Lean with a healing touch

Posted on 7 Oct 2010 by The Manufacturer

Advanced Medical Solutions has used innovative R&D capabilities to win a strong position as an international supplier of wound treatment technology. The company’s move to a new, £4.5m modern facility goes hand in hand with a commitment to lean and continuous improvement.

The Winsford-based company started as a wound dressing research house in 1991 and floated on the USM in 1994 with full LSE listing in 1996. It pioneered the development of high performance, transparent polymer dressings and later introducing alginate dressings, produced from seaweed for fast healing in a moist environment. In 2002 the company moved to the AIM market and acquired MedLogic Global Holdings, based in Plymouth, which provided the group with superglue-based medical adhesive technology. Liquiband sells in over 20 countries. Subsequently, the company acquired Corpura BV, based in the Netherlands, which manufactures foam products. Advanced Medical Solutions (AMS) also produces silver alginate dressings which are effective against a wide range of microorganisms including MRSA. Wound care products are supplied as own brand and as private label.

The group employs 241 people across three locations, at Winsford, Plymouth and Etten Leur in The Netherlands, including a field-based team supporting key global markets in Europe and the USA. The company had turnover of £24.1m in 2009, up 19% on 2008, with profit up 51% to £4.1m year on year. Their ActivHeal dressings are claimed to give annual costs savings of 54% to University College London Hospital NHS Foundation Trust.

The new medical devices facility at Winsford comprises R&D laboratories, offices, manufacturing and advanced warehousing, which allows rationalisation of AMS’s two facilities into a single new building and creates additional capacity to support future growth. The facility is scheduled to be fully operational by the end of 2010.

Steve Platt, general manager of AMS’s new world class Winsford facility joined AMS in June 2010 and comes with outstanding lean experience. Platt began his early career with Toyota Manufacturing (UK), followed by JCB.

He then became a consultant at RWD Technologies implementing lean in the automotive sector, rail industries and MoD, followed by managerial positions at Danish company Nilfisk-Advance, where he was responsible for the build of a new factory for industrial cleaning equipment in Hungary based on the Toyota model.

Lean thinking
Platt’s passion for lean is playing a major role in the development of AMS operations at all levels. “We want continuous improvement to become a part of daily life. We are adapting the structure internally following the lean approach, identifying and specifying key roles which will encourage continuous improvement responsibility at all levels.

We are focused on the workgroup and KPIs are closely tracked at high level and workgroup level.” AMS has a centralised management centre, with a carefully structured approach to KPIs transferred across the business. “Our key measures are safety, quality, output, cost, people training, and the environment. These measures are tracked on a daily basis and are prioritised in that order, starting with safety,” he explains. Every day a crossfunctional meeting is held for 20-minutes for anybody with input to these KPIs.

There is hourly tracking of all lines, with planned versus actual metrics.

The company has a number of six sigma experts within the group, mainly used to address very infrequent issues (about one in a million) “as we get more benefit from practical problem solving,” says Platt. He shares opinion with some Toyota experts who suggest that six sigma often offers problem-solving without solving the problem! Platt reckons “In some cases it could take six months to collect the data for a six sigma analysis, when a simple 5-Why analysis could suffice. We have to remember the sense of urgency to resolve daily issues and not let them linger on. However, six sigma is an effective tool for problem solving when a 5-Why activity won’t do.”

Typically, AMS uses an 8-D approach to problem solving:

1 defining the problem
2 the objective
3 identifying the history of the issue
4 a brainstorm session
5 fishbone approach
6 point of cause – root cause analysis and 5-Why investigation
7 Pareto analysis of the result of any action taken
8 and standardised confirmation – to confirm that everything is OK and the approach standardised.

“Generally this approach works for the majority of our problems if you follow the change process specifically in terms of mentoring and developing our existing teams. Interim Performance Management (IPM) helps support and maintain the focus.”

Plant operations
The AMS plant produces advanced wound dressings which have to meet stringent national and international regulatory approvals (US FDA, European Medical Device directive and others).

Though the basic technology is based on textile processing, significant extra process controls are required, and all the processes are carried out in strict clean room conditions. The new equipment is designed to provide significant improvements in capacity and efficiency to handle a growing range of products.

The first stage of manufacture of alginate products is fibre spinning.

The spun product is then undergoes consolidation of the fibres into a structured dressing material to suit the individual user needs which is then packaged, labelling and sterilised.

During the spinning process, the fibres are produced with materials mostly supplied locally with sodium alginate sourced from Scotland.

The sodium alginate is mixed with water and other additives, extruded and converted to insoluble calcium alginate prior to de-watering with acetone and drying. The spinning equipment features a new acetone recovery plant which significantly improves recovery and saves significantly on running costs. For the time being, the old plant at Road 3 is still running on a 24/7 basis. When the new plant comes on stream in this month, it will be able to run the same throughput on a one or two-shift basis, allowing for growth in the future as new products are introduced.

Fibre consolidation is carried out on a carding line that currently runs 24 hours a day, five days a week. “We are keeping the old equipment, but the new line has been upgraded to operate one or two shifts per day, depending on capacity throughput. The carding equipment takes the fibre and runs it through a number of processes, designed to open and express the fibre properties whilst consolidating to form a nonwoven textile material that is designed to meet the specific attributes to meet the customer needs. The packaging system is highly automated. However, a lot of labour is required to manage quality. “We utilise X-ray in-process inspection equipment as part of our quality assurance programme but also use a combination of machine and a human element for completeness of the quality inspection processes.” The product is terminally sterilised, tested and approved prior to release to customers for use.

AMS also provides a number of different wound dressing technologies, including Foam/Foam Island, film, hydrocolloid, and hydrogel plus membrane. As part of the company’s commitment to expansion, new high speed, multi stage multi-component converting equipment is due to be installed in 2011.

AMS has also improved its warehouse facilities featuring very narrow aisle trucks to condense the storage system.

“We are currently in the process of developing an internal delivery system which will support further efficiencies and stock control,” says Platt.

AMS has proved to be relatively recession-proof. Demand for advanced medical dressings continues to rise and the company anticipates significant growth. “We are constantly looking at how to structure the business for greater efficiency and growth. AMS has grown very quickly from a small research-based seed. This has brought a number of issues and regular change. Consequently, we have made the business very transparent, which enables us to react in a very timely manner in order to deliver our full promise to the customer,” says Platt.

As a lean champion, Platt still sees a lot of opportunity to reduce the seven wastes which are currently evident in the company (i.e. waiting, over-production, rework, motion, processing, inventory and conveyance). “All these elements of waste are actively being driven out. Lean promises continuous improvement, but considering the KPIs, quality comes before efficiency as a key constraint, as it’s no good delivering rubbish fast.” In terms of supply chain optimisation, discussions have begun on a supplier development programme, along the lines of the Toyota Manufacturing programme. “For example, if a supplier is regularly late or has quality issues or trying to drive down prices, then it’s our intention to go and support that supplier from a lean viewpoint so we can achieve a win-win.”

The new plant has been built to meet the latest building regulation standards, with a high level of thermal insulation to reduce the carbon footprint. Lighting is controlled by movement sensors to avoid wastage, and the heating system is fully programmable. Most of the office heating is provided by a solar wall. The south-facing end wall of the building is warmed by the sun and air is ducted through hollow sections to be heated. Part of the lean programme also addresses environmental sustainability.

As mentioned, the acetone recovery system has been designed to capture and recover vapour and hydrated acetone streams arising from the spinning process for recycling within the process. The printing line’s electrically heated drying system has also been replaced with a more efficient gas burner system.

Three minute management
Platt is an advocate of ‘Three Minute Management” which means that anybody in the business, from a cleaner to the CEO can walk around the business and look at anything from the team-board to the management centre, and know the status of the business within a few minutes, without asking anybody – from costs of consumable items and scrap value to monthly performance on sales and quality.

“Consequently, we’ve seen a lot of improvement in key areas, such as quality and output,” he says.

Platt suggests that the key driver for lean thinking in a sophisticated manufacturing operation like AMS is the use of the process confirmation tool. “We have checks for each process and parameter, so that everybody from the CEO to a team leader can monitor KPIs. The team leader monitors quality on a daily basis, then there is a group-wide escalation process to maintain the standard, with sign-off.

“This is a robust, visual system which ensures that change is sustained and does not drift with time.”

The future
Looking to the future, AMS believes there is plenty of growth to be had. “We are well established throughout Europe and are moving much more aggressively in the US. We also have plans for expanding the foam business and are always developing new and innovative products, with a heavy focus on R&D to deliver new and innovative wound healing products,” says Platt.

“The change process is challenging. The key issue is to ensure you can move at a speed where people are comfortable to move along with the business. But people have to be committed to change and actively accept the need to change.” The move into a new light, clean and advanced plant makes the process of encouraging a climate of change and continuous improvement even more accessible. Lean thinking is being shown to improve the processes, costs and quality of life for all parties involved.