Countermeasure

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KAIZEN Step 4:

“Identification of
countermeasure”
KAIZEN Training of Trainers
2015

KAIZEN Facilitators’ Guide


Page __ to __ .
Objectives of the session
At the end of the session, trainees are able
to:
1.Define necessity of a countermeasure
2.Describe how to identify countermeasures by
using useful QC tool
3.Describe how to check feasibilities of the
countermeasures by using useful QC tool
4.Demonstrate the process of identification of
countermeasure at the working environment
1
KAIZEN STEP

Process 7 Standardization

STEP
Check effectiveness of
6 countermeasure
STEP
5 Implementation of countermeasure

STEP Identification of
4 countermeasure
STEP
3 Root Cause Analysis

STEP
2 Situation Analysis

STEP
1 Selection of KAIZEN theme
2
KAIZEN Step 3 and Step 4

Find out root Find out Identify realistic


causes of the countermeasur countermeasures in
contributing es to solve our working
factor(s) the root causes situation/condition
QC tool: Tree diagram QC tool: Matrix diagram

KAIZEN Step 3 KAIZEN Step 4 3


Outline of how to make
Tree Diagram
1. Put all the identified root causes in Step 3 on left
end
2. Brainstorm countermeasures with team
members against identified each root cause
– 1st line countermeasure
• Clarify ideal situation towards root cause
• Connect the line with each route cause systematically
– 2nd line countermeasure
• Discuss detailed activities to realize the 1st line
countermeasure(s)
– If identified countermeasures are not clear, we can
break them to 3rd line countermeasures
4
Primary countermeasures
Root causes (1st line countermeasures)

Primary
countermeasures for
Root Cause 1 (a)
Root cause 1
Primary
countermeasures for
Route C cause 1 (b)
More than one primary
countermeasure can be
Primary
come up with for one
countermeasures for root cause
Root Cause 2 (a)
Root cause 2
Primary
countermeasures for
Route Cause 2 (b)

Primary
Root cause 3 countermeasures for
Root Cause 3 (a)

5
Primary (1st line) Secondary (2nd line)
Root causes countermeasures countermeasures

Primary
Root cause Secondary countermeasure (a)
countermeasures for
1 Root cause 1 (a)
for primary countermeasure(a)

Secondary countermeasure (b)


for primary countermeasure(a)

Primary
Secondary countermeasure (a)
countermeasures for
for primary countermeasure(b)
Root cause 1 (b)

Primary
Root cause countermeasures for Secondary countermeasure (a)
2 Root cause 2(a)
for primary countermeasure(a)

Secondary countermeasure (b)


for primary countermeasure(a)

Primary
Secondary countermeasure (c)
countermeasures for for primary countermeasure(a)
Root cause 2 (b)

Secondary countermeasure (b)


for primary countermeasure(a)
6
Primary (1st line) Secondary (2nd line)
Root causes countermeasures countermeasures Tertiary …

Primary
Root cause Secondary countermeasure (a)
countermeasures for
1 Root cause 1 (a)
for primary countermeasure(a)

Secondary countermeasure (b)


for primary countermeasure(a)

Primary
Secondary countermeasure (a)
countermeasures for for primary countermeasure(b)
Root cause 1 (b)

Primary
Root cause countermeasures for Secondary countermeasure (a)
2 Root cause 2(a)
for primary countermeasure(a)

Secondary countermeasure (b)


for primary countermeasure(a)

Primary
Secondary countermeasure (c)
countermeasures for for primary countermeasure(a)
Root cause 2 (b)

Secondary countermeasure (b)


for primary countermeasure(a)
7
Matrix Diagram
• Matrix diagram is “Feasibility check” ……?

useful to check Can we implement the


feasibility of all the countermeasures with our
available resources?
final-line Impact by the
countermeasures interventions?

8
Items for feasibility check Scales for
feasibility check
Item What should be checked Scale Meanings
3 High priority, Easy
How is the positive impact to do
Importance of solving the problem? 2 Moderate
No negative impact?
1 Low priority,
How soon the problem Difficult to do
Urgency need to be tackled?
Is it possible to implement
Difficulty the countermeasures
technically easy or not?

Time How long does it take to


consumption solve the problem?
Are resources (human,
Resources materials, financial )
availability available for
implementation of
countermeasures? 9
Example of Matrix Diagram

Consumption

Feasibility
Importance

availability
Resource
Difficultly
Urgency
• Make a circle

Time
Countermeasures
on the score
of identified
Develop training material 3 3 1 1 1 9 feasible
countermeas
Conduct TOT 3 2 1 2 1 9 ures
Sort and Set 3 2 3 2 2 12
Develop M&E tool 3 3 2 3 2 13
Develop storage rules 3 3 2 1 2 11
Weekly monitoring 3 3 1 2 2 11
Weekly inventory 3 3 3 2 2 13
Scale Meanings
3 High priority, Easy to do Countermeasures get “11 points
and/above in total out of 15 (>70%)”
2 Moderate
are selected for implementation 10
1 Low priority, Difficult to do
It is necessary to clarify the scale and cut off point for feasibility check
Cut off=70%

Importance

Urgency

difficulty

Time consumption

availability
Resource

Feasibility
Scale:
3= high priority, easy to implement
2= middle level priority
1= low priority, difficult to implement
Root cause Primary Secondary
Countermeasures Countermeasures

Staff is not trained Training on handling Teaching material development 3 3 1 1 1 9


injectable
Conduct training 3 2 1 2 1 9
Conduct sort and
No proper storage Use labeling and color coding for
place
set of store
setting of injectable store 3 2 3 2 2 12

Develop M&E tool 3 2 2 2 1 10


No clear
regulation of Develop Develop regulation of
storage of regulation injectable store 3 3 2 1 2 11
injectable
Sensitize the regulation
3 3 1 2 2 11
No instructing Instruction from Coordinate with pharmacy and
develop check sheet
3 3 3 2 2 13
from pharmacy pharmacy

Training and dissemination 3 3 2 2 2 12


No clear hand
over of medicine Change system of
Develop handing over note and
handing over
checklist 3 3 3 2 2 13

Un clear order Redesign of order Improve order sheet with other 3 2 2 1 1 9


11
sheet design sheet department
Tips for identification of
countermeasures
• Reflect all identified root causes in Step 3
to Tree Diagram
• Check whether detailed countermeasures
are identified or not; breakdown of
countermeasures by the level of
countermeasures

12
Cont.

• Consider effective usage of available


resources; Avoid identifying
countermeasures with “increase / put
something resources”
• Discuss countermeasures that can be
implemented by your section itself
• Check conflict of activities among
identified countermeasures

13
Thank you very much for listening

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