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MISTAKE-PROOFING防误措施
1ACEElementsQCPCRootCause/CorrectiveActionPassportProcessManagementStandardWorkMistakeProofingMarketFeedbackAnalysis6SQualityClinicActivityTPM
2ACE内容质量诊断程序图表根本原因修正行动设计开发通行证程序管理标榜化作业防误措施市场反馈分析6S质量诊断行动全面生产性维护
3ACEElementsEngineeringNewProducts,Processes&SystemsPassport-Systematicmethodforreview/approvalofnewdesignsStandardMethodProcessManagement-Meanstoidentify&mapkeybusinessprocessesStandardWork-RepeatableprocessesthatareeffectiveandefficientQualityImprovementMethodsQCPC-Simpletooltoidentifyproblemsandinefficiencies(turnbacks)MFA-DatasummariesthatdisplayhowcomponentsperforminfieldRootCause-MethodtodrivetothetruesourceofproblemsStandardEnvironmentNew6S-WorkplaceorganizationandvisualcontrolTotalProductiveMaintenance-Continuouslyimprovingequipmenteffectiveness/availabilityMistake-Proof-Creationofdevicesthatensureataskisalwaysdonecorrectly
4ACE内容开发新产品、程序和系统设计开发通行证-检查/批准新设计的系统方法标准方法程序管理–识别并展示重要商业程序的方法标准化作业-可重复的有效程序质量改进方法质量诊断程序图表-识别问题和低效率（返工）的简单工具市场反馈分析-展示组件是怎样工作的数据摘要根本原因-发现问题的真正来源的方法标准环境新6S-工作场地组织和直观控制全面生产性维护-不断地改善设备的有效性和可用性防误措施-确保任务总能正确完成的设备的措施
5Increaseprofitabilitybyeliminatinginadvertentmistakes消除无谓的错误可增加利润率Increaseproductivitybyreducingwastedtime减少浪费的时间可提高生产力Improvecustomersatisfactionandqualitybyeliminatingescapes消除逃脱可提高客户满意度和质量Increasereliabilitybycontinuouslyimprovingproducts,servicesorprocesses不断改进产品、服务或程序可提高信誉BenefitsofMistake-Proofing防误措施的好处
6Theyarenotthesamething!MistakesCauseDefects.他们是不同的！错误导致过失Mistakesvs.Defects错误vs过失Mistake错误Defect过失Pumpingdieselfuelintoyourgastank.将柴油加入汽油箱Runningaredlight.撞红灯Forgettingtounplugyouriron.忘记拔掉电熨斗的插头Placingthe“original”inyourcopierfeeder“facedown”.将原件放进了复印机的进纸处并正面冲下or
7Misunderstandingrequirements误解了要求Skippingaprocesssteportasks漏掉了一个工作步骤Performingprocessstepsincorrectlyorinthewrongorder未正确地或以错误地顺序执行程序步骤Contamination污染MostCommonMistakes最常见的错误Leavingoutapartorapieceofinformation漏掉了一个零件或一条信息Adjustmentandmeasurementmistakes调节和测量错误Timingmistakes定时错误Usingthewrongpart,toolorinformation使用了错误的零件、工具或信息
8Mistake-Proofingisawayofusingwisdomandingenuitytocreatedevicesthatensureataskisalwaysdonecorrectly.防误措施是指运用智慧和独创性发展出一个能确保任务总是能正确完成的设备的方法。Mistake-Proofing防误措施Itremovesuncertaintyfromthesituationswhereerrorsaremostlikelytooccur,suchas:它去除了最可能发生错误的情形中的不确定性，如：Repetitivetasks重复性的任务Complexinstructions复杂的说明书Calculations/Adjustments计算/调节Look-alikeparts相似的零件
9WhydowedoMistakeProofing?为什么我们要采用防误措施？Topreventturnbacksandcustomerescapesfromrecurring,sincethecosttofixaproblemincreasesrapidlythelateritisfound:为防止缺陷和客户逃脱情况再次发生，因为问题发现得越晚所花的费用就会迅速增加：Ifadefectoccurshere如果在这儿发生过失andit’sfoundhere,并在这儿被发现，itcosts:就要花费：Rework,repair,scrapandescapescostUTC$148millionperyear.Warrantyexpensescostusanother$600millionperyear.Thecostoflostcustomerloyaltyduetoescapesisimmeasurable.返工、修理、废弃和逃脱每年要花掉UTC1.48亿。保修费用每年花掉我们另外6亿。由于逃脱而丧失了客户的信任的损失则不可计算。Design设计Develop Process进行加工Op2Customer客户Op1Op1Op2$1$10$100$1,000$10,000
10Mistake-Proof防误措施theDesign设计Redesigntheproduct重新设计产品Eliminatethemistakecondition消除犯错误的条件Redesignforsymmetryorasymmetry重新进行对称或不对称设计Changethematerials改变材料Changecomponenttype,characteristicsorsupplier改变组件的类型、特征或供应商2ApproachestoMistakeProofing预防错误的2个途径Mistake-Proof防误措施theProcess加工Changeoraddtooling改变或增添工具Changeprocesssteps改变加工步骤Adduseofchecklists,templatesorgages增加使用清单、模板或测量仪Implementcontrolcharts执行控制图表
11ProcessDescription:Makingapotofcoffee程序描述：泡一壶咖啡ExampleofMistake-ProofingtheDesign防误措施范例设计BeforeImprovement:改进前：Waterneededtobemeasuredforeachpotofcoffeeoftenresultingincoffeethatwastooweakortoostrong泡前每壶咖啡的水量都要测量常常导致咖啡过淡或过浓。
12ProcessDescription:Makingapotofcoffee程序描述：泡一壶咖啡ExampleofMistake-ProofingtheDesign防误措施范例设计AfterImprovement:改进后：Coffeemakerwasredesignedtomeasureandaddthepreciseamountofwaterfromawaterbottle重新设计咖啡机以使每次从水瓶中加入的水的量都一样多
13ProcessDescription:Alabelispastedintoarecessinamoldedchassis程序描述：将标签贴在底盘的凹槽内ExampleofMistake-ProofingtheDesign防误措施范例设计BeforeImprovement:改进前：Therecessandthelabelwerebothrectangular.Thelabelcouldbegluedinupside-down.凹槽和标签都是长方形。标签可能会贴反。Recessin chassis底盘的凹槽Label标签ModelT6AC110V10WAfterImprovement:改进后：Anotchwasmadeinthecornerofthelabel,andintherecessofthechassis.Incorrectmountingiscompletelyeliminated.在标签和凹槽的一角做一个切口。就能完全防止错误发生。Recessin chassis底盘的凹槽Label标签ModelT6AC110V10W
14ExampleofMistake-ProofingtheDesign防误措施范例设计ProcessDescription:Installslidesintoaslideprojector程序描述：将幻灯片装入幻灯机中BeforeImprovement:改进前：Aresomeslidesupsidedown?有一些幻灯片装反了吗？AfterImprovement:改进后：Topedgeofeachslidemarkedwithareddot.每张幻灯片的上边都有一红点。
15ExampleofMistake-ProofingtheDesign防误措施范例设计ProcessDescription:Torquinganumberofboltsrecesseddeepinacavity.程序描述：将大量螺栓拧进空腔深处的凹槽内BeforeImprovement:改进前：Thesocketextensionrequiredtoreachtheboltscausednicksandscratchesinthepaintedsurfacesthatitcontactedduringassembly.在操作的过程中，用来拧螺栓的拧杆柄会对油漆表面造成刮伤。AfterImprovement:改进后：Arubberhosewasinstalledoverthesocketextensionandwasspecifiedontheworkinstructions.一个橡皮管被装在拧杆柄上并在工作说明书上有详细说明。
16Mistake-Proofingisawayofusingwisdomandingenuitytocreatedevicesthatensureataskisalwaysdonecorrectly.防误措施是指运用智慧和独创性发展出一个能确保任务总是能正确完成的设备的方法。Mistake-Proofingisn’tWords!防误措施不是文字！Word“Solution”文字“解决方法”Problem:The“OneDay“employeebadgeformasksforbadge#andclock#.Employeesoftenwritetheirclock#inthebadge#spot.问题：“一日”雇员的证件表格要求填写证件号和钟点号。雇员常将钟点号填在证件号的位置。Badge#证件号Clock#钟点号(filledoutbyEmergencyServices)（由紧急服务部填写）(filledoutbyemployee)（由雇员填写）TrueMistake-Proofing真正的防误措施1DayBadge#1日证件号AllgrayareasfilledoutbyEmergencyServices所有灰色区域由紧急服务部填写EmployeeClock#雇员钟点号AllyellowareasfilledoutbyEmployee所有黄色区域由雇员填写
17Guidepinsorinterferencepins向导图钉或干涉图钉Templates模板Partkitsusingshadowboxing使用能防止错误的零件包Limitswitches限制阀MostCommonTypesofMistake-ProofDevices最常见的防误设备Counters计算器Alarms闹钟Weightsandmeasures称重秤和测量仪Checklists清单Controlcharts控制图表
18Mistake-ProofingProcessChanges防误码程序的改变Improvetheprocess!改进程序！Simplify简单化Reducesteps,parts,forms,dataonforms,numberofprocesssteps,etc.减少步骤、零件、表格、表格上的数据、加工步骤的数量等。Consolidate/Co-Locate巩固/共用Bringoperationsclosertogether,reducework-in-process(WIP)使操作变得更紧凑，减少过程工作（WIP）Standardize标准化Maketheprocessvisual使程序可见Moveresponsibilityandauthoritydownintheorganization将责任和权利下放给组织
19Try-Storming(vs.Brainstorming)尝试风暴（对头脑风暴）Involvetherightpeople让合适的人参与Walktheprocessandgetthefacts检验程序并获得事实Don’tjustsitandthinkaboutsolutions...TRYTHEM!不要只是坐在那儿想解决问题的方法…去尝试！CreatingMistakeProofing创建防误措施
20The“NastyTest”(vs.the“Solution”)“恶心的试验”（对“解决方法”）Whenyouthinkyou’vegotthebestsolution…TRYTOMAKEITFAIL!!!当你认为你已找到最佳解决方法时…试着去让它失败Involveallusers让所有使用者参与Mistake-proofdevicesmustbe100%effectiveatdealingwithaparticularmistake在处理特殊错误时防误设备必须100%有效Ifnot,theywillbeignored如果不能，就应放弃Ensurethemistake-proofdoesn’tcreateanotherproblem确保防误措施不会引起其它问题TestMistakeProofingwiththe“NastyTest”用“恶心的试验”来验证防误措施
21Formally,aspartoftheQCPC/MFAProcess形式上的，作为QCPC/MFA程序中一部分WhendoyoudoMistake-Proofing何时采取防误措施Noticemistakeasithappens当错误发生时要留意Developasimplefixtopreventitfromrecurring.开发出一种简单方法来防止它再发生Implementthesimplefixintothestandardprocess在标准程序中运用这种简单方法UseQCPCtocollectTurnbackdata使用QCPC来收集缺陷数据UseParetoAnalysistoIdentifytopturnbacks用Pareto分析来识别最高缺陷率PerformRootCauseAnalysistoidentifyRootCause用根本原因分析来识别根本原因Develop&implementMistake-Proofstopreventrecurrence.开发并执行防误措施来防止错误的再发生2)Real-time,wheneveryounoticeamistaeoccurringorthepotentialforamistake实时的，无论何时你发现一个错误或有出错的可能性
22Thereare3LevelsofMistake-Proofingbasedoneffectivenessandspeed:防误措施有三个基于有效性和速度的等级：LevelIII:Detection等级三：发现LevelII:Alert等级二：警告LevelI:Prevention等级一：防止ThreeLevelsofMistake-Proofing防误措施的三个等级
23LevelIII,Detect:AllowsyoutodetectyourMistakeafterithasoccurred.(1point)等级三，发现：在已经发生之后发现错误Checklists清单Computerbeeps电脑提醒ManuallyactivatedSpellCheck手工拼写检查LevelII,Alert:AlertsyouastheMistakeishappening.(2points)等级二，警告：当错误正在发生时提醒你Sensors,alarms,controlcharts传感器、闹钟、控制图表Counters计算器AutomaticSpellCheck自动拼写检查LevelI,Prevent:PreventsyoufrommakingtheMistake.(3points)等级三，防止：防止你犯错误Eliminatingthemistakecondition(changingthedesign)消除犯错条件Automation自动控制Spelling“Auto-corrector”拼写“自动更正器”ThreeLevelsofMistake-Proofing防误措施的三个等级
24MistakeProofingQualifyingLevelItems防误措施合格水平内容Thefollowing2itemsarerequiredtoachievetheACEQualifyinglevelforMistakeProofing要取得ACE的防误措施合格资格必须完成以下两项内容ACEelementawarenesstrainingforallemployees.针对所有员工的ACE内容认知培训2.DocumentandpostontheACEDisplayBoardatleast1exampleofMistakeProofingImplemented(anylevel.)至少记录并张贴一个已完成的防误措施（任何等级）在ACE展示板上
25Summary总结Mistakesarenotinevitable.错误不是不可避免的。AMistake-Proofisacreativedevicethatpreventsamistakefromhappening.Itshouldbe:防误措施是一项有创造性的设备能防止错误发生。它应该是：Simple简单的Inexpensive不昂贵的Reliableatpreventingdefectsorgivingpromptfeedback.在防止错误或给出提示反馈时可靠的。MistakeProofingiscriticaltoprocessimprovement.防误措施对程序改进很重要。NecessarytoachieveQCPCturnbackreductiongoals.对达到QCPC减少缺陷的目标是必要的Mistake-Proofingenhancesourworkenvironmentbymakingiteasiertodoourjobswell.防误措施通过使我们的工作更容易作好来改善我们的工作环境
