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GROUP MEMBERS:
SHAKELA JAVED ROSHELA KHAN RAFIA HANI BUTT KAMRAN AHMED SAIRA BIBI M.SHOAIB
SUBMITTED TO:
LETTER OF TRANSMITTAL
COMMANDER (Rtd) AZHAR NISAR (Course Instructor) Total Quality Management BBA 7D
Subject: Report Submission Sir, This report examines the application of 5s of Housekeeping in a Hospital. The object of this study is Aga Khan Hospital, Stadium Road, Karachi. An effort has been made to make this report as all-inclusive as possible, keeping in view the time constraints and limitations of the study. However, main focus has been on the overall application of 5s of Housekeeping and the strategy adopted to achieve the objective at Aga Khan Hospital. With the help of different books, assistance from different web sources and by the visit of Aga Khan Hospital we have gathered the information for this report. I hope you find this report satisfactory any deficiencies observed in this study would be viewed with due leverage for inexperience on the part of researchers in carrying out study. Sincerely yours, Rafia Hanif Butt Shakila Javed Roshela Khan (REG#16420) (REG#16450) (REG#16429)
Muhammad Shoaib (REG#16397) Kamran Ahmed Saira Bibi BBA 7D (REG#16365) (REG#14217)
ACKNOWLDEGMENT
We would first and foremost like to thanks ALMIGHTY ALLAH who in HIS infinite mercy gave us a bountiful courage and strength. We would like to acknowledge Mr. Deedar Panjwani Manager housekeeping at Aga Khan Hospital, He patiently answered all of our questions .We are very thankful to him that he gave us his precious time and shared his worthless experience and knowledge with us and helped us in successfully completing the project. Our deepest thanks to our Lecturer,CDR (RETD.) AZHAR NISAR who & provided his major support. He has taken pain to go through the whole exercise along with us and made necessary adjustments as and when needed. We also express our thanks to, Bahria University Karachi campus for extended support.
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ABOUT AUTHORS
ROSHELA KHAN
Father name: Shamshear Ahmed khan PROFESSIONAL QUALIFICATION AND EDUCATION: BACHELOR OF BUSINESS ADMINISTRATION-MARKETING Bahria University (Karachi Campus) Semester (I) GPA: 3.92 CGPA:3.92 Semester (II) GPA:3.93 CGPA:3.92 Semester (III) GPA:3.92 CGPA:3.92
Year
Education
Institution
2008 Grade A F.Sc Pre-medical Govt.Degree College (Karachi Board) SRE majeed 2006 Grade A -ONE Matriculation (Karachi Bangalore town secondary school Board) WORKING EXPERIENCE: I have completed an Internship with Aerolube Private Limited, for a period of Six weeks with effect from July 23, 2010 till August 30, 2010.
MAJOR PROJECT: Marketing Plan on NEW PRODUCT DEVOLEMENT (Hair sun block) in Marketing project Credit Rating & performance of JS GROWTH FUND in Finances project Swot analysis on the McDonalds. In Media course made documentary. The working process of HRM in Aga khan university hospital in my HRM project. Business plan development (Breakfast express) in entrepreneurship. Organized an event for charity in Change management course.
SHAKILA JAVED
Fathers Name: Nasir Ali Javed
Academic Qualification: Education BBA(FINANCE) Year 2009- date 2008 2006 Institution Bahria University CGPA/Div/Grade 3.67 Grade A Grade A
D.A Higher Secondary School for Girls F.G Minwala Girls Secondary School
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Karachi in the field of General Banking. Achievements: Awarded certificate for organizing event, Charity for a Cause at Bahria University.
2008 2006
A A-ONE
Academic Achievements: Awarded Merit Scholarship in university for outstanding academic achievements. Awarded certificate for organizing event, Charity for a Cause at Bahria University.
Matriculation 2005 Cadet College Larkana EXPERIENCE: I have experience of 1 month at MCB as internee.
MUHAMMAD SHOAIB
Fathers Name: Abdul Sattar PROFESSIONAL QUALIFICATION AND EDUCATION: BACHELOR OF BUSINESS ADMINISTRATION MAJORS FINANCE (CGPA 2.85) 2009 2012 (Under-process) E-mail ID: shoaibrajput90@yahoo.com
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5s HOUSEKEEPING APPLICATION IN HOSPITALS Bahria University (Karachi Campus) HIGHER SECONDARY CERTIFICATE (H.S.C) Govt. Collage of commerce shahra e Faisal Board of Intermediate Education Karachi, With Accounting, economics, statistics SECONDARY SCHOOL CERTIFICATE (S.S.C) P.N Model School MAJEED SRE 3 Board of Secondary Education Karachi, With Mathematics, Physics, Biology WORKING EXPERIENCE: I am working as head of accounts in an event management company Worked as assistant operation manager in management company MAJOR PROJECT: Marketing Plan on NEW PRODUCT DEVOLEMENT in Marketing Management In Media course made documentary. The working process of HRM in Pakistan international Airline in my HRM project. Business plan development (Breakfast express) in entrepreneurship. Organized an event for charity in Change management course
B grade
SAIRA BIBI
. Fathers Name: FAZAL KAREEM E-mail: Sairarana12@yahoo.com Education details:
DEGREE BBA Hons-marketing (in process) Intermediate Matriculation YEAR 2012 INSTITUTION Bahria University, Karachi GRADE/CGPA
2008 2006
Projects: Report on MCB Bank, Report on Marriot hotel Karachi, Report on GBL Company, organize seminar on secrets behind success and report on marketing plain Computer skills: MS Office 2007 and Photoshop.
ASSESSORS COMMENTS
____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________
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PREFACE
Quality Assurance and Housekeeping has mean and ends relationship. 5s is an effective tool to enhance the level of Housekeeping in a workplace. Implementing a good housekeeping plan not only helps to build a clean, tidy and organized work environment, but also helps to mitigate losses and reduce workplace accidents resulting from poor housekeeping. Through out the course of writing this report, the research team has tried utmost to include all available information. This research study covers the, 5s Housekeeping Application in Hospitals Hospitals covered are Jinnah Hospital Karachi & Aga Khan University Hospital Karachi to understand its insinuation in these hospitals. The underlying report gives an insight to the extent and effect of 5s housekeeping in hospitals.
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EXECUTIVE SUMMARY
Our group conducted the research on 5s housekeeping application in hospitals and this is the objective of our report. The basic purpose of 5s application is PLACE FOR EVERYTHING & EVERYTHING IN ITS PLACE & it promotes Quality, Safety, Productivity and Clean environment. We visited Jinnah Hospital for observation and Aga Khan University Hospital Karachi to interview the official of housekeeping department to examine to what extend they are implementing 5s application & how effective they are. In the interview we conducted at AKUH, they showed and described that they are implementing 5s application with certain modifications according to culture & environment and adhere to polices they use for maintaining standards and give high-quality services to their customers.
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Table of Contents
LETTER OF TRANSMITTAL................................i ACKNOWLEGEMENT..ii ABOUT THE AUTHORS..iii ASSESSORS COMMENTS...vi PREAFCE..vii EXECUTIVE SUMMARY .......................................................................................................... viii AIMS OF THE RESEARCH...1 OBSTACLES FACED2 INTRODCUTION...3 OVERVIEW OF AGA KHAN HOSPITAL..3 OVERVIEW OF JINNH HOSPITAL....3 ABOUT 5S HOUSEKEEPING...4 RESEARCH METHODOLY......5 DATA ANALYSIS.7 APPLICTAION OF 5S HOUSEKEEPING AT AKIH.7 APPLICATION OF 5S HOUSEKEEPING AT JINNAH HOSPITAL...13 COMPARISON & EFFECTIVEESS OF 5S HAUEKEEPING APPLICATION...14 CONCLUSION.18 RECOMMENDATION20 REFERENCE MATTERIAL21 BIBLIOGRAPHY.22
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TABLE OF FIGURES
Figure 1 ........................................................................................................................................... 7 Figure 2 ........................................................................................................................................... 8 Figure 3 ........................................................................................................................................... 8 Figure 4 ........................................................................................................................................... 9 Figure 5 ........................................................................................................................................... 9 Figure 6 ......................................................................................................................................... 10 Figure 7 ......................................................................................................................................... 10 Figure 8 ......................................................................................................................................... 11 Figure 9 ......................................................................................................................................... 11 Figure 10 ....................................................................................................................................... 12 Figure 11 ....................................................................................................................................... 13 Figure 12 ....................................................................................................................................... 13 Figure 13 ....................................................................................................................................... 14 Figure 14 ....................................................................................................................................... 14 Figure 15 ....................................................................................................................................... 15 Figure 16 ....................................................................................................................................... 15 Figure 17 ....................................................................................................................................... 15 Figure 20 ....................................................................................................................................... 16 Figure 18 ....................................................................................................................................... 16 Figure 19 ....................................................................................................................................... 16 Figure 21 ....................................................................................................................................... 17 Figure 22 ....................................................................................................................................... 17 Figure 23 ....................................................................................................................................... 17
THE PROJECT
5s HOUSKEEPING APPLICATION IN HOSPITALS
AGA KHAN NVIERSITY HOSPITAL, & JINNAH HOSPITAL KARACHI
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INTRODUCTION:
At its core, Total Quality Management (TQM) is a management approach to longterm success through customer satisfaction. (1)In a TQM effort, all members of an organization participate in improving processes, products, services and the culture in which they work. TQM views an organization as a collection of processes. It maintains that organizations must strive to continuously improve these processes by incorporating the knowledge and experiences of workers. The simple objective of TQM is Do the right things, right the first time, every time. (2)
5s HOUSEKEEPING APPLICATION IN HOSPITALS JPMC is arguably Pakistan's largest hospital. It has a large number of wards and the doctors are proficient. (5)
RESEARCH METHODOLOGY
Research objectives: Objective is to study application, benefits as well as effectiveness of application of 5s housekeeping in hospital. Possible Scheme of Approach: Owing to the considerations, following complimentary approaches to research are possible: 1. Personal interview: In personal interview interviewer & respondents sits face to face. 2. Observation: A method of data collection in which the relevant situation & behaviors facts, actions and are recorded. 3. Secondary data (literature review): Secondary data has historical importance and is good basis for deducing and pin pointing the short comings SELECTED APPROACH: Research design: To achieve objective of study exploratory research method was selected. Exploratory research: Utmost information, data, was gathered through an exploratory research. This was accomplished by the use of: Web sites, Personal Interviews, observations. Sample design: Due to many constraints whole population cant be studied. Therefore a small representative of population was selected. Population/universe: in this research population is limited to housekeeping departments of hospitals. Sampling technique: To conduct sampling non-probabilistic sampling was carried out. In which Snow ball sampling was conducted to get experts opinion. In this study deliberate sampling was used because of nature of study. Research tool: data collection
Primary data:
Observation: In collection of data for research, personal observation was carried out. We observed the environment, different areas of our interest such as cleanliness of patient rooms, cafeterias etc. Through this approach many useful information was gathered. Observed hospitals: Jinnah hospital Karachi Aga Khan Hospital Karachi.
5s HOUSEKEEPING APPLICATION IN HOSPITALS Schedule: Survey was conducted on 10th May 2012 (afternoon) at Jinnah hospital Karachi, 24th march 2012 at Aga khan university hospital. Personal interview: Using snow ball technique of sampling, personal interview was conducted with the expert of manager housekeeping at AKUH who has experience of more than 20 years of this field. This method of collecting data is usually carried out in a structured way where output depends upon the ability of the interviewer to a large extent. Interview Schedule: The interview was conducted on 24 March 2012, at Aga khan hospital at evening according to respondents convenience. Respondent: Mr. Deedar Panjwani Manager housekeeping at Aga Khan Hospital. Interview details: Questions that were asked during interview are mention at the Reference section.
Secondary Data:
Literature review: We gathered material by searching on internet about 5s housekeeping application of already published reports related to our topic & we also watched several videos to get the better understanding of the topic. ORGANIZTION & ANALYSIS OF DATA: After the data collection, the procedure turns to the task of analyzing them. The analysis of data requires a number of activates, we the researcher then classify the raw data into some purposeful and usable categories which is provided in the next section.
1: SEIRI
The housekeeping department at AKUH has 522 employees including 80 females, comprising of 15 supervisors, 2 secretaries, and 1 assistant secretary. They are scheduled into three shifts. They are then sorted, meaning that the worker is appointed for cleaning of a certain place, he/she has to clean the same place same time every day. This prevents the workers from not completing their task and leaving it for others to complete. There are three types of ward at AKUH, the General ward, Semi-private ward, and Isolation ward as shown in fig.no1.
Figure 1
General ward
The Mobs & dusters used in GENERAL WARD are sanitized & reused.
Semi-private ward
Mobs used in SEMI PRIVATE WARD are also sanitized & resused.
Isolation ward
All Mobs & dusters used in thirs ward are not re-used rather they are burned. as isolation ward has critcial patient So to prevent germs from spreading they ar burned.
5s HOUSEKEEPING APPLICATION IN HOSPITALS AKUH has a unique method of getting rid of /disposing of waste: as shown in fig no2. These bags includes the dicsarded material which has avery high potential of transfering diseases e-g used syrings,gloves,mas ks,vaccinations etc.
GREEN BAGS
Thes include all wastages which are less infected like specimen,liquid& solid waste etc.
BLUE BAGS
RED BAGS
Figure 2
Red bags AKU never disposes of these red bags in the ordinary way, in order to avoid their re use and recycling, these bags are burnt out at AKU insulators. As per MR. Deedar AKU recently outsourced pollution free insulator from France. Both green and blue bags are further packed in the cartons and given to the contractors to discard. The material being wasted after chemography and radiology are retained for up to 3-4 months in the hospital and then a team is being outsourced from abroad to discard this waste. Apart from all activities of housekeeping, there is a special activity at AKUH known as PROJECT WORK. It is periodical, done every Friday. It includes, shampooing, scrubbing & polishing.
Figure 3
Figure 4
2: SEITON
Organzing at AKUH: Everything was so organized by ensuring that there is place for everything. We obsereved from corridor to wards ,from library to labotaries,cafeteria everyhting was organized in a best way.
Figure 5
The inventory related to housekeeping is outsourced from FAISALABADs Sitara chemical in large containers on monthly basis. The expiry period is being tagged on each container; the chemical (sodium hypochlorite) is to be used in ratios daily for making the solution i.e1/39. This solution has to be used within 24 hours and the remaining is discarded as it becomes ineffective. Moreover the inventory includes dusters, mops (dry and wet) and discarded mops. The workers are guided to ensure first that the patients donor have any allergy to these chemicals such as asthma and then start cleaning the rooms. All stuff necessary for operations & functioning of services were at its place in excellent manner.
3: SEISO (Clean the Place Thoroughly and Keep Everything in Its Place)
AKUH is one of the best hospitals in Pakistan for its cleanliness & hygiene environment. View of Aga Khan Hospital entrance, which looks to be totally clean and green. The idea behind making the hospitals clean is to make the patients feel better as they step in the hospital. We can say that third step of 5s that is sieso (Clean) is followed in its true sense in the Aga Khan Hospital.
Figure 6
AKUH gives utmost importance to cleanliness and hygiene. As the turnover of patients daily is 125-130, therefore, whenever a patient is discharged, the bed sheets, the mattress and the bed is sanitized. It is then hygienically ready for the next patient. The disinfectants and sanitizers are properly tested and then used for cleaning. AKUH uses Sodium Hypo chloride as disinfectant, which is supplied by Sitara Chemicals in Faisalabad. The level of chlorine should be 5-7 in this chemical. The Inspection Control Team maintains the record and is responsible for this. For cleaning of the floor fig.7 shown process is used. This has to be used with great care as it can spoil clothe, materials, but it is the most effective disinfectant.
SEISO(cleaning) Achieved through
Sanitizer
Figure 7
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For sustaining the best practices of standardization in housekeeping, AKUH has allotted time to workers to complete their task on time. A standard is also maintained with the diluted disinfectant that is it cannot be used after 24 hours of its dilution. This is done to achieve maximum effectiveness of the disinfectant. Short circuit cameras are used to inspect and overcome the problem of theft.
5: SHITSUKE
To maintain and sustain good housekeeping services, the housekeeping staff at AKUH at its inception was trained by SERVIVE MASTER COMPANY, which is one of the best Chicago, based Service Company. They were skilled with best services of housekeeping which has led AKUH to a standard. The management of housekeeping believes that it is their responsibility to first practice the housekeeping application themselves, which will set the example for the rest of the workers to follow the same, otherwise the workers take advantage of this.
Educate
Train
Sustain
Figure 9
11
5s HOUSEKEEPING APPLICATION IN HOSPITALS When new workers are appointed, they are trained and then allotted specified work. The workers are disciplined and it is evident from the fact that 35 workers perform their task at night without supervisor.
Figure 10
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Start
End
Figure 11
It has been well said that standards precede from upper management, the housekeeping management at Jinnah Hospital lacks interest in maintaining a proper system and ensuring that it is being carried out at all levels, thereby making the hospital inefficient in providing quality
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As it is said prevention is more than cure, but here at Jinnah hospital it seems to be untrue. Patients are welcomed by different diseases borne from this water. This stagnant water is the best place for the mosquitos growth as well as different diseases also arises from here.
Figure 13
This is view of Aga Khan Hospital entrance, which looks to be totally clean and green. The idea behind making the hospitals clean is to make the patients feel better as they step in the hospital. We can also conclude that third step of 5s that is sieso (Clean) is followed in its true sense in the Aga Khan Hospital.
Figure 14
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This shows the care for the patient in the Jinnah Hospital. It is one of the rooms beside the ward that is full of sewerage water allowing the germs to grow.
Figure 16
This is chemical laboratory of AKUH which is viewing tidy, organized & healthy environment for working. This will obviously give fewer chance of error in medical reports.
Figure 15
Figure 17
15
Figure 19
Jinnah hospital Condition where there is no dustbin and everywhere rappers are lying as
if there is no swapper.
Figure 18
Figure 20
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Figure 21
Figure 22
Miserable view of Jinnah hospital Karachi no Organziations no palce for anything even for patients.
This is very brief comparison of effectiveness of 5s housekeeping application in hospitals. We covered both hospitals which implement 5s & which dont implement it to know how big the result & benefit of application of 5s is housekeeping. As by looking the environment of Jinnah Hospital it is clear that there is no concept of 5s in this hospital. The environment is totally hazardous for the health of patients that is why Jinnah Hospital has lost its identity in providing quality service to its patients. Where as in Aga Khan totally different environment is provided, patients feel relaxed as they enter into hospital by looking its greenery and cleanliness.
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Conclusion:
Aga Khan University Hospital has left no stone unturned to achieve the best possible quality for their patients. Since its inception they believed on quality of service for their patients. They are the first who got ISO 22000:2005 certified in Nutrition and food service department. The first ever hospital in Pakistan based on food production and service in Pakistan to be certified on these specialized food safety standards. Although 5s is a Japanese concept but very well implemented at aga khan hospital. Aga was good example for us where we could see the practical application of 5shouskeeping application unlike Jinnah hospital Karachi. The staff of aga khan is very cooperative n very well educated which add one more attribute to their excellence. Whereas in Jinnah hospital, a lot of improvement is needed and that is not possible without government intervention. Being a cheaper hospital, mostly lower class patients are admitted to this hospital, they are treated very rudely by the staff and no standardized procedures are followed for proper cleaning. In a nutshell, the implementation of 5S at Jinnah hospital is a great challenge for the Government of Pakistan.
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CHAPTER XI
RECOMMENDATIONS: We suggest following recommendations for aga khan for continuous improvement and overcoming their problems When possible, the housekeeping staff must take care of the patients themselves too. If they are doing their cleaning, and the patient needs a pillow, wants propped up in bed, needs a drink, or whatever non-medical request they might have, the housekeeping staff should do all that they could do to help. All the patients should be called fifteen (15) minutes before their appointment, so they may not wait much in hospital and the waiting area can be easily cleaned as there would not be long queue of patients. Customer should be informed all about their disease by doctor; he should give his due time for consultation and let them know about their remedy. It will also build trust between doctor and patient. They can conduct weekly or fortnightly seminars for the patients, suffering from same disease. It will help them to cure themselves as soon as possible. We suggest following recommendations for Jinnah Hospital to improve and overcome their problems Jinnah hospital needs to implement the housekeeping concept, since the people working at the hospital do not even know the basic activities that are carried out by housekeeping staff, so proper training must be provided to the staff. Even though outsourcing is an option available for housekeeping. Jinnah hospital does not even have a hygienic waiting area, all the patients (including even those who were infected with chronicle diseases) sit in the same waiting area, where the probability of disease catching is very high. So proper cleanliness of waiting area and separate waiting area for patients with chronicle diseases is required. The government must take measures for overall cleanliness, ensuring maintenance of the building and its infrastructure, linen management, waste management, pest control, infection control, safety and security of the patients in this hospital.
REFERENCE MATERIAL
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Bahria University, Karachi Campus National Stadium Road Karachi Tel #9924002-6/219 DIRECTOR FACILITIES MANAGEMENT, AKUH Karachi 20 March, 2012 RESEARCH VISIT BY STUDENTS Dear Sir Assalam-o-Alikum
Bahria University is federally accredited university based at Islamabad with its campus at Karachi. University is educating its students in the fields of management sciences, computer Engineering Medical and Dental Surgery. Management science students are guided to carry out subject based research in various business and corporate organizations. This enhances their ability to think independently and resolve the management problem logically. Some students of BBA-7D have selected your organization to carry out research with reference to 5s HOUSEKEEPING APPLICATION IN HOSPITAL as a part of TQM course. The names of the students are given below: 1. 2. 3. 4. 5. 6. Rafia Hanif Butt Shakila Javed Roshela Khan Muhammad Shoaib Kamran Ahmed Saira Bibi (REG#16420) (REG#16450) (REG#16429) (REG#16397) (REG#16365) (REG#14217)
You are requested to please provide guidance and relevant information/data (unclassified) which may help the above students in carrying out the research. Please allow them to take a round of your organization as convenient to you. Thanking you in anticipation. Sincerely, __________________ Bahria University (Karachi campus)
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5s HOUSEKEEPING APPLICATION IN HOSPITALS 1. 2. 3. 4. Why 5s process seems so important to you though its a Japanese concept? Can you highlight some key areas where 5s had proved to be beneficial so far? Have you people implemented it since the conception of Aga Khan? If not then when? On a general note, what do you think about having 5s housekeeping concept in a business? At the same time is it more important for a service business rather than a manufacturing one or equally important for both? 5. To what extend Aga khan is able to apply methodology of 5s? 6. What obstacles and hurdles aga khan face while application of 5s? 7. What benefits Aga khan is getting by applications of 5s in comparison with past? 8. Why housekeeping in clinics and hospitals is important? 9. Do you keep an updated list of things to do using some standardized criteria? 10. At the end of the day, do you compare what was done with what had been planned and plan the tasks for the following day? 11. Do you try to identify and standardize every activity? 12. To keep all items that you need and discarding items that u don't need what u people do for that? 13. When an emergency e.g. any disaster happen in a city, how do you people manage discipline? 14. How would you cleaning and inspection easier for achieving zero grime and zero dirt? And also maintaining this cleanliness? 15. What are infection control policies in your organization? 16. Which cleaning technique and procedure make you unique in Pakistan? 17. How do you manage housekeeping space( storage of supplies) 18. How do you know your certain batch of medicine is expired, is there any policy for it? 19. Areas where do you face problems for achieving quality standard?
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Bibliography
1. (March 20,2012). Retrieved from http://asq.org/learn-about-quality/total-qualitymanagement/overview/overview.html 2. (March 22, 2012.) Retrieved from http://www.isixsigma.com/methodology/total-qualitymanagement-tqm/introduction-and-implementation-total-quality-management-tqm/ 3. (March 22, 2012).Retrieved from http://hospitals.aku.edu/karachi/Pages/home.aspx 4. (March 22, 2012). Retrieved from http://piqc.edu.pk/casestudies/Dr_Syed_Mairajuddin_Shah_Quality_Journey_of_Aga_Khan_University_ Hospital,_Karachi_Healthcare_Quality_Presentation_PIQC.pdf 5. (March 21, 2012). Retrieved fro,http://wikimapia.org/355933/Jinnah-Hospital-Jinnah-Post-GraduateMedical-Centre 6.1. (March 21, 2012, Retrieved from https://www.high5s.org/bin/view/Main/WebHome 6. (March 21, 2012). Retrieved from 6.http://www.docstoc.com/docs/64427728/5-S-Management
7(May 8, 2012). Retrieved from http://www.youtube.com/watch?v=gHBtr86Pgzk 7.1. (May 8, 2012). Retrieved from http://www.youtube.com/watch?v=G-hBCwIERG0
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