1、,问题解决和根源分析（8D）,一些概念问题解决流程（8D）:团队信息Team Formation定义问题 Problem Definition临时措施 Containment根源分析 Root Cause Analysis纠正措施 Corrective Actions验证改善措施的有效性Verification of Corrective Actions执行纠正措施/标准化 Implementation & Standardization 承认小组及个人的贡献 Congratulate the Team,What is it all about?,概念,怎么样获得客户的满意：及时执行有效的改善
2、对策 避免问题再次发生甚至预防问题发生,1. 概念,PDCA 戴明/休哈特循环圈,1. 概念,PDCA 戴明/休哈特循环圈在行动以前先做好计划 Very important to plan properly before you do!不停地检查/确认你的行动是否有效 Always check/verify your results against your actions在行动得到验证后，确保改善方案得到全面和持续的实施 Act after results are verified to ensure complete implementation and ensure continuati
3、on,1. Concepts,问题解决流程,是解决问题或品质异常的结构化方法论 Structured methodology of solving a problem or quality issue达到问题的快速解决和客户的全面满意 Rapid problem solving and total customer satisfaction是问题根源分析和改善措施实施的有效工具 Powerful tools in root cause analysis and corrective action implementation,2. The Problem Solving Process,2.
4、The Problem Solving Process,If the only tool you have is ahammer, everything looks like a nail,以数据为依据Assess the problem and the effectiveness of the solution on data, not speculation or opinions在整个问题解决的过程中，运用基本的统计工具，以达到可测量的结果Fundamental statistical tools are used throughout the problem solving proce
5、ss to ensure measurable results,2. The Problem Solving Process,什么时候需要使用8D？When do you use a Reactive Problem Solving process?,高优先级的问题 For high priority problems 超出规格 When specifications are not met 过程失去控制 When a process is out of control需要正式的改善报告 When formal evidence of problem resolution is require
6、d,2. The Problem Solving Process,High,Low,Urgent,High,Important,ImportantUrgent8D Reactive Problem Solving,ImportantNot Urgent Proactive Improvement Process (Kaizen),Not ImportantNot Urgent Get a new job,Not ImportantUrgent Reprioritize work,Low,2. The Problem Solving Process,The 8D system is a prob
7、lem solving process that定义问题 Identifies problems采取临时对策 Takes interim containment actions可测量的方法描述问题 Describes problems in measurable terms找出根本原因 Finds the root cause(s)纠正措施 Corrects problems by eliminating the root cause(s)预防措施 Prevents problems from recurring by implementing appropriate corrective a
8、ctions,8 Discipline methodology8D流程：以团队的力方法解决问题 8D process: a team approach to problem resolution起源于1987，福特汽车 Originated from Ford Motor in 1987,2. The Problem Solving Process,(a) 成立团队Team Formation,是否需要一个团队（有多种功能团队成员）？Is a team (with multi-functional team members) necessary? 三个臭皮匠赛过诸葛亮?如果是，根据工作的相关性
9、和经验选择团队成员，指定每个成员的角色以及其职责 If yes, then select the team members based on job relevance and experience, and clearly set roles and responsibilities for each team member,2. The Problem Solving Process (a) Team Formation,重要点：为整个团队设立一个清晰的目标 IMPORTANT: Set a clear common goal/objective for the team4. 团队成员要为
10、问题解决负责 Team members are accountable and responsible for the problem一个团队最好有46个成员 Four to six members in a team (ideal)设定一个清晰的规则 （召开会议）Set clear ground rules,2. The Problem Solving Process (a) Team Formation,(b) 确定问题Problem Definition,假设团队运作良好，下面开始定义问题Assuming all goes well with the team dynamics, let
11、s begin to define the problem,2. The Problem Solving Process,用简单的条款鉴定/定义问题 Clearly identify and define the problem in simple terms2. 客户是谁？Who is your customer?3. 必须界定2个问题：Must address 2 issues:为什么不良会流出到客户 Why did the defect escape to the customer?不良为什么/怎样发生 Why/how did the defect occur?,2. The Probl
12、em Solving Process: (b) Problem Definition,什么不良？数量？What is the defect?不良出现在那个位置？固定的还是随机出现？Where is the defect located? Fixed or random? 有多严重？How severe is the defect? How many? PPM?什么时候发生的？批次？受影响的数量When? Date code(s) affected?是来料还是制程不良？ At incoming or production or field failure?,2. The Problem Solv
13、ing Process: (b) Problem Definition,2. The Problem Solving Process: (b) Problem Definition,Reported Issues1.（客户反馈在客户端不良率太高） Customer test failure rates are too high2. （这个高端客户的业务会受到很大影响）Business with this high profile customer is in jeopardyProblem Topic客户测试不良率不能接收 Customer test yields are unacceptab
14、leAnalysis leads us to the following problem statement 目前客户测试我们的产品合格率为75%，要求合格率为95%以上，比要求低20%The customers test yield on our product is 75% (current state), the required yield is 95% minimum (desired state), the customers test yield is 20% less than the acceptable level (gap). Conclusion: The Proble
15、m Statement meets the general criteria,Example,(c) Containment,We then need to do damage control (stop the bleeding),2. The Problem Solving Process,采取对策阻止不良品继续发生/流出到客户 Actions taken to stop further defects/escapes to the customer临时措施不是纠正措施，只是纠正行动 These actions are NOT corrective actions they are jus
16、t CORRECTIONS临时措施只是用于控制不良 These actions are only for damage control,2. The Problem Solving Process: (c) Containment,下面这些行动为采取长期对策前的临时对策 These are immediate temporary actions taken before permanent corrective actions附加的检查 Additional inspection隔离不良批次停止出货 Quarantine lots and/or hold shipment清库重检Purge f
17、inished goods store and rescreen培训员工 Training停线Stop build,(d) Root Cause Analysis,下面，我们需要判定问题的根本原因Then we need to determine the root cause(s) of the problem,2. The Problem Solving Process,完成问题的清晰定义后，我们需要有针对性的收集因子和数据 After problem has been clearly defined, objectively gather the facts/data收集数据的例子 Exa
18、mples of types of data to collect:a) 日期/时间 Date/timee) 规格 Specificationsb) 操作条件 Operating conditionsf) 环境 Environmentc) 事情进展 Sequence of eventsg)设备状态 Equipment statusd) 最近的变更 Recent changesh)培训 Training,2. The Problem Solving Process: (d) Root Cause Analysis,完成数据收集，开始原因分析 After data collection is co
19、mpleted, it is time to start root cause analysis.首先，什么是根本原因？ But first, what is a root cause?,2. The Problem Solving Process: (d) Root Cause Analysis,What is a root cause?Just like a plant chop off the root and it will not grow,2. The Problem Solving Process: (d) Root Cause Analysis,斩草除根!,釜底抽薪!,根本原因
20、是导致不良产生的最基础的原因-消除根本原因可以杜绝不良再发生 The root cause is the fundamental cause of the defect eliminating the root cause will prevent the defect from recurring根本原因能被合理识别 Root causes are those that can reasonably be identified根本原因通常都是与流程相关的（业务或制造），是可以固定并且可控的管理因素 Root causes are those management has control to
21、 fix - true root cause is ALWAYS process related (business or manufacturing),2. The Problem Solving Process: (d) Root Cause Analysis,不良Defect,直接因素Direct Cause,根本原因 Root Cause,作用因素 Contributing Cause,作用因素Contributing Cause,2. The Problem Solving Process: (d) Root Cause Analysis,下面这些不是根本原因 These are N
22、OT root causes:作业员错误 Operator error 测试或者检查流出 Test or inspection escape 机器或工具故障 Machine or tool breakdown,2. The Problem Solving Process: (d) Root Cause Analysis,操作员错误的解决方案？Solution tooperatorerror?,2. The Problem Solving Process: (d) Root Cause Analysis,冤枉啊!,Actually.作业员错误：Operator error is真实原因为：不充足
23、的培训或不充足的防故障系统Reality = inadequate training or inadequate fail-safe system例如：一批产品漏件 Example : Missing component in one kit 员工失误漏放元件 Operator error in omitting the component 没有防呆措施避免漏放元件 No mistake-proofing method in preventing omission mistakes,2. The Problem Solving Process: (d) Root Cause Analysis,
24、Actually.测试或检查漏失：Test or inspection escape is真实原因：测试或检查流程/系统不健全 Reality = test or inspection process/system is not robust例如：电路开路：Example : Electrical open 电气测试开路不良流出Electrical test escape 不完整的电气测试验证系统Incomplete electrical verification system,2. The Problem Solving Process: (d) Root Cause Analysis,Ac
25、tually.设备/工具故障 Machine or tool break down真实原因：不充分的设备维护保养 Reality = preventive maintenance is inadequateSMT设备上输送带卡死 Example :Conveyor jam in SMT machine 输送带齿轮没有润滑No lubricant on conveyor bearings 不充分的设备维护保养Inadequate preventive maintenance,2. The Problem Solving Process: (d) Root Cause Analysis,Root
26、Cause Analysis (RCA) is a structured step-by-step technique that focuses on finding the root cause of the problemRCA的目标是：The goal of RCA is to find out (a) 发生什么？What happened?(b) 为什么发生？Why it happened?(c) 怎么样去预防避免再发生？What can be done to prevent it from happening again?,2. The Problem Solving Process
27、: (d) Root Cause Analysis,为什么做根源分析？Why root cause analysis?预防不良再次发生We want to prevent the defect from recurring!更好地解决问题，而不是让它再次发生！Better to solve the problem than to let it happen again!,2. The Problem Solving Process: (d) Root Cause Analysis,2. The Problem Solving Process: (d) Root Cause Analysis,治
28、标还是治本？,为什么需要这么麻烦？Why so troublesome?为达成全面的客户满意We want to achieve TOTAL customer satisfaction如果一个月前报告给客户说这个问题已经得到了彻底的解决，但今天客户又发现同样的问题，会怎么样？ If the problem was resolved a month ago and then your customer discovers the same problem again today, what then?,2. The Problem Solving Process: (d) Root Cause
29、Analysis,开始做RCA前，我们需要问些正确的问题 To initiate RCA, we need to ask the right questions有效的问问题方法可以收窄可能原因的范围Effective questioning narrows the scope of possible causes,“ If you dont ask the right questions, you dont get the right answers. A question asked in the right way often points to its own answer ”,2. T
30、he Problem Solving Process: (d) Root Cause Analysis,以下几个工具和框架可以帮助我们问正确的问题 There are tools and frameworks to help us ask the right questions:,工具：ToolsQC七大手法 Seven Quality Tools5 Whys6西格玛 Six Sigma Tools,2. The Problem Solving Process: (d) Root Cause Analysis,Seven Quality Tools 鱼骨图Cause and Effect di
31、agrame)散布图Scatter plot 流程图Flow chartf)控制图Control chart 柏拉图Pareto chartg)检查表Check list 直方图Histogram,2. The Problem Solving Process: (d) Root Cause Analysis,2. Seven Quality Tools: (a) Cause and Effect Diagram,Also called a fish bone diagram or Ishikawa diagram, named after its founder Prof. Kauro Ish
32、ikawa in 1943Clear systematic way to classify the nature of the causes of a problem/effect into 6 main categories: Man, Machine, Method, Material, Measurement, and Environment,First Level Causes:How does this major bone cause the effect to occur?Second Level Causes:What causes the first level cause
33、to occur?Third Level Causes:What causes the second level cause to occur?,2. Seven Quality Tools: (a) Cause and Effect Diagram,2. Seven Quality Tools: (a) Cause and Effect Diagram,Every idea counts!,Do not judge,使用头脑风暴法：Use brainstorming to generate ideas,用于描述过程流程 Useful in showing a process flow识别潜在
34、的问题点 Identify potential trouble spots显示谁是下游客户 Shows who is the next customer,2. Seven Quality Tools: (b) Flow Chart,2. Seven Quality Tools: (b) Flow Chart,2. Seven Quality Tools: (b) Flow Chart,已创造者意大利社会经济学家帕拉图命名 Named after Italian founder Vilfredo Pareto (1848-1923)主要原则是“关键的少数和次要的多数” Principle of
35、“vital few” and “trivial many”大约有80%的不良是由20%的因素造成的Approximately 80% of the condition of a system is due to 20% of the variables affecting the system主要作用：将解决问题的主要精力用于占20%的关键少数导致多数（80%）不良的因素，而不是花费精力去做一些很多改善但对整体改善不大的项目 Useful tool to concentrate problem solving efforts on the “vital few” (20%) causes t
36、hat account for the majority (80%) of the effects observed, instead of wasting efforts on the “trivial many” causes,2. Seven Quality Tools: (c) Pareto Chart,2. Seven Quality Tools: (c) Pareto Chart,Example,A graphical technique that displays the central tendency of the data and the variability用图形形式显
37、示一个变量的频率分布 Shows a visual picture of the frequency distribution,2. Seven Quality Tools: (d) Histogram,A graphical technique that displays the relationship between two variables x and y用图形显示两个变量之间的相关关系 Shows a visual picture of the correlation relationship between these two variables,2. Seven Quality
38、 Tools: (e) Scatter Plot,2. Seven Quality Tools: (e) Scatter Plot,品质变异形成的原因： 一般在制造的过程中，无论是多么精密的设备、环境，其品质特性一定都会有变动，都无法做完全一样的产品，而引起变动的原因可分为两种，一种是偶然（随机）原因，一种为异常（特殊）原因3.1、偶然(随机)原因(Chance causes): 是指不可避免的原因、非人为的原因、共同性的原因、一般性原因，是属于控制状态的变异。3.2、异常(特殊)原因(Assignable causes): 可避免的原因，人为的原因，特殊性原因，局部性原因等，不可能让其存在，
39、否则会造成很的损失。,2. Seven Quality Tools: (f) Control Chart,控制图的作用 控制图法是具体应用控制图对生产过程进行分析和控制的一种方法。它的主要作用：A、用于工序分析，即分析工序是否处于控制状态。 用于此用途时，应随机抽取样本，搜集数据，绘制控制图，观察与判断工序状态：若发现异常，则追查原因，采取措施，检查效果，并使其标准化、制度化。B、用于工序控制： 用于此用途时，主要是预报与消除工序状态失控，以保持工序处于控制状态，防止不良品产生。C、其他用途： 控制图还可以用来调查工序能力指数，以及为质量评定、产品设计、工艺设计积累数据。,2. Seven Q
40、uality Tools: (f) Control Chart,More details in SPC training package,Out-of-control situations!,2. Seven Quality Tools: (f) Control Chart,Example,避免人员漏失的工具 Tool to prevent omissions防呆的方法Mistake- proofing method,2. Seven Quality Tools: (g) Check List,正,2. Seven Quality Tools: (g) Check List,There are
41、 tools and frameworks to help us ask the right questions:,ToolsSeven Quality Tools5 WhysSix Sigma Tools,2. The Problem Solving Process: (d) Root Cause Analysis,5 WhysOriginated from Toyota Production System in the 1970sAsks why an event happened until we come to the root causeSimple but short, focus
42、ed questions,2. The Problem Solving Process: (d) Root Cause Analysis,妈妈, 为什么天空是蓝色?妈妈, 为什么月亮是圆的?妈妈, 为什么云是白色?妈妈,5 Whys能快速了解到问题发生原因而且不需要统计分析Can be learned quickly and does not require statistical analysis通常，问到5个问题足够触及到根本原因Usually, asking “why” five times is enough to arrive at the root cause,2. The Pro
43、blem Solving Process: (d) Root Cause Analysis,5 Whys一个问题有多种原因 A problem can sometimes have multiple root causesSee example in next slide,2. The Problem Solving Process: (d) Root Cause Analysis,5 Whys: Example 2,问题：生产线使用中量具超出校验期限Problem: Gauge found in use on production floor beyond calibration date为
44、什么设备校验逾期？Why was the gauge in use beyond its calibration date?因为设备没被召回而且操作员没有检查校验标签 Because the gauge was not recalled and the operator did not check the calibration label,为什么设备没被召回？Why was the gauge not recalled?应为设备没在召回清单中 Because the gauge was not on the recall list为什么没在召回清单中？Why was the gauge no
45、t on the recall list?因为量具刚买回来 Because the gauge was just recently purchased为什么新量具没加入到召回清单？Why are new gauges not added to recall list?因为没有程序规定或者特定的培训针对如何处理采购中的量具Because there is no procedure or specific training on purchasing gauges ROOT CAUSE #1,2. The Problem Solving Process: (d) Root Cause Analys
46、is,5 Whys: Example 2,问题：生产线使用中量具超出校验期限Problem: gauge found in use on production floor beyond calibration date为什么设备校验逾期 Why was the gauge in use beyond its calibration date?因为设备没被召回而且操作员没有检查校验标签Because the gauge was not recalled and the operator did not check the calibration label,为什么员工没检查校验标签？Why di
47、d the operator not check the label?因为员工为新招聘入职，没有培训过检查校验标签Because the operator was recently hired and had not been trained to check calibration labels为什么没有培训员工检查校验标签Why wasnt the operator trained to check calibration labels?因为在线培训中没有特别规定 Because on-the-job training did not specify and it was overlooked为什么在线培训中没有规定培训校验标签？Why doesnt on-the-job training address calibration labels?主管没有考虑到 Not considered a priority by supervisors ROOT CAUSE #2,
