There are seven steps as follows-

Step 1: Kaizen Theme selection: First step of Kaizen is to select a Kaizen theme. Kaizen theme is a “Problem” or “Issue” that your section/department is facing, and staff of the section or department would like to reduce the problem for their workplace and its client. Kaizen theme should be able to implement with existing resources and implemented by the section staff.

Step 2: Situation analysis: Kaizen theme was selected in the Step 1, and this is equal to the “Problem”. There are different “Contributing factors” that compose of the “Problem”. Therefore, the first process of “Situation analysis” is to brainstorm within Kaizen team on factors that contribute to the “Problem”. After identification of “Contributing factors” to the “Problem”, it is necessary to measure frequency of occurrence of identified “Contributing factors” of the problem. It is important to note that record of step by step of the current process as it is done and not how it would have been done is mandatory, as it will facilitate identification of type of data to be collected.

Step 3: Root cause analysis: Root cause analysis is a process to identify and understand the contributing factors or causes of a system failure. To do so, “Fish bone (Cause–Effect) diagram”, can help in brainstorming to identify possible causes of a problem (effect). While drawing fish bone diagram remember “Head of fish” is not the kaizen Theme. Common mistake found in beginners is that they put Kaizen theme as “Head of fish”.  “Head of fish” is the contributing factor of the problem to be resolved (the effect). For example, “Reduce long waiting time at OPD” is chosen as Kaizen them. However, long waiting time may be caused by different causes or influenced by different factors (contributing factors) such as “Staff is not coming on time and cannot start clinic earlier”, “Registration taking a lot of time” and so on.

Step 4: Identification of countermeasures: In this step, it is necessary to understand how to identify countermeasures using Tree diagram and evaluate feasibility using Matrix diagram. It is also important that a second line countermeasure is also well identified, and connection among countermeasures is also well defined. Thus, those points need to be carefully observed and provided with technical inputs for proper identification of countermeasures. After identification of countermeasures, feasibility needs to be checked with Matrix diagram. For example, if “conduct training” is identified as 1st line countermeasure. Then, 1) develop training materials, 2) conduct a training session, and 3) monitoring and mentoring of trained staff, can be identified as second line countermeasures.

Step 5: Implementation of countermeasures: All countermeasures identified in Step 4 are accommodated into action plan for implementation of countermeasures. The action plan is developed using 5W (When, Where, Who, What, Why) and 1H (How) method to clarify key issues. A checklist must be developed to monitor the progress of countermeasures implementation and timeframe. Both action plan and checklist need to be displayed where all staff can see and access.

Step 6: Checking effectiveness: In this step, same data collected in Step 2 need to be collected again for comparison of data to see the effectiveness of Kaizen activities implemented in Step 5. Same scale of frequency needs to be applied on Pareto chart of before and after Kaizen. Plotting points of cumulative ratio also need to be checked. Another important thing to check is identification of effective countermeasures and other effects.

Step 7: Standardization of effective countermeasures: The main purpose of this step is to maintain good results of Kaizen are to prevent recurrence of tackled problems. Step 7 adds another cycle called Standardize-Do-Check-Act (SDCA) cycle as discussed above to ensure continuation of effective measures to prevent fallback. After development of Standardization plan, there must be a mechanism to continue practicing effective measures to prevent fallback. We often see that majority of Work Improvement Teams, when they complete Step 6, they start relaxing and forget taking Step 7. As facilitator, member of Management Team or QIT, we need to remind them to implement Step 7.