Michigan Quality System

Michigan Medicine Home

Home |Mission|Improvement Work|Resources|About Us|FAQs

Reports & Whitepapers


Internal Resources Internal to Michigan Medicine employees only


A one page report for problem solving, proposals, plans and status reviews. Named for paper size (slightly larger than 11"x17"). Creating an A3 focuses a team or person to think in a structured way about a problem. A3 usually contains these parts: title, background (why this is a problem), current state (facts about the current state, gaps, quality problems), goals, analysis (the root causes of the problem), recommendations (countermeasures to address the root causes), plans (who will take what steps when to implement the recommendations), and follow-up plans. The A3 is visual, concise, and tells a story.

andon board
A visual control device in a production area, typically a lighted overhead display, giving the current status of the "production system and alerting team members to emerging problems.

andon cord
A cord or mechanism allowing a worker to signal that a defect is suspected or observed, and assistance is needed.

Transferring human intelligence to automated machinery so machines are able to detect the production of a single defective part and immediately stop themselves while asking for help. This concept, also known as jidoka, was pioneered by Sakichi Toyoda at the turn of the twentieth century when he invented automatic looms that stopped instantly when any thread broke. This permitted one operator to oversee many machines with no risk of producing vast amounts of defective cloth.

The mass-production practice of making large lots of a part and then sending the batch to wait in the queue before the next operation in the production process. Contrast with single-piece flow.

An established design or production facility operating with mass-production methods and systems of social organization. Contrast with greenfield.

The layout of machines of different types performing different operations in a tight sequence, typically in a U-shape, to permit single-piece flow and flexible deployment of human effort by means of multi-machine working. Contrast with process villages.

The installation of a new type of tool in a metal working machine, a different paint in a painting system, a new plastic resin and a new mold in an injection molding machine, new software in a computer and so on. The term applies whenever a production device is assigned to perform a different operation.

cycle time
The time required to complete one cycle of an operation. If cycle time for every operation in a complete process can be reduced to equal takt time products can be made in single-piece flow.

error proofing, mistake-proofing
See poka-yoke

five S's
Five terms beginning with S utilized to create a workplace suited for visual control and lean production (Sort, Shine, Set in Order, Standardize, and Sustain).

five whys
The practice of asking "why" five times whenever a problem is encountered, in order to identify the root cause(s) of the problem so that effective countermeasures can be developed and implemented.

The progressive achievement of tasks along the value stream so that a product proceeds from design to launch, order to delivery, and raw materials into hands of the customer with no stoppages, scrap, or backflows. "Singe-piece flow" is the lean ideal.

Term meaning "the real place" where value-adding work is performed. In healthcare, this would include inpatient units, ambulatory care clinics, emergency departments, operating rooms, etc. Also spelled genba.

A new design or production facility where best-practice, lean methods can be put in place from outset. Contrast with brownfield.

The creation of a "level schedule" by sequencing orders in a repetitive pattern and smoothing the day-to-day variations in total orders to correspond to longer-term demand. Also used to describe "leveling" the workload of workers in a system.

hoshin kanri
See Policy Deployment.

See autonomation.

A system for producing and delivering the right items at the right time in the right amounts. Just-in-Time (JIT) approaches just-on-time when upstream activities occur minutes or seconds before downstream activities, so single-piece flow is possible. The key elements of Just-in-Time are flow, pull, standard work(with standard in-process inventories, and takt time.

Transformational (vs. incremental) change of a system.

Continuous, incremental improvement of an activity, process or value stream to create more value with less muda.

Card or ticket used as a visual signal to trigger or control the flow of materials.

lead time
The total time a customer must wait to receive a product after placing an order. When a scheduling and production system are running at or below capacity, lead time and throughput time are the same. When demand exceeds the capacity of a system, there is additional waiting time before the start of scheduling and production, and lead time excees throughtput time. See throughput time.

Any design, scheduling, or production technology with scale requirements necessitating that designs, order, and products be brought to the machine to wait in a queue for processing. Contrast with right-sized tool.

Any activity that consumes resources but creates no value. Synonymous with non-value-added. See waste.

Variability or unevenness in demand.

Overburden or unreasonable expectations of a worker or machine.

An activity or activities performed on a product by a single machine. Contrast with process.

PDCA (also PDSA)
Plan-Do-Check-Act (or Plan-Do-Study-Adjust). Cycles of continuous quality improvement, analogous to the scientific method. (Originally developed and called the Shewhart cycle, subsequently popularized by W. Edwards Deming.)
Plan: Develop an Action Plan
Do: Implement Countermeasures
Check (or Study): Verify Results
Act (or Adjust): Identify Future Actions
The complete elimination of waste, or muda, so that all activities along a value stream create value.

A mistake-proofing device or procedure to signal errors or to prevent errors from occurring.

Policy Deployment (hoshin kanri)
A holistic management philosophy throughout the company that stresses long term improvement and success over short term gains. It aligns a company's functions and activities with its strategic objectives. It contains a detailed plan of action which ties together objectives, projects, and improvement targets.

A series of individual operations required to create a design, completed order, or product.

processing time
The time a product is actually being worked on in design or production and the time an order is actually being processed. Typically, processing time is a small fraction of throughput time and lead time.

process villages
The practice of grouping machines or activities by type of operation performed; for example, grinding machines or order-entry. Contrast with cells.

product family
A range of related products that can be produced interchangeably in a production cell. The term is often analogous to "platforms."

A system of cascading production and delivery instructions from downstream to upstream activities in which nothing is produced by the upstream supplier until the downstream customer signals a need. The opposite of push. See also kanban.

queue time
The time a product spends in a line awaiting the next design, order-processing, or fabrication step.

right-sized tool
A design, scheduling, or production device that can be fitted directly into the flow of products within a product family so that production no longer requires unnecessary transport and waiting. Contrast with monument.

Term derived from martial arts meaning "master". A personal teacher or mentor with deep mastery of a body of knowledge.

single-piece flow
A situation in which products proceed, one complete product at a time, through various operations in design, order-taking, and production, without interruptions, backflows, or scrap. Contrast with batch-and-queue.

Suppliers, inputs, processes, outputs, and customers; an acronym used in determining the scope of a lean project and identifying who should be involved.

spaghetti chart
A map of the path taken by a specific product as it travels down the value stream in a mass-production environment, or the path of an employee performing their work. So-called because the route typically looks like a plate of spaghetti.

standard work
A precise description of each work activity specifying cycle time, takt time, the work sequence of specific tasks, and the minimum inventory of parts on hand needed to conduct the activity. Documents the current "best way" of doing the work.

takt time
The available production time divided by the rate of customer demand. For example, if customers demand 240 widgets per day and the factory operates 480 minutes per day, takt time is two minutes; if customers want two new products designed per month, takt time is two weeks. Takt time sets the pace of production to match the rate of customer demand and becomes the heartbeat of the any lean system.

target cost
The development and production cost which a product cannot exceed if the customer is to be satisfied with the value of the product while the manufacturer obtains an acceptable return on its investment.

throughput time
The time required for a product to proceed from concept to launch, order to delivery, or raw materials into the hands of the customer. This includes both processing and queue time. Contrast with processing time and lead time.

Total Productive Maintenance (TPM)
A series of methods to ensure that every machine in a production process is always able to perform its required tasks so the production is never interrupted.

turn-back analysis
Examination of the flow of product through a set of production operations to see how often it is sent backwards for rework or scrap.

A capability provided to a customer at the right time at an appropriate price, as defined in each case by the customer.

value stream
The specific activities required to design, order, and provide a specific product, from concept to launch, order to delivery, and raw materials into the hands of the customer.

value stream mapping
Identification and diagramming of all the specific activities occurring along a value stream for a product or product family.

visual control
The placement in plain view of all tools, parts, production activities, and indicators of production system performance, so the status of the system can be understood at a glance by everyone involved.

waste (seven types)
Lean thinkers traditionally classify waste into seven types: overproduction or working ahead of demand; waiting for the next processing step, unnecessary transport of materials (for example, between process villages or facilities), overprocessing of parts due to poor tool and product design, inventories more than the absolute minimum, unnecessary movement by employees during the course of their work (looking for parts, tools, prints, help, etc.), and production of defects. Waste of human talent is often considered an eighth form of waste.


U-M Medical School
| Hospitals & Health Centers | U-M | TEXT-ONLY

University of Michigan Health System
1500 E. Medical Center Drive  Ann Arbor, MI 48109   734-936-4000
(c) copyright Regents of the University of Michigan
Template developed & maintained by: Public Relations & Marketing Communications
Contact UMHS

The University of Michigan Health System web site does not provide specific medical advice and does not endorse any medical or professional service obtained through information provided on this site or any links to this site.
Complete disclaimer and Privacy Statement