Category: Problem Solving

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5S Erosion – Continued

In the post on 5S erosion, I posed a couple of questions.

What, exactly, is the function of a 5S audit?

What, exactly, is the problem [the audit is supposed to solve]?

How do you know [that is the problem]? What have you observed?

The responses have been interesting, wide ranging, but so far have not directly addressed the questions.

If you were preparing a simple A3, “auditing” would be one of the checks or countermeasures.

But what problem would you be addressing?

What have you observed that indicates there is a problem?

Note that I am not questioning the value of having a standard for workplace organization.

I am not even directly challenging audits, measurements, etc. However these things must have a clear purpose, or we are just blindly implementing tools and repeating mantras. And if we cannot articulate the core purpose of these things to each other, how can we ever ask others to do these things with any more authority than “because I said so” or “because it is in this book?”

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5s Erosion: What Is The Problem?

I had another opportunity today to discuss why I am not a big fan of “5S audits.” I fully realize that 5S audits are out there in a big way and are almost pro-forma as a “lean practice.” I have not run into any consultants who do not have some kind of 5S audit in their collection of tools, and the topic has pretty constant traffic on the Lean Enterprise Institute discussion forums – and just about anyone who offers one up gets a lot of requests for copies.

Before I go too far, though, let me explain what I mean when I say “5S audit.”

What I typically see is a single page with a 6×6 matrix of squares on it. Down the left hand side in column 1 are labels for whatever 5 “S words” are being used in this particular version. Across the top in the top row are points assignments from 1 to 5.

The grid is then filled with criteria in each “S” to get the specified number of points, maximum 5 in each category.

Auditor takes the checklist, looks at the area being audited, perhaps asks some questions, and assesses, for each “S” how many points are given.

It is typical to then make some kind of chart – spider diagrams are popular – and assign the area a score, perhaps an average, so they are, for example, at “Level 3” on their 5S efforts.

Does that about capture it? There are variations, but I do not care so much about the form as I do the function.

And what, exactly, is the function?

That is a question that does not get asked often enough, and if it does, the asker does not press hard enough on “exactly.”

Let’s keep in mind that this audit consumes time and resources and produces nothing. Therefore it had better be an effective countermeasure to some kind of problem.

What, exactly, is the problem?

How do you know? What have you observed?

Give that a little thought.

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Understanding the Solution

Another great insight from “Toyota Kata” by Mike Rother.

We often think great problem solving means solving the problem, that is applying countermeasures, and we may even propose and apply several countermeasures in the hope that one of them will stop the problem. In contrast, in Toyota’s way of thinking, if the solution is not obvious, it means we have not yet understood the situation sufficiently. Time to go and see again.

So here I am, in the beginning stages of trying to figure out how to get this problem solving culture anchored – not in a single site, but in about a dozen – spanning at least 16 time zones, with six or seven languages involved. I have to keep the message very focused, direct, and simple. I have spent the last couple of months in “go and see” mode.

One of the things I am beginning to emphasize to these management teams is that their problem solving is typically far to broad in scope. They are trying to find general solutions to broad ranges of problems, like part shortages. But “Why do we have part shortages” is the wrong question. Asking that question requires studying a huge population of part shortages, and quickly entering into “Pareto paralysis.”

Jamie’s comment to the Pareto Paralysis” post was a good one. Pareto charts are a powerful analysis tool, but in my view, they are best used when breaking down which cause to work on, rather than trying to break down which problem to work on. There is a huge difference.

What I see is that teams spend too much time time deciding what problem is most important, to the detriment of actually spending time solving problems. But I digress.

Rather than spend a lot of time breaking down “part shortages,” how about taking one part shortage. Instead of asking “Why do we have part shortages” I want to know “Why was that part late today.?”

Taking a look at a single instance, rather than a whole class of problems, does a couple of things.

First, it lets the management team do something that is critically important in these beginning stages: They learn to dig in and gain solid understanding of the situation of a single problem. They have to look at how the process was supposed to work, and understand when, where and why it broke down. Frankly, until they can explain that to me, in detail, I am not the least bit interested in proposed solutions. They first have to teach me well enough that I can understand what they understand.

Going back to the quote, at that point, if the system level solution is not obvious, then it is likely that I don’t yet understand the situation. That means that they have not yet understood it enough to explain it to me, which means they need to go back and dig some more.

The other thing, though, is that the way to learn good problem solving is to:

  1. Start with single instances, rather than classes of problems.
  2. Practice, practice, practice.

Why is it important for senior leaders to get good at this kind of problem solving? After all, aren’t they paid to manage others to do this? Yup, they are. But until they have mastered the game, they are not good coaches.

What I need is senior leaders who are going to insist on the same level of understanding from their people. Leaders need to understand what questions to ask, and how to re-focus people from “We have too many part shortages” to “Why was that part late today?” If each person can teach two more how to think that way, we’ll get there pretty fast.

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Problems Hidden In The Open

We were down on the shop floor watching an assembly operation. The takt time was on the order of three hours. The assembler was new to the task, and the team leader periodically came by and asked if he was “doing OK.” The reply was always in the affirmative.

As the takt time wound down to under five minutes to completion, this operation was the only one not reporting “Done.”

The count down hit zero, things went red, the main line stopped, and the line stop time started ticking up.

The team leader, other assemblers, the supervisor began pitching in to assist. Between them, the job was completed in about 10 minutes, and the line restarted.

So, again, my favorite question:

What’s the problem?

Lets try breaking it down to four key questions.

  1. “What should be happening?”
  2. “What is actually happening?”

    3. The above two questions define the gap.

  3. “Why does the gap exist?”
  4. “What are we doing about it?”

These questions simply re-frame PDCA, but without so much abstraction.

So, in this situation:

What should be happening?
Two things come to mind immediately.

  1. The work should be complete on time.
  2. As soon as you know it isn’t going to be complete on time, please tell someone so we can get you help.

For this to work, though, the team member needs a clear and unambiguous way to answer a key question of his own: Am I on track to finish on time? Ideally the answer to this question is a clear “Yes” or a clear “No,” with no ambiguity or judgment involved. (Like any “Check” it should produce a binary result.)

On an automobile line with a takt time on the order of 55 seconds, the assembler can get a good sense of this. If he loses more than three or four seconds, he isn’t going to make it. But “a good sense” isn’t good enough.

Even in this fast-moving situation, you will see visual indicators that help the team member answer this question. Take a look at this photo.

toyota-assy

See the white hash marks along line at the bottom of the picture? Those mark off the moving line work zone into ten increments of about 5 ½ seconds. The assembler knows where he should be as he performs each task. If he is a hash mark behind, he isn’t going to finish on time. Pull the andon. We can safely say that, in this example, we have accomplished (1) and (2) above.

With longer takt times, it is much tougher for a human to have a good sense of how much time will be required to complete the remaining work. That makes it that much more critical that some kind of intermediate milestones are clearly established and linked to time.

What would be a reasonable increment for these checks? –> How far behind are you willing to let your worker get before someone else finds out? I’d say a good starting point is at the point when he can’t recover the time himself, the problem is no longer his. Following the standard work is the responsibility of the team member. Recovering to takt time is the team leader’s domain. At the very least, he is the one who pitches in and helps, or gets someone else to do so. But he can’t do this if he doesn’t know there is a problem.

So – what should be happening?

The team member must have continuous positive confirmation that he is on track to complete the work on time. With the failure of that positive confirmation, he should pull the andon and get assistance.

The team member must call for assistance (“pull the andon”) if his work falls behind the expected progress for any reason whatsoever.

What is actually happening?

In our example, the team member didn’t get help until it was too late. In fact, he verbally assured the team leader he was “OK” on a couple of occasions. The line stop was irrefutable evidence of a problem. That was a good thing. This company has a takt time, and runs to it. Think of what would have happened if they didn’t. It might take hours, or days, before this problem surfaced. (We are nowhere near the root cause yet. The line stop is just evidence of a problem, not the problem itself.)

Why does the gap exist?

It is a hell of a lot harder to answer this question than the other two. In this case, you are going to have to peel back a lot of layers before you get to the actual, systemic, root cause. But in the immediate sense, with a takt time bordering on three hours, there is really no realistic way a worker can judge if he has fallen too far behind to catch up. The fact that, in this case, the assembler was still learning the job, and that just compounds the situation.

From casual observation – when the team leader visited, he asked if things were OK and accepted the reply – I would start to investigate whether the team leader had a good sense himself of where the work should be at his regular check points… if he has regular check points at all.

But all of this is speculation, because after 10 minutes of watching the initial response to the line stop, our little group had moved on. I am mentioning these things as possibilities because you likely have the same issues in your shop. (And if you don’t have a rigorous sense of takt time, it is equally likely you don’t know about those issues even at the level we saw here. At least THIS company can see the evidence of the problem. That is a credit to their visual controls.)

What are we going to do about it?

Obviously there are a couple of immediate things that can be addressed to at least contain the problem. (That is, convert a hard line stop into multiple andon calls so the actual problems are seen earlier.)

I would want to establish a regular routine for the team leader’s checks. His leader standard work. At regular intervals, he should be checking progress of the work. How often? How far behind do you want the assembly to get before you are certain someone finds out about the problem? In this case, even every 20 minutes is less rigorous than the hash marks on the auto assembly line. But it would be a start.

So we have the team leader coming by every 20 minutes.

But he can’t just ask “How is it going?” We clearly saw that didn’t work. It isn’t that the assembler lied to him, it is that the assembler didn’t know because there was no standard.

What work should be complete 20 minutes into the work cycle? At 40 minutes? At 60? What verifiable facts can the team leader check by observation? There are a lot of ways to do this, most of them very simple and non-intrusive. Think it through.

But wait – now the team leader himself has standard work. What cues him to do it? Is he supposed to notice that 20 minutes has elapsed? In this case, the company already has a pretty sophisticated andon and sound system. It would be a pretty simple matter to put in an audible signal that told the team leader to make his checks. But, again, that is just one solution. I can think of a couple of others. Can you?

What is the team leader checking for? This is a critical question.

Think about it.

What was the original answer to “What should be happening?” (which is “the standard”)

We said:

  1. The work should be complete on time.
  2. As soon as you know it isn’t going to be complete on time, please tell someone so we can get you help.

We want the assembler himself to be checking #1.

So why do we have the team leader check?

So he can verify that the assembler is pulling the andon when he should. This is important because it is human nature not to ask for help until it is too late. This isn’t limited to factory floors. How many cardiac patients die because they ignored the warning symptoms for fear that it isn’t serious enough to get help?

It isn’t enough to ask the team member to call for help. You have to expect it, encourage it and require it.

Interestingly enough, as I was writing this post, John Shook posted his story about converting the culture at NUMMI.

A cornerstone of Respect for People is the conviction that all employees have the right to be successful every time they do their job. Part of doing their job is finding problems and making improvements. If we as management want people to be successful, to find problems, and make improvements, we have the obligation to provide the means to do so.

But, some of our GM colleagues questioned the wisdom of trying to install andon at NUMMI. “You intend to give these workers the right to stop the line?” they asked. Toyota’s answer: “No, we intend to give them the obligation to stop whenever they find a problem.” [emphasis added]

What was the problem in our example? We don’t know yet. We certainly can’t start looking for causes.

But the evidence of a problem was that the team member could not complete the work in the time expected. That is, he was not successful doing the job. And the line stopped because the support system failed to pick up the fact that he was falling behind until it was too late to recover.

It really does come down to respect for people.

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Reducing Inventory

Yesterday’s post on vendor managed inventory touched on a couple of things about “lean” and reducing inventory that I’d like to explore further.

All too often “inventory reduction” has been a way to “sell” a lean manufacturing implementation. The reduction of inventory becomes the objective. While this isn’t inherently a bad thing, it is all to easy to get caught up in the trap of “management by measurement” and do it the wrong way.

Reduced inventory is a result of good kaizen, but it isn’t the justification for doing it. The purpose of kaizen is to solve problems, specifically the problems that disrupt the smooth flow of work and creation of value. Solving those problems saves time – worker’s time, customer’s time, leader’s time because everything runs more smoothly and predictably.

The primary reason that inventory is there is because things aren’t smooth and predictable. Once they are, you can take some of it out.

The necessity to have inventory at any given point in the system is evidence of a problem that has not yet been solved. (Including, sometimes, simply having poor inventory management, which is another way of saying “overproduction.”)

By asking “What must we do to live without this piece of inventory?” you can uncover the next problem to solve, and then make a decision to solve it.

If it is solved, then inventory can be reduced. But it doesn’t happen automatically, you have to actually take it out of the system and keep it from coming back.

But in any case, this is a lot different than just shoving the ownership of the inventory onto someone else.

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Design Innovation Example

This post on the Fastcompany.com blog shows a clever desktop manufacturing invention.

But what really got my attention was the development process that starts at 3:40 in the video. It shows the process of developing it. They may not call it “3P” but, by and large, this is what it looks like.

As they develop ideas, they try them out in simulation, learn, improve, try, learn, improve. As the design matures in stages, they are moving forward, step by step, with concepts that are solid. This process is fast, flushes out problems early, while they are cheap to fix, and fun.

Contrast this with what might be created by a traditional process with the assignment of making a “tabletop NC cutter for cardboard.”

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Get Specific

A couple of days ago I had an interesting session with an improvement team in a fairly large company. They have been working on this for almost 10 years, and believe that while they have made some spot progress, they are clear that they have spent a lot of money but not yet established what they call a “lean culture.” Their implied question was “How do we get there?”

My question was “When you say ‘a lean culture,’ exactly what are you thinking about?”

What do people do? How do they behave?

“People find and eliminate waste every day.”

OK, so if they were doing that, what would you see if you watched?

There was a bit of a struggle to articulate an answer.

I see this all of the time. We rely on the jargon or general statements to define the objective, without really digging down the next couple of layers and getting clear with ourselves about what the jargon means to us. This is especially the case when we are talking about the people side of the system.

But the people are the system. They are the ones who are in there every single day making it all happen. It is people who do all of the thinking.

Consider these steps:

  • Define Value.
  • Map your value streams.
  • Establish flow.
  • Pull the value through the value stream.
  • Seek perfection.

This is the implementation sequence from Lean Thinking by Womack, Jones and Roos, that has been the guideline for a generation+ of practitioners.

Learning to See taught that generation (and is teaching this one) to establish a current-state map of the value stream, and then a design the future state to implement as flow is established. The follow-on workbooks focused on establishing flow and pull, and did it very well.

While not the only way to go about this, it does work for most processes to establish flow in materials and information.

But what do people do every day to drive continuous improvement, and how are those efforts organized, harnessed, and captured to put the results where they can truly benefit customers and the business?

Here are some things to think about.

What exactly is the target condition for your organization? Can you describe what it will look like? Can you describe it in terms of what people experience, and do, every day?

When your people go home to their families and share what they did at work today, what will they talk about? And I don’t just mean the engineers and managers. What will the front-line value-creating people remember from the workday?

How will they talk about problems?

If your target future state now includes changes in how people work, ask yourself more questions.

When, exactly, are they going to do these things you described? By “when” I mean what time, starting when, ending when.

What, exactly, do they do when they encounter a problem during production?

How, exactly, do you expect the organization to respond to that problem? Who, exactly, is responsible to work through the issue and get things back on track? How long do they have to do it? If the problem is outside their scope, what is supposed to happen? How, exactly, does additional support get involved?

If these new activities involve new skills, when and how, exactly, are people supposed to learn them and practice them to get better at it? Who is supposed to teach them, when, where, and how? How will you verify that the new skills are being used, and are having the effect you intend?

“If we do this, what will happen?”

And then what? And then what?

Think it through.

The “people” future state is far more important than future state of the material and information flow.

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John Shook: “A Technical Problem or a People Problem?”

John Shook dives into some of the messy issues of true root cause in his most recent post.

We touched on a similar issue here a few months ago. But it is always worth coming back around to people because because in this system (actually in any system) there are always two issues with people.

  1. People are the most fallable part of the process.
  2. The process cannot operate without them.

The reflex is often to go into total denial about #1 and expect people to be vigilant and perfect every time. “Weed out the bad apples, and everything will be fine.” Of course that doesn’t work.

In John Shook’s example, he traced through Ohno’s classic “5 Why” example.

1. Why did the machine stop?
There was an overload and the fuse blew.
2. Why was there an overload?
The bearing was not sufficiently lubricated.
3. Why was it not lubricated sufficiently?
The lubrication pump was not working sufficiently.
4. Why was it not pumping sufficiently?
The shaft of the pump was warn and rattling.
5. Why was the shaft worn out?
There was no strainer attached, and metal scrap got in.

Then Shook asks a really interesting question:

Why was no strainer attached?

Why not indeed? Isn’t that somebody’s job?
And now, as he points out, we have transitioned from “technical” to “people.”

Maybe the standard work for the maintenance worker or machine operator didn’t go far enough. Or maybe the standard work did specify changing the strainer but the worker failed to observe the standard. How was the standard developed, how was it communicated and trained? How easy was it to “forget” to change the strainer?

Coming, as I do, from mostly “brownfield” environments, the existance of standard work in the first place isn’t something that we can take for granted.

Nevertheless, Shook is making a critical point here. It does not matter whether there was no standard work, or whether the standard work broke down for some reason that we do not yet know (another “Why?”). This is still a process problem. We must start with a working assumption that the team member cares, and is doing the very best job possible, given the expectations, the resources, and his understanding at the time.

I am aware of a couple of cases where engineering change implementation pulled up short of actually observing the new installation and looking for unforeseen problems. One of them was quite subtle, and actually took a few weeks to find the basic cause, much less the root cause.

Another resulted in a bolt snapping during final torque. Messy to fix, but better in the factory than in the field.

These are additional cases where technical problems resulted from process breakdown, and in both cases, it was a case of unverified or blindly held assumptions, and not following through with the customer process.

Shook concludes with two really important points, and I can’t agree more. First:

…the work design must also include the “human factors” considerations that make it possible to do the job the right way, and even difficult to do it the wrong way.

I like to say “Make the right way the easy way” if you want things done in a certain manner.

Which brings us to Shook’s final point: You have to look at the total package – the human and the technical as an integrated system. You can’t separate them because. You can’t “take people out of the process.” All you can do is construct the process to give people’s minds the most opportunity to focus on improving the work rather than burdening them with making sure they get it right.

Always work to support people to do the right thing in the right way. If the organization carries a belief that it is necessary to force or “incentivize” people to do the right thing, then there is a people problem, but it isn’t with the workers.

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Evidence of a Problem

In most references describing the process of good problem solving, the first real step is to explain what actually is the problem.

It is easy to get tripped up at this stage and describe the problem in terms of the desired target, or in terms of “lack of” a specific countermeasure. That, of course, skips over the whole point of gaining a deep understanding of the situation before moving too far into intestigating causes.

I heard a great way to frame that first bit of description tonight from Richard.

“What is the evidence of a problem?”

That word, “evidence” does a much better job of conveying the point that this should be a description of the things that are observed, heard, felt, etc. rather than any kind of analysis.

In many cases a “big problem” is actually evidence of many small ones. “Too much inventory” is one of those. So is “defect rates” or any other aggregated measure. If you are running KPIs you probably know that, because they aggregate so much, they are often relatively insensitive until things are so far into the hole that it is a mess to untangle. Better to instrument your processes at much finer levels and get “evidence” in real time.

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Back to Basics

The Lean Enterprise Institute is taking up a “Back to Basics” theme.

But what, exactly, are “the basics” of the Toyota Production System?

This is critically important. Permit me to cite an analogy.

Look at a house. What do you see? What would you say are “the basics?”

At first glance, all houses have walls, a roof. They have a door. They are divided into rooms for various activities and purposes. A “basic house” is going to have an entry, a living room, a kitchen, a couple of bedrooms, a bathroom. More complex houses will have more rooms, fancier architecture, higher grades of materials, be bigger, but the basics are all there.

OK, that is a basic house.

I make this point because when people talk about the basics of “lean manufacturing” they talk about the things you can see. If I open up Learning to See, and turn to the “Green Tab” the chapter’s title is “What Makes A Value Stream Lean.” That chapter is primarily (right after the talk about waste and overproduction) a list and description of “Characteristics of a Lean Value Stream.”

  1. Produce to your takt time.
  2. Develop continuous flow wherever possible.
  3. Use supermarkets to control production where continuous flow does not extend upstream.
  4. Try to send the customer schedule to only one production process.
  5. Distribute the production of different products over time at the pacemaker process (level the production mix).
  6. Create an “initial pull” by releasing and withdrawing small, consistent increments of work at the pacemaker process. (Level the production volume).
  7. Develop the ability to make “every part every day” (then every shirt, then every hour or pallet or pitch) in fabrication processes upstream of the pacemaker process.

Now I have to say right now that I have always loved this chapter. I cannot count the number of people I have referred to “The Green Tab” as a fundamental primer. It includes all of the basics, just like our house.

In their latest book, Kaizen Express, the LEI has brought out some more detail on these same points, and added a few “rooms” to the house. One critical aspect they add is various topics that add up to quality. (It’s kind of like leaving out the kitchen or the bathroom if you don’t mention that.) They talk about zone control, line stop, and countermeasures to quality problems. (I will do a full review on this book soon.)

Then on page 99 starts four pages on Employee Involvement where they talk about practical kaizen training (PKT), and suggestion programs.

Let’s go back to our house. The things we said were “the basics” were the things you see when you look at it from the street, and go inside and walk around in it. But in an industrialized country, the modern single family residence is a miracle of accumulated knowledge and technology. The basics are the things that keep it from sinking into the ground, from catching on fire, from leaking and rotting. They are the things you can’t see, but unless you understand them, your house may look like the one next door, but it won’t perform like the one next door.

I have been in dozens of factories that had takt time, some semblance of continuous flow, pull systems, supermarkets, all of that stuff. They had run hundreds, maybe thousands, of kaizen events, and had suggestion programs. All of these things were visible just by walking around.

Yet most of them were stuck. They had reached a point when all of their energy was being expended to re-implement the things that had slid back. Three steps forward, three steps back.

They had read Ohno’s book, they knew the history of the Toyota Production System. They understood all of the engineering aspects of the system, and could install very good working examples of all of it.

But something wasn’t there, and that something is the foundation that keeps the house from sinking into the ground. It is the real basics.

Kaizen Express hints at it on pages 99 – 102, it is true employee involvement. And here is a real basic: Employee involvement is created by leader involvement. Not just top leaders, all leaders, at all levels.

To be honest, a lot of technical specialists don’t like that very much for a couple of reasons. First, engaging the leaders, at all levels, is really hard. It is a lot easier to get things done by going straight to the gemba and doing it ourselves – we show people how to do it, we “engage” them in the initial implementation, and everything is wonderful for the Friday report-out.

But I contend that the foundation of the Toyota Production System is the leadership system. It is the system of leadership that holds up all of the walls that we call takt, flow and pull. Those things, in turn, enable the leadership system to function better. The “characteristics of a lean value stream” evolved in response to the leadership system, in order to strengthen it. It is a symbiosis, an ecosystem.

“But it didn’t start out as a leadership system.” No, it did not. The history of how the Toyota Production System evolved is well documented, and the leadership system was less designed than it evolved. But let’s go back to our house analogy.

Primitive houses only have the “basics” I described above. They don’t have sophisticated foundations, some are just built on skids (if that). But because they lack the basics, most of those primitive houses don’t last.

And there is the paradox. When we say “back to the basics” we cannot only refer to the chronological history of how the system developed. We have to take the most successful, most robust example in front of us today, and we have to look at what fundamental thing holds this thing up and lets it grow more robust every day.

So let’s take a look at what Toyota teaches when they teach someone the basics.

The article Learning to Lead at Toyota was written back in 2004, but I still feels it offers a lot of un-captured insight into the contrast between what Toyota thinks are “the basics” and what most others do. I want to encourage everyone to get a copy, and not just read it, but to parse it, study it, and use it as an “ideal condition” or a benchmark. Compare your “lean manufacturing” and your leadership systems to what is described in here. Ask yourself the question:

Do we really understand the basics?

Note: There are now links to my study guides for Learning to Lead at Toyota on the Resources page.