Tag: Jidoka

Continuous Improvement At Le Tour

tourfrance_2013This upcoming Monday is a rest day for the riders in the Tour De France, and boy do I need it.  No, not because I’ve been logging the same number of miles on my bike in the flatlands of Wisconsin as the pros are on the mountain roads of the Pyrenees.  It’s because I’ve been watching hours and hours of coverage on breakaways, attacks, climbs and echelons – and there simply aren’t enough hours in the week to keep up with it all.

I’ll be the first to agree that the majority of people out there aren’t going to be riveted to their seats watching two hundred cyclists ride between four and six hours nearly every day for three weeks.  Even I tend to fast forward through the flat stages to get to the sprint finishes.  But I have a great admiration for the speed, stamina, distance, and effort at which they pound the pedals.  And just turning on the tv and watching the Tour probably wouldn’t have instilled a sense of awe in me either.  It really came after I read two of Lance Armstrong’s books, Every Second Counts and It’s Not About the Bike.  Within those books Lance gave detailed accounts of the inner workings of the training regimen, the strategic planning, and the teamwork necessary to compete at that level.  After understanding more about the intricacies of the sport, you begin to see more in the television coverage than simply a group of grown men out on a long and arduous ride.

This year’s tour is the 100th installment.  There are 21 stages over 23 days, and the route covers over 2100 miles.  Typically the Tour starts off with a flatter stage with no large mountain climbs, seeming to ease in to the three-week marathon.  The flatter stages tend to see a large peloton of riders approaching the finish line, resulting in a sprint to the finish where speeds reach over 40 mph.  Stage 1 in 2013 was a flat stage on the island of Corsica designed to end in a sprint.  It was a fairly uneventful ride, until the riders were around 15 minutes from the finish line, and chaos ensued as one of the team buses got stuck under the finishing line banner.

TourBusStuck1

The bus was wedged in, with its air conditioning system punctured on top.  People seemed to be wandering around trying to figure out a quick fix, but no one had an answer for this unprecedented situation.  The only thing that was clear was that if the peloton reached the finish line and the bus was there… well, it just wasn’t going to work!  Tour officials were forced to make quick decisions on how to deal with the situation.  Their first choice was to change the finish line further up the road, 3 km short of the finish.  Probably a better solution than a big crash or canceling the stage, but the teams had spent months preparing for the right sequence of events leading up to the original finish line and didn’t have a plan for how to win at a different location.

TourBusStuck2You could tell the poor bus driver felt absolutely horrible and helpless in the situation.

TourBusStuck3DriverIn the end, they were able to deflate the tires on the bus, back it out, and open up an exit on the side of the race to get the bus out of the way.  Then the race officials re-adjusted the finish line back to the original location.  As this adjustment was communicated again through the team radios, a crash ensued in the race involving several of the top sprinters, adding more chaos to the finish.  It turned out to be a much more exciting stage than anyone had expected.

So let’s do a little examination of how the bus happened to get stuck under the banner – what were the causes, were standards present and/or followed, and what kind of things can we put in place to prevent a situation like this from ever occurring again.  First off you might ask, why was the bus even driving on the course?  Well, they tend to parade buses and floats and other vehicles through the finish line before the riders reach the end.  And then you might ask, well what about all the other team buses?  Was this bus special and tall?  Why didn’t they run into it?

From what I can make out of news reports, the banner itself can raise up and down, and it usually up for the parade and down for the finish.  The Orica Greenedge bus was behind schedule, and the banner had already been lowered.  Then reports say the driver received instructions to continue moving on.  A comment from a race official stated he needed to stop and request that it be raised.  Clearly, several failures along the way contributed to the unfortunate state of affairs.

So, lean thinkers – do you blame the process or the people in this situation?  The easy road would be to say the driver was inexperienced and should have known better and it was his fault.  But I’d ask, why was the banner lowered before all the vehicles were through?  Why is the banner set lower than the height of the vehicles going through in the first place?

If I were to jump to a solution before truly understanding the cause, several potential countermeasures come to mind.  All vehicles that will pass under the banner should be measured prior to the stage and any potential problem heights should be noted and tracked through the finish line.  Or, all vehicles over a certain height are not allowed to go through the finish line.  You could even come up with a warning measurement system a few hundred yards ahead of the finish line that alerted the drivers and officials to a potential problem based on the current height of the banner.  All of these solutions, if implemented and followed, might very well prevent a similar situation from ever occurring again.

But we can do better.  All of those countermeasures add some form of complexity to the system.  Added steps of measuring vehicles, added technology near the finish line, added people to do all the extra work – each extra simply increases the opportunities for error, especially if it relies on human interaction.  Ask the question, what purpose does the banner at the end of the race serve?  It is a visual cue for sprinters so they know how close they are getting and when to begin their final attack.  It displays the time, presumably for spectators near the finish.  It has advertising for major sponsors of the race.  And I believe it holds timing system equipment and photo finish cameras on the sides.  You could deliver these functions in other ways.  Visual cues could be done with a balloon or soft hanging banner.  Times for spectators could be displayed on a screen not hanging over the finish line.  Timing system equipment and photo finish cameras can still be erected on the side of the course.

Side benefits might include one less large apparatus to erect and take down each day, one less place where mechanical or electrical maintenance is needed, or where other difficulties could occur.  Perhaps the resources used on these steps could do other value-added work instead.

Many times we consider how to counteract a problem we encountered by adding steps to stop it from occurring.  We should step back once in a while from the solution and ask the question – do we even need this in our process?  Is it still relevant, does the customer still need it?  Or can we remove the possibility of defects occurring by eliminating a step.  Can we make the whole process easier and less prone to defects by subtracting rather than adding?

I Came, I Saw, I Problem Solved… I Only Got To A Temporary Countermeasure. Do I Still Feel Worthy Of Lean?

Problem solving to root cause is an important skill to build capability in.  The “why” behind problem solving to root cause is so that you prevent problems from ever recurring again, thus eliminating potential waste from your future PDCAactivities.  Along the way you grasp the situation, take steps to contain the problem so you are still able to provide the product or service to your customers, understand potential direct causes, test the connection from cause to the problem, develop and test a countermeasure (your hypothesis towards preventing the problem from ever coming back), and put measures in place to sustain and check that the countermeasure works and is still in place.  (Yes, this is simply a description of P-D-C(S)-A with a containment step thrown in!)  It doesn’t matter if you’re talking about 4-Step, 8-Step, x-Step or DMAIC problem solving, the fundamental principles are all the same.

Most organizations that begin a lean transformation are already very good at what they think of as problem solving.  A problem comes up, I work hard to understand what caused it, I fix what caused it, and we’re up and running again.  I add it to our troubleshooting guides and therefore if it happens again we will be able to get up and running even faster because we know how to fix it!  And the veteran problem solvers will be able to tell you war stories of all-nighters where hours of investigation finally yielded something they never thought of: a motor wired backwards and turning in the wrong direction, a bit set wrong in the control logic, or an incorrect part sent and installed that looked just like another part but had different guts.  They might call it “stuff that never should have happened if someone else had done their job right in the first place”, because they are still learning what it means to focus on the process and not the people.  And how if only they’d called the expert in the first place they could have avoided all those hours of downtime because he’d recognize the symptoms and connect it to a problem he solved 5 years ago and could have told them exactly what to check and fix.

“Haven’t we worked on this problem before?” and “Didn’t we fix this last year?” are common phrases you might hear that should trigger you to wonder if you really understood the root cause of the problem the first time.  It feels like problem solving deja vu!  You honestly shouldn’t feel bad about it though, especially if you are still at the outset (read: first several years or perhaps decades depending on point or systemic problems!) of your lean journey.  Solving to root cause, so the problem never occurs again anywhere in your organization, is hard.  It can be hard to identify the root cause, hard to rollout countermeasures across groups in multiple global locations, hard to not get distracted by all the other fires you need to fight this week that seem like a much higher priority.

I recently switched cable, internet, and phone service providers from Time Warner to att uverseAT&T, for a whole host of reasons that could be turned into another post on “thinking customer”.  I’m actually very happy so far in a short period of time with what I now have from AT&T Uverse.  It’s not all ice cream and puppy dogs through the switch however, I have had a couple of internet setup issues that have been frustrating, but they’ve actually been more due to lack of knowledge and added system complexity on my end vs. something that was the service provider’s responsibility.

Yesterday I woke up to a new problem.  When I tried to open a web browser, I got an error message from my AT&T wireless router that popped up on the screen, saying “Excessive Sessions Detected.”  It explained that one of my computers had a whole lot of internet sessions going at once, and that it was likely the result of some form of a virus, or malware.  So, my head began doing problem solving.  Target = Able to access the web from all my devices.  Actual = Not able to from one PC.  Let’s continue to grasp the situation.  Check PC #2 – I get the same error.  Check IPhone – I get the same error.  Actual now equals “Not able to access web from any devices.”

Excessive Sessions Warning

Potential direct causes… 1) the error message tells me it may be a virus 2) the error message tells me I may have gaming software causing it 3) could be a problem with the router 4) a power problem or connection problem somewhere in the system 5) something is broken on AT&T’s end 6) my internet cache is full 7) just something weird that requires a restart.

Ok, so let’s try and work through the most likely causes – 2) I can eliminate this cause, don’t have any gaming software going on (sad, I know, I’m a long way from my college and single days!).  4) check to see I have power everywhere – all ok, eliminated.  1) the system error is telling me “virus” is the first place I should look.  So I run a check, and sure enough, it finds two items and eliminates them.  So as I restart my computer my mind is already jumping down the why chain to root causes like, inadequate standard for setting up my antivirus software, or inadequate process for selecting antivirus software.

Computer is restarted, and… nope, error message still pops up.  How about 7) – let’s restart the router and everything else.  Nope, error still there, can cross that one off.  Now it is about time for work, so I eat some breakfast, watch some TV, and off I go.  Midway through the day my wife tells me the TVs no longer work.  So now, new information surfaced that tells me that something in the system is degrading – the problem is getting worse!  So in my head I mapped out how the system worked and where problems could occur (see setup picture below), and couldn’t figure out what was changing to cause the new problems, because most of the TVs don’t run off the router.  Why did they work in the morning and then suddenly not work in the middle of the day?  Now I start leaning towards something on AT&T’s end as the direct cause.

ATT Setup Map

When I got home I hopped on the phone with AT&T, explained the situation and what I’d done so far, and then we went through their troubleshooting guides.  We do a reset from their end, restart computers and routers and DVRs, and the error still comes up. We cleared the internet cache and tried again.  Still have the error.  We’ve now eliminated 5) and 6), and AT&T is out of ideas on their end too.  Their only solution left is to send out a technician tomorrow, and maybe they’ll swap out a router to try and check 4) – the only direct cause we have left on the list.  This disappoints us, because we wanted to watch the new Modern Family!

As AT&T is finalizing the order for the technician, I decide to check one more thing.  On the error message there are two buttons – one says “Do Not Show” and the other says “Continue”.  I had tried “Continue” early on and didn’t get anywhere.  “Do Not Show” was labeled as something you should only click if you think the cause was gaming software 2) which we had already eliminated, and I didn’t want to ignore the error if I really had a problem or a virus.  So at this point I said what the heck and clicked “Do Not Show”.  It asked me to log in to my gateway, I did, and then it gave me a message – “The problem has been resolved.”

docmcstuffinsEureka!  We were now connected to the outside world again!  My three year old would not be without her Doc McStuffins in the morning!  We could watch Modern Family!  I could stream YouTube videos through my TV again!  I was the hero, I had “resolved the problem”!

My lean thinking was gnawing at me though.  I didn’t know what caused the problem in the first place.  I can’t recreate it.  I can’t develop any countermeasures to prevent it from happening again.  And I’m not sure the AT&T person really captured my “solution” in their knowledge database so that they try it with other customers in the future before deciding to send out a technician.  Yes, the problem is contained, and we are up and running again.  Is that good enough for this situation?  Or should I have done more?

Good organizations are very quick to recognize and contain problems, and to get up and running again to avoid customer service issues.  Great organizations have the discipline to spend time working towards truly understanding the root cause of the problem, developing adequate countermeasures, and ensuring waste never recurs.

What Can You Learn About Lean From a Garbage Can?

You can learn a lot about Lean from a garbage can.  Don’t believe me?  Well, let’s try a case study.  Here is a recycling trashcan from my office building, which has two openings for recyclables.  Someone has taped a sign over one side that instructs us to “Use this side only when right side is full”.  It is only taped on the top edge so you can flip it up very easily.  Study it, pause, don’t read ahead, take 2 minutes and extract as much about lean as you can.  Think deeply!  Then continue reading.

Recycle Garbage Can

 

 

 

 

 

 

 

 

Done?  So, here’s what I saw the first time someone pointed this can out to me.

Overprocessing waste – Someone recognized that the can capacity was overdesigned for the area.  Both sides were being used, but were not filling up by the time the cleaning crew came around to empty it.  There are two separate bins with garbage cans inside, so a crew member had to empty out two half-full, or less than half-full cans every time, even if only a few empty Coke bottles were in one of them.  It may seem small in the grand scheme of things, but take x number of cans in the building, x number of minutes to empty and replace the bags, x number of times per month… it does add up to some real time.  Cut that time in half and you have opened up whitespace for that crew member to do other value-added work, and likely cut in half the number of bags you use.

Empty Wallet Approach – When this problem was first recognized, one solution could have been to replace all the double trashcans in the building with single ones that were half the size.  But that probably would have cost someone some money.  They tried a very simple, cheap countermeasure first.

Poke a yoke – Another countermeasure could have been to put a sign up on the wall behind it, stating the guidelines, asking us to follow them.  I envision a bag of mixed results with that one.  Some people might read it and commit it to habit, but some will walk by and never even read that sign, and just throw their recyclables in either open hole.  What are you going to do then – hold a site-wide training session on the most efficient way to use a recyclable bin?  Send out a mass email with instructions that most people won’t read?  By placing a physical, visual sign over one of the holes, you are error-proofing your countermeasure by preventing someone from just tossing a bottle in the overflow side unless they were to “override” the system.

Knowledge waste – This sign was in place on all the cans I saw in our office location.  However, I happened to be walking around in another one of our buildings soon after this and saw the exact same can, but no sign on it.  And sure enough, there were bottles in each side.  Someone had developed this great countermeasure but they hadn’t shared it with others, and so their fellow employees are still dealing with the waste.  So to speak.

Did you think of some other lean concepts while studying the can?