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Application of VSM for Improving the Medical Processes - Case Study

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• Katarzyna Antosz   ORCID: orcid.org/0000-0001-6048-5220 20 ,
• Aleksandra Augustyn 20 &
• Małgorzata Jasiulewicz – Kaczmarek   ORCID: orcid.org/0000-0002-8332-3192 21  

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Lean Manufacturing has been used in many types of organizations, including healthcare. In the healthcare area, lean healthcare is a management philosophy to develop a hospital culture characterized by increased patient, and other stakeholder, satisfaction through continuous improvements. The starting point for improving activities in the healthcare is identification of the problems and wastes in the processes. In this context VSM is a helpful tool. That why the purpose of this paper is to present the possibility of application the VSM for improving the selected process in the healthcare. Thanks to the application of this method, the necessary information on the sources of losses in the analyzed process was obtained.

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Antosz, K., Augustyn, A., Kaczmarek, M.J.–. (2021). Application of VSM for Improving the Medical Processes - Case Study. In: Dolgui, A., Bernard, A., Lemoine, D., von Cieminski, G., Romero, D. (eds) Advances in Production Management Systems. Artificial Intelligence for Sustainable and Resilient Production Systems. APMS 2021. IFIP Advances in Information and Communication Technology, vol 631. Springer, Cham. https://doi.org/10.1007/978-3-030-85902-2_44

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Value Stream Mapping: A Case Study of Automotive Industry

2014, International Journal of Research in Engineering and Technology

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Bus body manufacturing play a key role in automotive manufacturing, as vehicle manufacturers often sub contract such enterprise to complete bus manufacturing process. In a fiercely competitive global environment, the bus body manufacturing enterprises are constantly looking for ways of meet their customer requirements of delivery on time, cost and quality in order for them to survive. However, bus body manufacturing enterprises barely meet the customer demands in terms of delivering on time due to long cycle times on the production floor due to low labour utilization, material wastage and unorganized work flows. In this research, we critically looked at improving productivity such enterprises by considering a case study of one of the leading bus body manufacturing enterprises in Kenya. Value Stream Mapping was used as the main productivity improvement tool supported by line balancing techniques. The results from the improved value stream map indicated an increase in efficiency of 13.1% and a reduction the cycle time by 7 days, demonstrating the potential of these tools for improving productivity in bus body manufacturing.

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Case Study VSM – Value Stream Mapping: ACME Troqueladora

The example that follows was excerpted from the book Learning to See (M. Rother. & J. Shook.1999) powered by The Lean Organization. Is the company “troqueladora ACME”.

INFORMATION ON STAMPING ACME.

ACME Troqueladora company produces various components for vehicle assembly parts. This case concerns a single product family: A sub-assembly “brackets” steel into two types: a left assembly (L) and a right (R) for the same car model. These components are sent to the client.

– Production processes: For this product family component manufacturing involve punching a metal part followed by a welding process and subsequent assembly. The components are stored and then shipped to the assembly plant vegetables on a daily basis. The entire process occurs in the following order and each piece goes through all the processes:

1. Die cut or cut:

• Automated 200-ton press is fed automatically. • Cycle Time (T / C): 1 second (60 pieces per minute) • Model Change Time: 1 hour (piece by piece) • Holding time: 85% • Inventory observed: – 4600 pieces of “L” stamped – 2400 pieces of type “R” stamped

2. Welding 1:

• Manual process with an operator • Cycle Time (T / C): 39 seconds • Time of Change model (T / M): 10 minutes • Holding time: 100% • Inventory observed: – 1100 pieces of “L” – 600 pieces of type “R”

3. Welding 2:

• Manual process with an operator • Cycle Time (T / C): 46 seconds • Time of Change model (T / M): 10 minutes • Uptime: 80% • Observed Inventory: – 1600 pieces of “L” – 850 pieces of type “R”

4. Assemble 1:

• Manual process with an operator • Cycle Time (T / C): 62 seconds • Time of Change model (T / M): None • Uptime: 100% • Observed Inventory: – 1600 pieces of “L” – 850 pieces of type “R”

5. Assemble 2:

• Manual process with an operator • Cycle Time (T / C): 40 seconds • Time of Change model (T / M): None • Uptime: 100% • finished goods inventory observed: – 2700 pieces of “L” – 1440 pieces of type “R”

– Department offices: Remove the finished goods to the warehouse, stores for the next shipment by truck to the customer.

– Customer Requirements:

• 18400 pieces per month. • 12,000 per month “L”. • 6400 per month Type “R”. • A daily shipping by truck assembly plant. • Packaging with 20 “brackets” on a tray and up to 10 trays per pallet.

– Working time:

• 20 days per month • 2 shifts operation in all production departments • 8 hours each shift, with overtime if necessary • 2 breaks of 10 minutes per shift

Then we began the development of such developing each of the generic phases referred to in paragraph deployment.

STEP 1 – Identify the product family: For the situation in question, it is clear that ACME had already defined by some criteria product families, and identified those on which you want to deploy the tool ( “brackets steel “). It is common that this situation occurs in most companies, that have been identified beforehand their families for marketing and marketing processes. The work of the responsible for the implementation of the tool will recognize whether the grouping criterion is appropriate for the purposes of VSM, and distinguish that family with greater business impact. Another available information concerning customer requirements and frequency.

The example given is more oriented to elucidate about the subsequent steps.

STAGE 2 – Diagram of the current state: Let’s detail the concrete steps in the development of this stage:

1. Draw icons customer, supplier and production control. They should draw all providers, only one or two, the main raw materials involved in the flow.

2. Enter customer requirements per month and per day in the box corresponding data.

3. Calculate daily production and container requirements.

4. Draw the icon leaves shipment to the customer and truck delivery frequency.

5. Draw the icon entering receipt, truck and delivery frequency.

6. Add the boxes of processes in sequence from left to right. is not taken into account how they are physically located the processes in the plant layout, only the order of the sequence.

7. Add boxes below each process data and the timeline under the boxes. The following figure shows the state of the VSM after application of steps 1-7 for the case of the family of products of the company ACME.

Figure. VSM current state ACME product family (steps 1 to 7).

8. Add the arrows and annotate communication methods and frequencies.

9. Get data processes and add them to the data boxes. Get them directly timing them.

vms_actual_vacio

– Cycle Time (T / C): Time it takes for a unit or part of exiting a process or operation.

– Assembly time or change (T / M): The time it takes to switch from one product type to another type of product.

– Operators: Number of people needed to operate the process.

– Working Time available Time available per shift in the process in seconds. This time is the total time fewer breaks, meeting times, cleaning times.

– Lot Size produce, in English acronym is EPE (every part every) which means “Every part every …” (Number of units or time). For example, if the process changes the type of product A to product type B 5,000 pieces EPE: 5,000. It can also be expressed in time.

– Time Occupation: The percentage of time the machine is busy in demand, for example if the machine in a 24-hour day is busy working 18 hours, your occupation will be 75%.

10. Add the symbols and the number of operators.

11. Add the arrows push / pull, and first in first out and add the inventory information: While walking through the plant points should be observed where inventory processes accumulates, these points are important because they draw on the map It says where the flow is slowing, the icon of inventories is the triangle. If inventory accumulates between two processes in more than one physical location we must draw 2 triangles.

12. Add the value-added work hours and delivery times in the timeline.

13. Calculate the cycle time total value added and total processing time. In the particular case of the family of products of the company ACME the result is presented by the following figure following the implementation of the steps 8-13.

Figure. VSM current state of the current product family ACME (steps 8-13) .vsm_acme2 actualvsm_acme2

It should be noted how is calculated the Lead Time (LT), not to be confused with the time of processing or value-added (VA). The lead time is the time from a production process is started until it is completed, and is calculated through inventory days to be had in each process when making the information is the best estimate to determine how long it takes a part or product to be produced and shipped to the customer.

The number of days of inventory for each process or workplace is the result of dividing the inventory level for daily consumption or customer requirement.

For ACME for example, to the punching process (cutting) must 4600 left brackets and 2400 rights brackets, if we divide these inventories by 600 brackets the customer requires daily, then 4600 units / 600 units-day: 7.6 days and 2400 units / 600 units-days: 4 days. In this case we use as long as 7.6 days. Same operation is performed for each inventory.

The observed results for ACME is surprising: The company needs to produce a piece 188 seconds, while that same piece takes 23.6 days to leave the plant to the customer.

STEP 3 – Diagram of the future state: Conceiving the future state VSM requires identifying opportunities for improvement in the current VSM, and raise the ideal situation that they have been used to reduce waste.

This is to minimize if not completely eliminate the “black spots” where the flow is observed in the current VSM is interrupted.

The fundamental idea is to try to arrange in a single stream all operations or processes that we reasonably can include in without interruptions occur, separating into streams or different loops incompatibilities to be in a single stream (Cuatrecasas, 2010). Thus minimizing the number of points where material accumulates in the process and waiting times to increase the lead time are generated.

The first necessary step is to calculate the Takt time:

1. What is the Takt time ?: Takt time calculation begins with the calculation of working time available between customer requirements in turn.

Tatk time =                              time available in a turn                         

customer requirements in a turn

Time available = 28800 – 1200 = 27600 seconds per shift

In the example of the company ACME 8-hour shifts so the total time shift is 28800 seconds work. Total time needed to play down the free or dead time, which is 20 minutes per shift or 1200 seconds (breaks). The client requires 460 units per shift (18400 pcs / 20 days / 2 shifts). So: Takt time resulting means to meet customer demands in the working time available, it needs to produce one piece every 60 seconds for the product family. Should try to make the process time cycle Pacemaker (pacemaker) is less than or as close as possible to the time Takt: Produce respect thereto is one of the main guidelines for developing a future VSM.

From this moment, for example troqueladora ACME and for any case study to consider the basic approach to the future state VSM issues are:

2. Where can I use a continuous flow processing? This is one of the most important issues to resolve. The graph of cycle times vs Takt time comparing cycle times of each process (workplace) against time Takt is a useful tool.

The following figure shows the situation in the case of the ACME troqueladora:

acme_chart1axcme_grafico Figure. Cycle times vs Takt Time

The Assembly 1 activity is what is called a “bottleneck” and should focus efforts on finding a solution that enables the reduction of T / C. However, the decision to group processes or workplaces to form a continuous flow cell depends, as previously mentioned, a reasonable criterion may be the same as the similarity between the cycle times.

We will assume that the assembly and welding processes are grouped to form a single loop can be considered feasible, ie the creation of a regular and uninterrupted flow comprising all the tasks in it is a task that can be tackled.

You must then balance the number of operators required for the cell by adding the cycle time of each process in the same (time content in the cell) between takt time so that all activities of assembly and welding can run in a continuous flow Takt time: (39 + 46 + 62 + 20) = 187/60 = 3.12 operators are necessary. Which suggests the need for a fourth worker as a possible alternative.

It is for cutting or punching as an independent operation (work center with a single operator), and welding and assembly cone a loop with 3 operators.

3. provisioning of finished goods supermarket or customer type is sent by order be created?

In the case of the ACME only two varieties troqueladora finished product R and L. If one has the option should begin creating a supermarket and subsequently finished parts when the required defined increments will be constant and may produce for regular send directly.

In ACME can forecast customer requirements used to determine the necessary production capacity in a next period. The company wants to know the current production using the Kanban method and send information to processes previous welding / assembly from supermarket finished pieces. Since the customer buys multiples of 20 trays of product, this is the size chosen for the “kanban size”.

4. Where you need to use a shelving supermarket in order to control the production of the above processes upstream departing from the provider?

In the case of ACME you will need to use a supermarket before shipment to control the flow of production: whenever material of this supermarket is removed will be sent kanban process welding / assembly for the manufacture of such material as has already been sent to the client.

The figure below illustrates the situation.

figure VSM_acme

Figure. Supermarket shelf with type operation before shipment.

3.5 What specific point in the production chain, production will be scheduled?

The pacemaker process (pacemaker) is the point from which are linked in programming processes foregoing, in the example the set point is welding / assembly. It is convenient to think of something beyond schedule upstream because it plans to introduce a system with operational pull between cutting and welding / assembly. This programming point regulates the value chain.

A complete and detailed set of questions can be proposed for the future VSM approach in any situation; but the main tasks always have to be:

a) Recognize operations or processes that can meet in continuous flow. b) Recognize what will be the pacemaker process (pacemaker) that will allow the production schedule. c) To decide the mechanisms to be implemented to achieve operational self-pull type of lean management (supermarkets, FIFO, Kanban cards, …).

The following figure shows the future VSM product family for the ACME troqueladora studied.

Figure. Future State VSM product for family ACME

The results are evident: each piece now takes 4.5 days to leave the plant to the customer, and even the processing time has been reduced. Waste have been removed.

4. STAGE 4 – Implementation of the future state: Once the future VSM conceived the next step is to devise an action plan for its implementation. As mentioned elsewhere, an appropriate way to proceed is through the implementation circuits.

1. What improvements would you be necessary for the flow of the value chain approach to design future state? In the case of ACME they devised the following improvements:

– Reduction of time changes with SMED and reduced lot size for printing, issuing a faster response to the value chain.

– Elimination of the long time required for switching between parts L and R, to make possible continuous flow.

– Improving the effectiveness of the second welding machine, it can now be together with another process in continuous flow.

– Elimination of waste in the welding station / assembly to reduce the total work of 168 seconds or less. (Which allows operators to use 3 to level the current demand).

Circuit 1: Circuit pacemaker process (welding / assembly).

Objectives: – Develop continuous flow from welding to assembly – Elements of Kaizen work to reduce total cycle time to 168 seconds – Remove the tool change time (SMED). – Improve the effectiveness of the welding machine 2 – Develop a pull-type system with a supermarket of finished parts. – Develop material handling routes between supermarkets and stations Goals: – Having only 2 days of inventory in the supermarket of finished parts – Not having inventory between workstations – Operate the station with 3 people

Circuit 2: Circuit stamping or cutting.

Objectives: – Establish pull system with a supermarket cut parts. – Reduce the batch size to 300 pieces and 160 left right pieces. – Reduce changeover time to less than 10 minutes.

Goals: – Have only 1.5 days of inventory in the supermarket of finished product. – Batch Size 300 and 160 pieces between changes.

Circuit 3: Circuit provider.

Objectives: – Develop a system to pull a supermarket of steel coils. – Enter daily deliveries of rolls.

Goals: – Have only 1.5 days of inventory in the supermarket rolls.

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