal Group
Technique Five Why’s Computer Aided
Engineering APQP
Situation Analysis Flowchart Failure Analysis Database Decision Analysis Action Plan Root Cause Analysis Cause & Effect Diagram Scatter Diagram Design of Experiments Poka Yoke Preventive Action Matrix
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Problem Solving Tools
Tool Purpose 8D Step
Trend Chart Indicator to track magnitude of symptoms
D1 D2 D3 D4 D5 D6 D7 D8
Pareto Chart Quantifier to prioritize and subdivide the problems D2 D8
Paynter Chart Indicator to monitor and validate the problems D2 D3 D6 D8
Repeated Why Method to move from symptom to problem description D2
Information DatabaseProcess to find root cause using Is/Is Not, Differences, Changes
D2 D4 D5 D6
Decision Making Method to choose best action from among alternatives D3 D5
Action Plan Record of assignments, responsibilities and timing
D1 D2 D3 D4 D5 D6 D7 D8
EW8DReport of problem solving process for management review
D1 D2 D3 D4 D5 D6 D7 D8
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Problem Solving Tools Quiz
Pareto Analysis
RAC-Root Cause
Analysis
Trend Charts
Problem Solving
Tools
?
?
Pareto Analysis RAC-
Root CauseAnalysis
?
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D0: Recognize the Symptoms
Detect the problem!Nonconforming ProductOut of Control Conditions on ChartsReworkTrend ChartsWhat others?
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D0: Recognize the Symptoms
Customer
Receiving / Inventory
Supplier
In-Process Inventory / Shipping
In Transit
In Transit
Company
Here?
Or Here?
Or Here?
Or Here?
Or Here?Or Here?
Or Here?Or Here?
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D0: Recognize the Symptoms Trend Chart
A line graph plotting data over time. Use to observe behavior over time Provides a baseline and visual examination of
trends No statistical analysis Look for trends and patterns Ask “Why?” Good for operations/processes where data for
control charts is not available
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D0: Recognize the Symptoms Trend Chart
Average Hours Worked Per Employee (3rd shift)4544434241403938373635
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecChange shift starting timesNew entrance opened.Task group established.
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D0: Recognize the Symptoms
Nonconforming ProductOut of Control Conditions on ChartsReworkTrend Charts What others?
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D0: Recognize the Symptoms Control Chart
A line graph of a quality characteristic that has been measured over timeBased on sample averages or individual
samples Includes statistically determined Control
Limits.Requires certain assumptions and
interpretation
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Interpreting Control Charts
Control Charts provide information as to whether a process is being influenced by Chance causes or Special causes. A process is said to be in Statistical Control when all Special causes of variation have been removed and only Common causes remain. This is evidenced on a Control Chart by the absence of points beyond the Control Limits and by the absence of Non-Random Patterns or Trends within the Control Limits. A process in Statistical Control indicates that production is representative of the best the process can achieve with the materials, tools and equipment provided. Further process improvement can only be made by reducing variation due to Common causes, which generally means management taking action to improve the system.
A. Most points are near the center line.B. A few points are near the control limit.C. No points (or only a ‘rare’ point) are beyond the Control Limits.
Upper Control Limit
Lower Control Limit
Average
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Interpreting Control ChartsWhen Special causes of variation are affecting a process and making it unstable and unreliable, the process is said to be Out Of Control. Special causes of variation can be identified and eliminated thus improving the capability of the process and quality of the product. Generally, Special causes can be eliminated by action from someone directly connected with the process.
The following are some of the more common Out of Control patterns:
Upper Control Limit
Lower Control Limit
Average
Tool Wear?
Change To Machine Made
Tool Broke
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Interpreting Control Charts
Upper Control Limit
Lower Control Limit
Average
Trends
Points Outside of Limits
A run of 7 intervals up or down is a sign of an out of control trend.
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Interpreting Control ChartsRun of 7 ABOVE the Line
Run of 7 BELOW the line
A Run of 7 successive points above or below the center line is an out of control condition.
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Interpreting Control ChartsSystematic Variables
Cycles
Predictable, Repeatable Patterns
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Interpreting Control Charts
Instability
Freaks
Sudden, Unpredictable
Large Fluctuations, Erratic Up and Down Movements
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Interpreting Control ChartsMixtures
Typically Indicates a Change in the System or Process
Sudden Shift in Level
Unusual Number of Points Near Control Limits (Different Machines?)
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Interpreting Control Charts
Stratification
Constant, Small Fluctuations Near the Center of the Chart
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Control Chart Analysis Reaction
There is a wide range of non-random patterns that require action. When the presence of a special cause is suspected, the following actions should be taken (subject to local instructions).
1. CHECKCheck that all calculations and plots have been accurately completed, including those for control limits and means. When using variable charts, check that the pair (x bar, and R bar) are consistent. When satisfied that the data is accurate, act immediately.
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Control Chart Analysis Reaction
2. INVESTIGATE Investigate the process operation to determine the cause. Use tools such as:
Brainstorming Cause and Effect Pareto Analysis
Your investigation should cover issues such as:The method and tools for measurement The staff involved (to identify any training needs Time series, such as staff changes on particular days of the week Changes in material Machine wear and maintenance Mixed samples from different people or machines Incorrect data, mistakenly or otherwise Changes in the environment (humidity etc.)
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Control Chart Analysis Reaction
3.ACT Decide on appropriate action and implement it. Identify on the control chart
The cause of the problem The action taken
As far as possible,eliminate the possibility of the special cause happening again.
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4. CONTINUE MONITORING Plotting should continue against the existing limits The effects of the process intervention should become visible. If not, it should be investigated.Where control chart analysis highlights an improvement in performance, the effect should be researched in order that:
Its operation can become integral to the process Its application can be applied to other processes where appropriate
Control limits should be recalculated when out of control periods for which special causes have been found have been eliminated from the process.
The control limits are recalculated excluding the data plotted for the out of control period. A suitable sample size is also necessary.
On completion of the recalculation, you will need to check that all plots lie within the new limits
Control Chart Analysis Reaction
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D0: Recognize the Symptoms Other Indicators
Customer Concerns & IssuesWarranty DataQuality ReportsProduct Quality Planning
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D1: Establish the Team
Establish a small group of people with the knowledge, time, authority and skill to solve the problem and implement corrective actions. The group selects a team leader.
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D1: Establish the Team The 8D Team Members
Cross Functional or Multi-DisciplinaryProcess OwnerTechnical ExpertOthers involved in the containment,
analysis, correction and prevention of the problem
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D1: Establish the Team Team Roles
Several roles need to be established for the team. These roles are: Leader, Champion, Record Keeper (Recorder), Participants and (if needed) Facilitator.
LeaderGroup member who ensures the group performs its duties and responsibilities. Spokesperson, calls meetings, establishes meeting time/duration and sets/directs agenda. Day-to-day authority, responsible for overall coordination and assists the team in setting goals and objectives.
Record KeeperWrites and publishes minutes.
ParticipantsRespect each others ideas.Keep an open mind.Be receptive to consensus decision making.Understand assignments and accept them willingly.
ChampionGuide, direct, motivate, train, coach, advocate to upper management.
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D1: Establish the Team Problem Solver Characteristics
Persistent Intuitive (supported by mechanical aptitude) Logic & discipline Common sense Ability to balance priorities Ownership Inquisitive and willing Creative and open minded Needs proof & facts
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D1: Establish the Team Effective Team Characteristics
LeadershipClearly define goalsClearly defined responsibilitiesTrust & RespectAuthorityPositive AtmosphereGood two way communicationEffective action plan with timing
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D1: Establish the TeamManagement Responsibility
Provide time and resoucesProvide mentoringUnderstand need for changeRecognize accomplishments & team
process
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D1: Establish the TeamBrainstorming
Generate a great number of possible solutions to a problem
Use to avoid conventional or in-the-box thinking
Overcome mental blocks, inspire creativity
Take advantage of team synergyIdeas from different perspectives
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D1: Establish the TeamTeam Check List
Team Check List Yes No
Has a champion accepted responsibility for monitoring the measurables?
Have measurables been developed to the extent possible?
Have special gaps been identified? Has the common cause versus special cause relationship been identified?
Has the team leader been identified?
Does the team leader represent the necessary cross-functional expertise?
Has team information been communicated internally and externally?
Has the team agreed upon the goals, objectives, and process for this problem solving effort?
Is a facilitator needed to help keep process on track and gain consensus?
Does the team have regular meetings?
Does the team keep minutes and assignments in an action plan?
Does the team work well together in following the process and objectives?
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D2: Problem Description
Describe the problem in measurable terms. Specify the internal or external customer problem by describing it in specific terms.
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D2: Problem DescriptionProblem Statement
Problem statement =Object + concern + quantificationExample:
20% of Tuesday’s first shift production of end cap #3245A have a ¼” to ¾” crack at the lower left corner of the strain relief hole.
Remember: A well defined problem is half solved!
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D2: Problem DescriptionFive Why’s
A technique for stepping through successive layers of symptoms to find the root problem statement.
Go to the point of occurrence of the problem (gemba) Begin asking “Why?” Using a flowchart, track back from symptom to
symptom until you find: The root cause A level where permanent corrective action can be
implemented A point where “Why?” can no longer be answered
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D2: Problem DescriptionFlowchart
A picture of a process using symbols and arrows to represent sequence of the steps.
Action Step
Action Step
Document associated with a step such as a
form or report
Question or Decision?
Action Step Action Step
Yes No
Start or input at the beginning of a process
Completed process
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D2: Problem DescriptionSituation Analysis
Tool used to break broad problems into smaller prioritized pieces to attack one at a time.
Many problem solving efforts start with large, messy, poorly defined, unforcused issues.
This method is detailed in the book The New Rational Manager by Kepner & Tregoe
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D2: Problem DescriptionPareto Analysis
A Pareto chart offers the following benefits: Focuses on the problems or causes of
problems that have the greatest impactDisplays the relative significance of
problems or problem causes in a simple, quick-to-interpret, visual format
Can be used repeatedly to produce continuous improvements
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D2: Problem DescriptionPareto Analysis
Ball Lifting Cause Frequency Percent
(%)Cum Percent
(%)
Bonder Set-up Issues 19 38% 38%
Unetched Glass on Bond Pad
11 22% 60%
Foreign Contam on Bond Pad
9 18% 78%
Excessive Probe Damage 3 6% 84%
Silicon Dust on Bond Pad 2 4% 88%
Corrosion 1 2% 90%
Bond Pad Peel-off 1 2% 92%
Cratering 1 2% 94%
Resin Bleed-out 1 2% 96%
Others 2 4% 100%
Total 50 100% -
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D2: Problem DescriptionPaynter Chart
This chart is combination of Trend and Pareto charts.
Provides information on actions taken and shows effects.
Can be modified for Returns, Scrap, Rework, etc.
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D2: Problem DescriptionPaynter Chart
Number of 3rd shift workers affectedProblems: July Aug Sept Oct Nov Dec TotalTraffic jam on Hiway 90 84 4 3 0 90Buses Late 30 30 9 8 30 30Not Enough Parking 17 16 17 8 0 17Bad Weather 9 10 20 21 9 9Road Construction 4 0 0 0 21 4
150 140 50 40 60 150
= Containment Action: Change Shift Starting Time= Corrective Action: Open second gate, change shift starting times back to 'normal'.= Corrective Action: Task Group established.
% Late Employees Third Shift # Late Employees100 60
90 54
80 48
70 42
60 36
50 30
40 24
30 18
20 12
10 6
0 01 2 3
Buses Late Bad Weather Not Enough Parking
Average Hours Worked Per Employee (3rd shift)4544434241403938373635
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecChange shift starting timesNew entrance opened.Task group established.
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D2: Problem DescriptionInformation Database
A tool for organizing all data about a problem into four categories: What, Where, When, Extent.
Used for Problem AnalysisDetailed in The New Rational Manager
by Kepner/Tregoe
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D2: Problem DescriptionInformation Database
Is Is NotWhat: What is the object you are having a problem with? What could be happening but is not?
What is the problem concern? What could be the problem concern, but is not?
Where: Where do you see the concern on the object? Be specific in terms of inside to outside, end to end, etc.
Where on the object is the problem NOT seen? Does the problem cover the entire object?
Where (geographically) can you take me to show me the problem? Where did you first see it?
Where else could you have observed the defective object, but did not?
When: When in time did you first notice the problem? Be as specific as you can about the day and time.
When in time could it have first been observed, buy was not?
At what step in the process, life or operating cycle do you first see the problem?
Where else in the process, life or operating cycle might you have observed the problem, but did not?
Since you first saw it, what have you seen? Be specific about minutes, hours, days, months. Can you plot trends? What other times could you have observed it but did not?
How Big: How much of each object has the defect? How many objects could be defective, but aren't?
What is the trend? Has it leveled off? Has it gone away? Is it getting worse?
What other trends could have been observed, but were not?
How many objects have the defect? How many objects could have had the defect, but didn't?
How many defects do you see on each object? How many defects per object could be there, but are not?How big is the defect in terms of people, time, $ and/or other resources? How big could the defect be, but is not?
What percent is the defect in relation to the problem?
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D2: Problem DescriptionChecksheet
Checksheets are simple and effective method of gathering information on the job.
Ensures consistency of data collected. Simplifies data collection and analysis. Highlights trends. Spots problems.
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D2: Problem DescriptionChecksheet
Part Number 621532-B Part Defect ChecksheetDate 12-16-04
Defect 1st Shift 2nd Shift 3rd Shift Totals
Nicks 22 14 5 41Missing holes 1 0 0 1Missing screws 8 4 0 12
Totals 31 18 5 54
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D2: Problem DescriptionHistogram
Chart using bars of varying height to show frequency distribution of some characteristic.
Use for problem recognition, problem definition, data analysis, and validation of corrective actions.
Visually evaluate spread, centering, capability.
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D2: Problem DescriptionHistogram
23mm OD HistogramP/N 543612 on Machine 6
0
1
2
3
4
5
6
19 21 23 25 27More
Outside Diameter
Freq
uenc
y
Frequency
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D3: Containment
Define and implement those intermediate actions that will protect the customer from the problem until permanent corrective action is implemented.
Verify with data the effectiveness of these actions.
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D3: Containment Contain Symptom Flow
Stop Defect at EachPoint in the ProcessBack to the Source
Validate that ActionTaken is Fully Effective
Immediate Containmentwith Current
Information andProblem Description
ChooseVerify BeforeImplement
Validate After Implementation
Certify parts and ConfirmCustomer DissatisfactionNo Longer Exists
DetermineEscape Point Should an existing ‘check’ (control)
have caught the defect?
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D3: ContainmentObjectives
The objective of this step is to isolate the effects of the problem by implementing containment actions.
Once a problem has been described, immediate actions are to be taken to isolate the problem from the customer. In many cases the customer must be notified of the problem.
These actions are typically ‘Band-aid’ fixes. Common containment actions include:
100% sorting of components Items inspected before shipment Parts purchased from a supplier rather than manufactured in-
house Tooling changed more frequently Single source
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D3: ContainmentContainment Action Checksheet
Containment Action Checksheet Yes No
Has immediate containment action been taken to protect the customer? Has the concern been stopped at each point in the process back to the source? Have you verified that the action taken is FULLY effective? Have you certified that parts no longer have the symptom? Have you specially identified the 'certified' parts? Have you validated the containment action? Is data being collected in a form that will validate the effectiveness of the containment action?
Has baseline data been collected for comparison? Are responsibilities clear for all actions? Have you ensured that implementation of the containment action will not create other problems?
Have you coordinated the action plan with the customer?
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D4: Determine Root Causes
Identify potential causes which could explain why the problem occurred.
Test each potential cause against the problem description and data.
Identify alternative corrective actions to eliminate root cause.
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D4: Determine Root Causes
Root Cause of Event (Occur or Occurrence) What system allowed for the event to occur?
Root Cause of Escape What system allowed for the event to escape
without detection?
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D4: Determine Root CausesRoot Cause Analysis – 5 Why’s
The 5 why's refers to the practice of asking, five times, why a failure has occurred in order to get to the root cause/causes of the problem.
There can be more than one cause to a problem as well.
This root cause analysis is often done by a team with knowledge the problem process or item.
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D4: Determine Root CausesRoot Cause Analysis
Process of analyzing “is” & “is not” pairs of information for differences and changes that lead to root cause
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D4: Determine Root CausesRoot Cause Analysis
Is Is NotWhat:
Object Heavy traffic
Defect Late Employees
Where:
Seen on object I-70 Expressway
Seen geographically East bound I-70 near Main Street
When:
First seen July 7, 1996
When else seen Ever since
When seen in process (life cycle) Afternoon
How Big:
How many objects have the defect? Third shift (4:00PM)
How many defects per object? Once per day
What is the trend? Increasing --> SPECIAL CAUSE!
Enhanced Problem Description -->
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D4: Determine Root CausesCause & Effect Diagram
Shows the relationship of causes and sub-causes to an identified effect or problem. Clearly identify the problem or effect to be diagrammed in the box at the right
Draw the fishbone structure Identify the major categories, factors, the causes
related to the effect. Brainstorm, or note the causes of the problem that fall
within each of the major categories. Each branch may have sub-branches, or sub-sub-
branches As ideas are generated determine which branch of the
"bone" they should be placed
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D4: Determine Root CausesCause & Effect Diagram
Effect
Man Machine
Method Materials
Measurement
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D4: Determine Root CausesScatter Diagram
Scatter diagrams are used to study possible relationships between two variables. Although these diagrams cannot prove that one variable causes the other, they do indicate the existence of a relationship, as well as the strength of that relationship.
A scatter diagram is composed of a horizontal axis containing the measured values of one variable and a vertical axis representing the measurements of the other variable.
The purpose of the scatter diagram is to display what happens to one variables when another variable is changed. The diagram is used to test a theory that the two variables are related. The type of relationship that exits is indicated by the slope of the diagram.
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D4: Determine Root CausesScatter Diagram
Strongly correlated
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D4: Determine Root CausesScatter Diagram
Moderately correlated
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D4: Determine Root CausesScatter Diagram
No Correlation
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D4: Determine Root CausesDesign of Experiments - DOE
Shanin’s Red X Component SearchTaguchi’s Methods Classical Design of Experiments
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D5: Select & Verify CA
After root causes and possible corrective actions have been identified, select the corrective actions that will permanently correct the problem.
Decision analysis may be needed if the choice is not obvious.
Verify that the selected corrective actions will resolve the problem.
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D5: Select & Verify CAPoka Yoke
Poka Yoke Devices Are Built within the Process In General Have Low Cost Have the Capacity for 100%
InspectionRemember SQC is performed outside the process which adds cost and allows defects to escape the system.
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D5: Select & Verify CAPoka Yoke
OrientationPoka Yoke
Interference FitPoka Yoke
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D5: Select & Verify CAPoka Yoke
Floppy disks have many poka-yokes built in. One example is you cannot insert the disk into the drive completely if the disk is upside down. This is because of the corner notch [#1].
720k disks have no hole [#2] while HD disks have hole (mechanism senses)[#3].
Spring loaded shutter mechanism - Do you remember the old 5.25 inch floppies from the early to mid-1980’s? Failsafe disk surface protection [#4].
Slide Tab to protect against erasure. Mechanism senses [#5].
‘Precision’ alignment. Disk alignment holes and notches [#6] ensure the disk is properly aligned and also provides a ‘focus’ area for manufacturing.
2
1 1
3
4
55
4 6 66
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D5: Select & Verify CAPoka Yoke
Computer Files
Microsoft: File type identified by file name suffix. If one does not add the correct suffix, the program the file is from will not recognize it.
Macintosh Poka Yoke (1984): File type and creator application are identified and embedded in the first part of every file. File name plays NO part in recognition by the originating program.
Computer Floppy Drives
Microsoft: Disk must be inserted and ejected by hand. It is possible to eject a disk while it is being written to.
Macintosh Poka Yoke (1984): Disk drive grabs disk as it is being inserted and draws it in and seats it. Disk cannot be manually ejected. You must drag the ‘desktop’ icon for the disk to the ‘Trash’. The drive then ejects the disk as long as there are no disk operations taking place.
New lawn mowers are required to have a safety bar on the handle that must be pulled back in order to start the engine. If you let go of the safety bar, the mower blade stops in 3 seconds or less. This is an adaptation of the "dead man switch" from railroad locomotives.
Warning lights alert the driver of potential problems. These devices employ a warning method instead of a control method.
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D5: Select & Verify CACorrective Action Check List
Corrective Action & Verify Check List Yes No
Has corrective action been established?
Does it meet the required givens?
Have different alternatives been examined as possible corrective actions?
Have Poke-Yoke techniques been considered?
Has each alternative been screened?
Have the risks involved with the corrective action been considered?
Was the corrective action verified?
Was the corrective action proven to eliminate the root cause?
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D6: Implement & Validate CA
Implementation can proceed when best corrective action has been selected & verified.
An effective implementation plan reduces problems.
Validation is obtained by tracking performance over time after implementation to ensure the corrections are permanent.
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D6: Implement & Validate CAImplementation Check List
Implement CA & Validate Over Time Yes NoHas the implementation plan been constructed to reflect Product Development Process events and engineering change process?Do the corrective actions make sense in relation to the cycle plan for the products?Have both Design and Process FMEAs been reviewed and revised as required?Have significant / safety / critical characteristics been reviewed and identified for variable data analysis?
Do control plans include a reaction plan?
Is simultaneous engineering used to develop process sheets and implement manufacturing change?
Is the Paynter Chart in place for validating data?
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D7: Prevent System Recurrence
Implement the corrective actions in other potentially affected areas.
Ensure the systems that allowed the problem to occur and escape have been corrected.
The problem is now Type III requiring a larger scale continual improvement project of some type.
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D7: Prevent System Recurrence Prevent System Problems Check List
Prevent System Problems Check List Yes NoHave the system prevention practices, procedures & specification standards that allowed the problem to occur and escape been identified?
Has a champion for system prevention practices been identified?
Does the team have the cross-functional expertise to implement the solution?
Has a person been identified who is responsible for implementing the system preventive action?Does the system preventive action address a large scale process in a business, manufacturing or engineering system?Does the system preventive action match root cause (occur & escape) of the system failure?Does the team utilize error proofing and successive checks on a proactive on-going basis to eliminate the occurrence and escape of all defects?Has a pieces over time (Paynter Chart) been used to indicate that the system preventive actions are working?Has the System Preventive Action been linked to the Product Development phase?
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D8: Congratulate the Team
Recognize the collective efforts of your team. Publicize your achievement. Share your knowledge and learning.
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D8: Congratulate the TeamCongratulate The Team Checksheet
Congratulate The Team Checksheet Yes NoHave documented actions and lessons learned been linked to Product Development Process for future generations of products?
Has appropriate recognition for the team been determined?
Has application for patents & awards been considered?
Has team been reassessed?
Has the team analyzed data for next largest opportunity?
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References
http://elsmar.com/ http://www.isixsigma.com/spotlight/default.asp http://www.isixsigma.com/dictionary/glossary.asp http://www.asq.org/learn-about-quality/ Prince Corp, Corrective Action Manual The New Rational Manager, Kepner & Tregoe http://deming.eng.clemson.edu/pub/tutorials/ http://www.qualityspctools.com/menu.html Ford Team Oriented Problem Solving http://www.cjkurtz.com/qualitytools.htm
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