HUMAN ERROR PREVENTION CHECK LIST

Workstation/B
Underbody
WT -

Defect Rate before - 1 (at Final Line)

Sr.No/Year -

01/F11

Severity - V1+ (FMEA Severity - 9)

Date -

20.09.2011

Defect rate after 3 weeks of solution - 0

CFT -

Shinde,Dhage,Kadu,Suryavanshi

Defect -

ABS block to pipe one joint loose

Wh
y did not follow
Operator
main step of tightening
the joint

Wh
y

Operator forgets

Wh
y
Repetative and monotonous
Activity

Wh
y

Rema
rk
Continuous attention is required
to perform the job.

Wh
y

SPN
Principles

Question to be asked to the process

Solution

Effectivnes
s

Cost

Implementation

SPN

Can we eliminate the error-prone process?

NA

Can we eliminate harmful objects?

NA

Can we automate the process?

Automation of the ABS joints tightening with special machine

Can we provide supporting tools like

checklists/gages/samples?

Provide check list after tightening of all joints on ABS block

Can we simplify changes/differences in the operations?

(standardization, code matching, etc)

Provide marking on each joint which is visible only after tightening

Colour each joint with red paint to diffrenciate after tightening

Install poka yoke to verify the tightening of each joint by taking

feedback from electric runner

12

Give check point to checkman

Elimination

Replacement

Facilitatation

Detection

Mitigation

Can we distinct changes/differences in the operations?

(color coding, unique shape, etc.)
Can We adjust the properties of the operations which suits
human beings?
Can we record the motion of the earlier operation and verify
it before starting the next operation
Can we restrict the motion in such way that it will notice the
abnormility?
Can we verify the results before starting the next
operation ?
(sensing shape/state/quality of work)
Can we make function parelle(Redundant)?(Additional
Control)
Can we incorporate some shock absorbing
materail/equipment?(Like Fuse)
Can we make unsafe conditions more safer so as to not to
produce the defects?(Protection)

NA
Marking to be done after each joint tightening
NA

NA
NA

Solution Implementation

Sr.No
1

Actions
Install poka yoke to verify the tightening of each joint by taking feedback from electric runner

Resp

Date

Status

Vitthal

30.09.11

Closed

Common Examples
1 2 wheelers stand indicator
2 Luggage compartment of air craft with mirror
3 Master or duplicate key at reception of a hotel
4 Forget to switch off lights in a hotel , key mechanism
5 Electric sockets
6 Low battery indicator of a laptop
7 Sleep timer for a AC or TV
8 To Do list

Principle
Verify and indicate abnormility
Facilitaion
Redundancy
Verify and indicate
Restrict motion
Record, verify and indicate abnormility
Redundancy ???
Support system