Using DMAIC to Guide Improvement
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By Bob Yenkner
Many dental laboratories make an honest effort toward improvements, but the consistency and breadth of the improvements are simply not there. Conversations with various laboratory owners and managers about failed efforts in making improvements and, most importantly, how to make them stick seems to point to a lack of a standardized approach. However, laboratories can follow a generic (and proven) “recipe for success” that will put them on the right path for success.
DMAIC (Define, Measure, Analyze, Improve, and Control) refers to a data-driven improvement cycle used for optimizing and stabilizing business processes and designs. As John Maxwell observes, “It doesn’t matter how sound your thinking is if it is based on faulty data or assumptions.”
The Define step’s goal is to clearly define the business problem or issue that is causing your laboratory to suffer. State the problem (eg, Our remake rate is way too high). Write down what you currently know (or don’t know), and gather information/data to clarify facts to make sure you have selected a worthy opportunity for improvement. Finally, set objectives for improvement (eg, Reduce remake rate by 25% in the next 60 days). The Define step is also a good time to determine who will be working on the project and how much time they will spend on it each day.
The Measure step establishes current baselines as the basis for improvement. This is a data collection step, necessary to establish a baseline that will be compared to the measurement at the conclusion of the project to determine objectively whether significant improvement has been made. A recent project at a laboratory suffering from a loss of productivity in the CAD/CAM area required 6 weeks of each technician writing on a piece of paper how many minutes it took to scan/design/nest/mill to clearly identify what should be the baseline for each of the four steps. Once again, the improvement team decides on what should be measured and how to measure it.
The Analyze step identifies, validates, and selects root causes for elimination. Root Cause Analysis is any structured approach to identify the factors that resulted in the nature, the magnitude, the location, and the timing of the harmful outcomes of one or more past events. An excellent approach to eliminating problems is using any of the Root-Cause-Corrective-Action (RCCA) tools such as Brainstorming, 5-why, Fishbone diagram, or Failure Mode and Effect Analysis (FMEA). There are many ways to perform a Root Cause Analysis, but probably the most effective is using a small team of employees to look at the problem from different angles. The team tries to identify what behaviors, actions, inactions, or conditions need to be changed to prevent recurrence of similar harmful outcomes. Equally important is to identify the lessons to be learned to promote the achievement of better consequences. Here, the old saying “Two heads are better than one” is appropriate.
The Improve step focuses on identification, testing, and implementation of a solution (or solutions) to the problem in order to sustain improved performance. Identify creative solutions to eliminate the key root causes in order to fix and prevent process problems. Simple tools such as brainstorming will help the team identify obvious solutions, but some projects can utilize complex analysis tools such as Design of Experiments if that will help. Most improvements can be completed on a “low-cost, no-cost” basis; focus on the simplest and easiest solutions. This means that the laboratory does not need to spend significant amounts of money to make improvements. Remember, your thinking doesn’t necessarily need to be original; it just has to be solid. The other major benefit to drive sustainability is that the employees are more likely to support the improvements because they came up with the ideas, versus management simply telling them what to do.
The Control step is to be sure the new process or corrective actions remain in place and, most importantly, prevent a return to the previous process, thereby sustaining the gains. The leadership team (owner, general manager, supervisors) should monitor the improvements to ensure continued and sustainable success.
If identified actions are not working as planned, or the goals are not being met, mid-course corrections may be needed to get back to the improvement plan. The team will update documents, business processes, and training records as required to document the new process. As the new process takes root and gains acceptance, repeat the DMAIC process as part of your continuous improvement plans.
Unsuccessful improvement efforts very often are the results of poor organization and approach. Successful efforts can be achieved through the DMAIC process, which will help the laboratory follow a solid plan. By using a standardized approach, laboratoriess can follow a generic (and proven) “recipe for success” that will put them on the right path for sustainable improvement. As Tiger Woods once said, “No matter how good you get, you can always get better, and that's the exciting part.”
Bob Yenkner is the owner of Practical Process Improvements in East Hampton, Connecticut, and partners with Business Development Associates in Glastonbury, Connecticut.