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Trainers Training on ISO 9001:2015 Requirements,

5S Good Housekeeping and Root Cause Analysis

PROBLEM SOLVING ISO 9001:2015 QMS


CLAUSE 10.2 :

3. Evaluate

Root Cause Analysis 1. Define the


Nonconformity/
Opportunity for 2. Correction
the need to
eliminate the
causes to
avoid
4.
Implement
the action
5 Review
effectiveness
of the
corrective
6. Update
risks and
opportunities
during
7. Make
Changes
to the
Improvement needed QMS if
occurrence/ action planning necessary
recurrence

Module 5

STEP 1: DEFINE THE NONCONFORMITY/OPPORTUNITY FOR IMPROVEMENT

Problem Solving Defining Nonconformity


Understanding the Problem REQUIREMENT

Gather data to define the extent IMPLEMENTATION


of the problem
Observe the workplace REQUIREMENT FULFILLED?
Analyze data
Acknowledge/Finalize the
CONFORMITY NONCONFORMITY
problem statement

Module 5 1
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

Sources of Nonconformity
REQUIREMENTS
SOURCES

Identify NC

Module 5 2
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 1: DEFINE THE NONCONFORMITY/OPPORTUNITY FOR IMPROVEMENT

CAUSE PROBLEM
Stating A Nonconformity Factor which contributes to
the occurrence of a problem
Effect or end - result of a cause
or combination of causes
The NC or Problem needs to be properly defined Uneven distribution of P Idle workers/ overworked
workload workers
to provide a clear description of the What
(detected NC or Problem) Long queues Q Increasing customer complaints
Define problem statement clearly to:
Understand what the problem is/is not Increasing rework rate C Increasing cost of operations

Recall or understand the issue when reviewed in


Frequent computer Frequent delays in the
the future breakdown
D processing of requests
Provide focus for root cause analysis
S
Start planning effective Corrective Action Poor working conditions High accident rate

Work overload M High absenteeism rate

Parts of Nonconformity Statement


Parts of Nonconformity
Statement

Exercise:
Identify if these statements
are correctly stated

Module 5 3
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

6. Poor working condition/ environment in the frontline


Sample Nonconformity Statement services, toilet not and clients waiting in line up to the parking
1. Increasing rate of rework in the issuance of training certificates, space outside based on customer complaints last January -
from average of 2 to 5 errors in a month which is a non attainment December
of target of 0 rework 7. Delayed payment to suppliers, con tract requires within
2. Decreased client satisfaction rating on timely project delivery for 60days from processing but payment vouchers on December
the year 2016, from 3.5 to 3, which is non attainment of target 2015#20, 23, 24, 89, 99 were deliveries starting January
rating of 4 8. Poor implementation of document control, obsolete copies
3. Frequent delays in the submission of reports, committed to submit
and unsigned copies are used. The procedure states obsolete
the report to DBM before the end of the quarter, however, it is
copies are retrieved.
submitted average of 7 days after deadline
4. Increasing work backlog, project terminal reports have not been 9. Poor records management, 2013 permanent files lost and
submitted since January up to December completed projects, which project reports of 2015 not retrievable.
deviates the submission date agreed with the client 10.Frequent unavailability of service vehicle, per vehicle request
5. High rate of employee turnover, average of 5 employees resigning #6, 8, 20, 40, which was confirmed by the Transportation
per month, across all the regions, resulting to unattained manpower Reservation Unit
complement requirement

Exercise:

Each team will brainstorm


if the statement provided is
correctly written and
discuss in plenary the Sample NC Statement:
Revised QMS Manual Section 2 requires that quality objectives including
answer. those needed to meet the requirements for the delivery of the project are
established at relevant functions and levels in the organization. These are
5 mins/ Regroup measured and analyzed in a balanced scorecard i.e. DPCRs. However, the
Planning and Design Section and Human Resources Section do not have
the required DPCRs at the time of audit.

Module 5 4
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

PROBLEM SOLVING ISO 9001:2015 QMS STEP 2: CORRECTIONS

CLAUSE 10.2 : Correction


The framework is:
1. Identify the immediate
actions for the problem
3. Evaluate
and contain the issue.
1. Define the the need to
eliminate the
4.
5 Review
effectiveness
6. Update
risks and
7. Make
Changes
2. Implement the actions to
Nonconformity/ Implement
Opportunity for
Improvement
2. Correction causes to
avoid
the action
of the
corrective
opportunities
during
to the
QMS if
resolve the problem and
needed
occurrence/ action planning
recurrence
necessary
apply the additional
control points or measures

Module 5 5
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

Exercise:
Each team will brainstorm
on the possible correction
based on the previous
NC statement.
Discuss in plenary the
answer.
15 mins

PROBLEM SOLVING ISO 9001:2015 QMS


CLAUSE 10.2 :
Sample NC Statement:
Revised QMS Manual Section 2 requires that quality objectives including
those needed to meet the requirements for the delivery of the project are
established at relevant functions and levels in the organization. These are
measured and analyzed in a balanced scorecard i.e. DPCRs. However, the
Planning and Design Section and Human Resources Section do not have 3. Evaluate
the required DPCRs at the time of audit. 1. Define the the need to 5 Review 6. Update 7. Make
4.
Nonconformity/ eliminate the effectiveness risks and Changes
Implement
Opportunity for 2. Correction causes to of the opportunities to the
the action
Improvement avoid corrective during QMS if
needed
occurrence/ action planning necessary
recurrence

Module 5 6
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/


STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/ RECURRENCE
RECURRENCE
Root Cause Analysis
Evaluating the NC
Find out the
A method that is used to
1. Brainstorm for possible causes root cause of
address a problem or
2. Show relationship among causes the problem
nonconformance to get to the
3. Validate causes root cause, for it to be
4. Identify and classify root causes eliminated thus, preventing the
according to controllability problem/ nonconformance
5. Select major root causes from RECURRING.

Failure of a process, which when resolved prevents


its recurrence
Factor that contributes to the occurrence of a
problem

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/


RECURRENCE

Finding The Root Cause


This will provide the Why (cause) and possibly lead to
the How (the solution)
Finding the root-cause should:

Use a disciplined approach ( or technique)

Address the system problem

Be a team effort

Be verified

Not stop at Staff Error

Module 5 7
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/


RECURRENCE

Some Root Cause Techniques


1) Ishikawa 7) FMEA
(fish-bone or 8) Pareto analysis
cause & effect 9) Other QC Tools
diagram) Histogram, Check
2) 5 Whys Sheet, Control Chart,
3) Barrier Analysis Process Flowchart,
4) Fault tree analysis Scatter Diagram,
5) Event analysis Graphs
6) Team Oriented 10) Brainstorming
Problem Solving

Friday, May 19, 2017 DPWH TRAINERS' TRAINING PROGRAM


29

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/ STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/
RECURRENCE RECURRENCE

ISHIKAWA DIAGRAM
A schematic diagram that shows the systematic relationship
The Causes
between a problem or effect and its causes
It is a cause-and-effect diagram that can reveal key relationships Man Machine Material
among various variables and possible additional insight into
process behavior
Characteristic
(Result)
Factor Factor

Method Environment Effect


Characteristic
Large Small
Remedial
BACKBONE (Result)
bone bone Tiny Cause Actions/ Correction
bone
Factor Medium Effect
Factor bone Corrective/
Actions

Cause

Module 5 8
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/


Categories of Causes RECURRENCE

Causes arising out of the actions


ISHIKAWA Diagram and 5 WHYs
Manpower SOPs are not followed
or performance of person
5 Whys - a question-asking method to determine
cause and effect relationship in particular problem
Causes arising out of the systems
Method Too many signatories
or procedures in doing the work
SLIPPERY and
UNSAFE FLOOR
Causes arising out of the items Shortage of internet
Material
needed to deliver the service facilities 2
Machine is leaking
3
Oil coupling is leaking
Causes arising out of the eqpt. Frequent breakdown
Machine
used to deliver the service of computer 1 4 Rubber lining inside oil
coupling is worn out
Oil on Floor
5
Causes arising out of the condition Lay-out, room Stock of rubber
Environment
in which the work is carried out temperature, facilities lining ran out

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/ STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/
RECURRENCE RECURRENCE

The 5 WHYs Technique How to Do Root Cause Analysis


Frequent delays in
1. Write the effect on the right-most part
the submission of and connect it into the spine.
reports

2 Frequent computer breakdown

3
No regular maintenance

4 Increasing Customer
1 No preventive maintenance
schedule Complaints on Long
Machine/ Waiting Time
Equipment 5 No office is in-charge of
computer maintenance

Module 5 9
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/


RECURRENCE 3. Identify the causes under each major cause
or group of causes by asking why at most
2. Identify the major causes or groups of
five times. Write each cause into the
causes. Write them into the large bones.
middle & small bones.

Man Machine Material

Increasing Customer
Complaints on Long
Waiting Time

Method Environment

4. Determine controllable and uncontrollable 5. Verify the root cause


root causes. SAMPLE
Analysis- The poor communication with the client on the timelines and too much
workload of the personnel are two of the leading and fixable/controllable root causes
by the Project Management Section.
Material Equipment

Slow processing of computers Material Equipment


Shortage of forms
Computer virus
Forms not provided on
No computer Jan February Frequent breakdown
maintenance Increasing Photocopier
Customer breakdown overuse
Complaints on No maintenance
Ineffective frontline
staff SOPs not followed Long Waiting Time Decreased client
Long cycle processing staff always busy Survey
Varied interpretation of rule coordinating inconsistent satisfaction
Too much workload Too many Contracts not followed
Proper orientation not provided rating on timely
signatories Varied interpretation of rule
Too much workload No SOP project delivery
Poor planning Proper meeting not done
for the year 2016,
Poor client communication from 3.5 to 3-
Manpower Method
Manpower Method

Module 5 10
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

MAN

1. Project Engineers are not aware


Exercise:
of DO 216, s2000 MATERIAL
2. Project Engineers are not aware
of DO 73, s1998
Each team will brainstorm on
3. PEs are not properly filling-up the

4.
project logbook due to
voluminous projects handled
Implementing chief does not
the possible root cause using
have ample time to monitor all
the projects
Non-
maintena
nce of
fishbone technique. Use the
logbook
ENVIRONMENT on site
during
project
previous NC statement.
1. Unable to update
logbook due to
inaccessibility of site
1.
2.
DOs are not implemented
DOs are not properly
disseminated
impleme
ntation
Discuss in plenary the answer.
2. Road/weather condition, 3. Issuances relative to
and peace and order are project implementation
not manageable are not being
discussed/tackled during
consultation meetings
4. Issuances are being
15 mins
MACHINE ignored how important
they are to project
METHODimplementation

STEP 3: EVALUATE THE NEED TO ELIMINATE THE CAUSES TO AVOID OCCURRENCE/ RECURRENCE
MAN

Revised QMS Manual


MATERIAL Section 2 requires that Sample NC Statement:
quality objectives
Revised QMS Manual Section 2 requires that quality objectives including
including those needed
to meet the those needed to meet the requirements for the delivery of the project are
requirements for the established at relevant functions and levels in the organization. These are
delivery of the project measured and analyzed in a balanced scorecard i.e. DPCRs. However, the
are established at
Planning and Design Section and Human Resources Section do not have
relevant functions and
levels in the the required DPCRs at the time of audit.
ENVIRONMENT organization. These are
measured and analyzed
in a balanced scorecard
i.e. DPCRs. However,
the Planning and
Design Section and
Human Resources
Section do not have the
required DPCRs at the
time of audit.
MACHINE
METHOD

Module 5 11
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 4: IMPLEMENT ACTION NEEDED

Problem solving: ISO 9001:2015 QMS


Clause 10.2 Corrective Action
Containment after 5-Why should
include:
4. Assign responsibility to register the CAR
3. Evaluate
the need to 5 Review 6. Update 7. Make
1. Define the
eliminate the Implement effectiveness risks and Changes
Nonconformity/
Opportunity for
2.
Correction
causes to
avoid the action
of the
corrective
opportunities
during
to the
QMS if and track the status.
Request for immediate actions from
Improvement occurrence/ action planning necessary
recurrence needed
concerned people.
Clear timelines are defined for each
action specified.

STEP 4: IMPLEMENT ACTION NEEDED STEP 4: IMPLEMENT ACTION NEEDED

Corrective Action Corrective Action


Tools and Techniques Tools and Techniques
4Ws & 1H TOOL / GUIDELINE 5 WHYs 4Ws & 1H TOOL / GUIDELINE 5 WHYs
Be specific 1. WHY did you
1. WHAT is Exhaust all possible select this solution? 3. WHEN is the Timetable (GANTT Chart)
3. WHY this schedule?
Activities with dates from start
the solution? solutions. Dont be drastic 2. WHY not another solution to be WHY not make it sooner
to finish or later?
As much as possible, avoid solution? implemented? Cost - benefit - analysis
solutions which require 3. WILL this solve
capital investment the problem? GANTT Chart - Person 4. WHY this person/s? Is he
4. WHO is / are they capable of
responsible
1. WHY this area? responsible? carrying out the solution?
2. WHERE is
Specific areas for 2. WHAT about
the solution to improvement other areas?
5. HOW is the GANTT Chart - Activities 5. WHY these activities?
be applied? Cost - benefit - analysis WHY not less costly
solution to be
activities with more
implemented? benefits?

Module 5 12
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

Gantt Chart
Controllable Solution/ Target Date Resource
Completion Responsible
Root-cause Activity Start Needs

ACTIVITIES
WEEK
1 2 3 4 5 6 7 8 9 1 1 1
0 1 2
1. Draw up current process
2. Remove non-value adding
operations
3. Determine preliminary improvement

4. Determine resource requirements

5. Make a skills inventory


6. Formalize responsibility matrix
7. Implement training plan
8. Update skills inventory
9. Pilot Test
10. Determine Results (positive/
negative)
11. Standardize

Module 5 13
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

SAMPLE Sample NC Statement:


RCA- The poor communication with CORRECTIVE ACTION: Revised QMS Manual Section 2 requires that quality objectives including
the client on the timelines and too Revise the Procedure. those needed to meet the requirements for the delivery of the project are
Provide a system for established at relevant functions and levels in the organization. These are
much workload of the personnel are tracking the workload. measured and analyzed in a balanced scorecard i.e. DPCRs. However, the
two of the leading and Provide forms for Planning and Design Section and Human Resources Section do not have
fixable/controllable root causes by the monitoring. the required DPCRs at the time of audit.
Project Management Section. Communicate the
changes in the
procedure.
Train the concerned
groups or personnel
regarding the changes
or revisions.

PROBLEM SOLVING
Exercise: ISO 9001:2015 QMS
Each team will brainstorm on CLAUSE 10.2 :
the corrective action based on
the root cause. Use the 1. Define the
3. Evaluate
the need to 4.
5. Review 6. Update
7. Make
Nonconformity eliminate effectiveness risks and
previous NC statement. /Opportunity
for
Improvement
2.
Correction
the causes
to avoid
occurrence/
Implement
the action
needed
of the
corrective
opportunities
during
Changes to
the QMS if
necessary

action planning
Discuss in plenary the answer. recurrence

15 mins

Module 5 14
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 5. Review effectiveness of the corrective action

Verifying Effectiveness of Actions


Often confused with verification of
implementation. Refers to Completion of
corrective action tasks.
Monitor and measure the process to
verify the effectiveness of the actions
taken.
Poor results often indicate wrong Root
Cause or wrong Corrective Action(s).
Consider performing audits as a
verification tool.

RISK REGISTRY
PROBLEM SOLVING
ISO 9001:2015 QMS
CLAUSE 10.2 :

3. Evaluate
1. Define the the need to 5 Review
6. Update risks
Nonconformit 4. and 7. Make
eliminate effectiveness Changes to
y/Opportunity 2. Implement
Correction
the causes
the action
of the opportunities the QMS if
for to avoid corrective necessary
Improvement needed during
occurrence/ action
recurrence planning

Module 5 15
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

STEP 7. Make Changes to the QMS if necessary


Opportunity Register- Opportunities are managed to improve
their likelihood and benefit.
Planning for Changes in the QMS
Clause 6.3 Planning of Changes
Consider:
purpose of the changes and their potential
consequences;
integrity of the QMS;
availability of resources; and,
allocation or reallocation of responsibilities
and authorities
Changes to the QMS shall be carried out in a
planned manner

WORKSHOP: RCA
Maintain the 3-4 teams created
To be familiar with the application of RCA use the
CONTINUAL
sample NCs .
IMPROVEMENT Identify correction, and apply root cause analysis and
identify corrective action
Use the CAR in documenting the NC, until corrective
action
Use the CAR form for the presentation

Module 5 16
Trainers Training on ISO 9001:2015 Requirements,
5S Good Housekeeping and Root Cause Analysis

Workshop : Using the CAR


DPWH CAR#Sample 01-
QMS Manual, Section 6.7.2e Disposition of records is in
accordance with the latest Records Disposition Records
Disposition Schedule (RDS) of the Department as approved by
the National Archives of the Philippines. However, the
Regional Office does not have a records disposition schedule.

DPWH CAR#Sample02-
As per DO#156, s. 2016 Annex K Implementation of the DoTS
for civil works, requires that the implementing unit shall
submit one set of certified true copy of all supporting
documents for accounting copy. However, there was no
evidence that the IO submitted one set of certified true copy
of all supporting documents for accounting copy with regards
Team Members
to all billings.

Workshop : Root-Cause Analysis

MAN MATERIAL

ENVIRONMENT ? THANK YOU!


Questions?

MACHINE Lets have an exam


METHOD

Team Members

Module 5 17