Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Fri Mar 07, 2008 4:40 pm Post subject: Improving Diagnosis. An Interactive Exercise
This post is a bit different from most of my others. The point is to generate a bit of discussion and the aim is to possibly improve the process of diagnosis. I have used this method to improve other things in my business, with good results. Hopefully this can be an online exercise to demonstrate how the method may work. My plan is to put forth these few thoughts and let others take it from there.
When a technician mis-diagnosing a problem it is a serious concern. My experience has been that when it occurs the tech normally feels quite bad. Depending on their situation and personality this may manifest in a number of ways. Some may act like they don't care, others may get mad or act aggressive, still others feel bad about themselves and on and on.
In any case, I believe they are well aware of the problem and see no advantage in bringing the mistake to their attention. A possible exception would be willful misconduct, but I feel this is extremely rare.
The above image points out what I see as a few possible causes. I have intentionally left out incompetence. I feel that would be a hiring problem and suitable for another discussion.
Are there ways any of these root causes can be prevented [lessened] by changes to the system?
Joined: 15 May 2007 Posts: 146 Location: Garden City, KS
Posted: Sun Mar 09, 2008 11:49 am Post subject:
I think that diagram pretty much encompasses everything. If I added anything, it would be lack of experience. I only bring that up in a case such as this: A shop decides that there is a need to provide service for "X" brand of vehicle. Techs are sent to training, equipment is purchased, and advertisements sent/posted. Now a brand "X" vehicle is sitting in the bay and even with all that training and equipment there is a period of adjustment for the tech. I would assume that period of adjustment would differ from tech to tech.
I feel that a very important aspect of good diagnostics is critical thinking. Many other aspects are controllable by the shop and the tech. But critical thinking seems to be something you have or you don't have. Is critical thinking teachable?
Later, Matt.
_________________ Matt Fanslow
ASE CMAT/L1
Crag-Technologies, Inc
www.wavehook.com
Joined: 19 May 2007 Posts: 206 Location: Camp Verde, AZ
Posted: Thu Mar 13, 2008 9:30 pm Post subject:
If I understand what you are saying, with the diagram, is that there are four main reasons for a missed diagnosis. The tech is distracted, he is hurried into making a diagnosis, he does not have accurate information, or he does not know how to make a proper diagnosis. The chart then shows several contributing factors for each of the main reasons. The contributing factors are then broken down even further.
Another group of root causes might be technician distractions. Some you have addressed. Others might be cell phones, radio too loud, family problems, customers in the shop, horse play in the shop, tech is sick and so on.
A person would use PDSA to plan what changes to make, make the changes, study the results, then take further action based on the results. SPC would show on a chart any changes to the system.
An example might be that using a SPC chart it its found that the misdiagnosis rate is 30%. Further investigation reveals that 90% of the misdiagnosed vehicles are less than 3 years out of warrantee. It is decided that more training is needed, so the techs get some training. The SPC chart shows that the misdiagnosis rate drops steadily to 25% and stays there.
Another PDSA cycle would be used. This time the shop signed up to the OE websites and trained the techs to use them. During the next few months the SPC chart shows another drop in missed diagnosed vehicles.
The PDSA is the action plan that we are going to take to make the changes. The SPC will show the results.
_________________ David Wittmayer
Owner / Manager
Hansen Enterprises Fleet Repair, LLC
Camp Verde, AZ
www.hefrshop.com
Joined: 17 May 2007 Posts: 38 Location: New Iberia, La.70560
Posted: Sat Mar 15, 2008 10:25 pm Post subject:
Hi Louis,
Thanks for this post.
One of the root causes that I didn't see is a lack of
experience. Would practice be considered part of the training process?
I can be given the connections to setup a scope on a sensor; with out experience I might consider a pattern a problem when it isn't.
Experience can relate to the system on the vehicle and the tools being used to diagnose.
A lack of experience might cause one to rerun a test. Basically lacking confidence in his diagnosis.
A shop may have more than one root cause affecting results. For example too many different makes to become experienced at diagnosing. In my shop, this means different scan tools for each Manufacturer
Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Sun Mar 16, 2008 11:07 am Post subject:
Does experience belong on the chart?
This is a very good question. I could give my opinion, but that is not in keeping with my aim for this forum. Rather I will offer some thoughts I hope will stimulate further discussion.
Is the term "experience" being used interchangeable with competently trained?
What constitutes experience?
Does doing a task over and over constitute experience, as it is being used here.
Is experience the same as [very similar to] self confidence?
Does the need for experience point to any other problems?
Is experience a matter of learned behavior(s) (e.g., critical thinking, root cause analysis, design of experiments, etc.)
Joined: 15 May 2007 Posts: 146 Location: Garden City, KS
Posted: Tue Mar 18, 2008 12:03 pm Post subject:
louis wrote:
Does experience belong on the chart?
This is a very good question. I could give my opinion, but that is not in keeping with my aim for this forum. Rather I will offer some thoughts I hope will stimulate further discussion.
Is the term "experience" being used interchangeable with competently trained?
What constitutes experience?
Does doing a task over and over constitute experience, as it is being used here.
I think so, yes.
Quote:
Is experience the same as [very similar to] self confidence?
I feel with positive experiences you gain self-confidence. With negative experiences you lose it.
Quote:
Does the need for experience point to any other problems?
Yes and no. I'll try to elaborate better at the end.
Quote:
Is experience a matter of learned behavior(s) (e.g., critical thinking, root cause analysis, design of experiments, etc.)
No.
This is a very good topic, really. I know I mentioned earlier that experience can and does play a part in misdiagnosis just like it plays a role in correct diagnosis. But, the more I think about it, the more I see this as what it is. Confidence. The bottom line is that the tests and results do not change from vehicle to vehicle. That meaning, a voltage drop is a voltage drop whether it is a GM you see everyday or a Ferrari that you've seen once in your career. From experience, we gain confidence and with confidence we gain efficiency. By that I mean we don't second guess ourselves.
Even as a young tech with very little experience I had success in correctly diagnosing vehicles the much more experienced techs had difficulty with. I attribute this to where I think Louis is taking this. I had a few things they did not. For one, I had superior information access. I also had the proper equipment at my disposal. I feel I was very well trained as well. My lack of experience changed nothing.
Perhaps, in many cases, experience can cause inefficiency in that our minds are not completely open. One of the most important, and difficult, tasks in diagnostics is to recognize that your path or approach is not leading you into an efficient and correct diagnosis and being able to change directions or bail out and start over. Too often we get stuck in our path. Very similar to a quarterback who drops back to pass but is only looking at one option the whole play, when a receiver further down the progression is wide open. Even when studying chess-masters, one of their keys to success if remaining flexible and often experience (like age ) hinders flexibility.
The ultimate answer here is that, in contradicting a past response of mine to this very thread, experience plays a lesser role than we give credit for. Experience cannot be overlooked for it's other attributes, but in the case of misdiagnosis it is a very small player. I think in a previous post I had mentioned a diagnostic triangle. Training, information, and tooling. These are pillars to building a correct diagnosis. Adding a comfortable and cultivating environment is perhaps another pillar, or at least better mortar, for building a more complete and repeatable system.
I'm glad you sat back and let this develop, Louis. I'm anxious to hear what you or anyone else has to add to this. Thanks! Later, Matt.
_________________ Matt Fanslow
ASE CMAT/L1
Crag-Technologies, Inc
www.wavehook.com
Joined: 17 May 2007 Posts: 38 Location: New Iberia, La.70560
Posted: Tue Mar 18, 2008 10:43 pm Post subject:
Louis Wrote
Quote:
Does experience belong on the chart?
This is a very good question. I could give my opinion, but that is not in keeping with my aim for this forum. Rather I will offer some thoughts I hope will stimulate further discussion.
What do I mean when I say “Experience". These are the definitions that rather fit the question I raised.
1-knowledge or practical wisdom gained from what one has observed, encountered, or undergone
2-a particular instance of personally encountering or undergoing something
3-"knowledge gained by repeated trials," "to try, test,"
4-Experiment
Experience can relate to both vehicles and tooling. When you think about vehicles, some of the systems have been around for a long time. The truth is that the design of systems do change, making the most experienced of techs, inexperienced. Am I the only guy who hates to have software up-dated. The new information is great but it takes me time to get use to what is new and what has been re-arranged.
Example:
For instance, when I first started attempting to use the Ford IDS, I was taught to locate and use the power balance feature. The first vehicle I encountered was a vehicle a customer was considering purchasing. I eventually looked at the power balance feature and observed that the crankshaft was slowing on one cylinder at a rate of about -15. I reported this event as a misfire. The next vehicle that I encountered had 1 cylinder at –50 and 2 others at –15 and –20. I replaced coils and plugs on all three. The cylinder with –50 cleaned up, not the others, same thing. After installing the old coils on those 2 cylinders I watched them for a while and noticed the drop in rpms occurred more frequently when load was added. I then examined Mode 6 and there were no misfires. When I questioned the rep concerning my confusion, he had me disconnect power from one of the injectors. Wow –55, he explained that’s a misfire. Now the point, even though I had training to connect the tool and find the Power Balance feature and had some understanding of what negative and positive events meant, I continued to learn by using the tool and it’s features on different vehicles. The need for additional exploration in order to use this feature more effectively is needed. An additional point is that with each encounter I could become more comfortable with what I am observing or less comfortable.
Quote:
Is the term "experience" being used interchangeable with competently trained?
This would depend on your Operational Definition of ”Trained”? If trained includes hands on practice to the point of being in state of Statistical Control of that process then the answer would be yes, if not the answer is no.
What is competently trained? Is it arriving at the correct diagnosis or does the correct diagnosis have to be reached in a time quota to be competently trained.
Quote:
What constitutes experience?
1.Does doing a task over and over constitute experience, as it is being used here.
It could be, some tasks take repetition to master, while other tasks don’t require a great deal of repetition. Then there are those task that tend to deteriorate with repetition.
Quote:
2.Is experience the same as [very similar to] self-confidence?
If the experience is good it could build self-confidence, if it is negative, it has the potential to destroy self-confidence.
Quote:
3.Does the need for experience point to any other problems?
At this point my theory is, experience is needed. The only problem I see is the difficulty in acquiring needed experience
The answers to your question are my own thinking at this point and don’t necessarily represent the views of the profoundly intelligent.
Thanks You for these great posts.
Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Wed Mar 19, 2008 2:40 pm Post subject:
What I hope for with this forum is to stimulate discussion and have folks arrive at answers, they can apply. I think with discussion, points might be brought out and we may learn new ways to think about things. This can be a very long-term process, but I think some great knowledge can be gleaned. From the points at hand, my observations are these:
Quote:
What do I mean when I say Experience". These are the definitions that rather fit the question I raised.
1-knowledge or practical wisdom gained from what one has observed, encountered, or undergone
2-a particular instance of personally encountering or undergoing something
3-"knowledge gained by repeated trials," "to try, test,"
4-Experiment
Thought one
Would this not also serve as a pretty fair definition of training? The primary difference as I see it: Training might be more formalized, and experience is sort of a trial and error learning process over time. From this respect, experience and training might be viewed as the same? If perfect training were available, perhaps experience would be unimportant. This is not the case, but with better training is experience as important?
Could experience be considered a slow, tedious and expensive substitute for better training?
In a field changing very quickly, can a business afford to rely on experience?
Thought two
IF self confidence is important in proper diagnosis [and I feel we agree it is] and experience can either help or harm self confidence, then experience, as defined here cannot be assumed as helpful. Rather, good experience might be helpful and poor experience might be harmful.
A person may observe, encounter, and undergo experience for twenty years and still be totally wrong. They may further experiment and try something for twenty years and not arrive at the proper answer. This can happen by improper observation, pre-determining what will be found or myopic relativism. I suggest this happens in the trade everyday and has for many years.
There are shops that press caliper pistons in everyday, with a C-clamp. They never flush the system beforehand nor expel the old fluid. They have done this for decades and their experience, observations and encounters say it is fine. They know no other way. The same with tightening lugs with an impact, aligning vehicles with a machine that does not repeat and using Dexron III in every transmission, the list goes on and on.
Has experience helped these people?
Is experience merely a way of learning and not knowledge in and of itself?
Is experience a great way of learning or just a commonly used way?
Practice does NOT make perfect. Practice contributes to making permanent. Only perfect practice may make perfect.
A last thought is, do the words “competently trained” have a reference to time? For instance, is arriving at a proper diagnosis sufficient or must there be a time reference?
It is said, given an infinite amount of time, an infinite amount of typewriters, paper and an infinite amount of monkeys, they would eventually type every great novel that has ever been written.
For an answer, I think the aim of training [from a business perspective] must be examined. Competently trained could be defined as accomplishing the aim of the training. I believe the aim of training is normally [eventually] to increase profit. This might be from quicker diagnosis [time,] fewer mis-diagnosis [time,] or increase in client satisfaction [relative to cost [time].]
Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Wed Mar 19, 2008 4:02 pm Post subject:
MattFMN wrote:
I'm glad you sat back and let this develop, Louis. I'm anxious to hear what you or anyone else has to add to this. Thanks! Later, Matt.
Hi Matt,
I think this gives a good example of the process necessary for true improvement. Each cause needs to be examined and each term needs to be understood. For instance the discussion with defining experience is excellent. The same with understanding 'competent training.' Without defining it, how could we know if we accomplish it.
Exercises like this can go on for quite a while and the company get better and better as they do. My hope is, people will see the potential and we may gain other contributors. There is no right or wrong answer at this stage, just understanding to be gained. Next we might discuss each factor and how they might be implemented.
Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Mon Mar 24, 2008 7:36 pm Post subject:
In a previous post I asked the following questions:
Quote:
Could experience be considered a slow, tedious and expensive substitute for better training?
In a field changing very quickly, can a business afford to rely on experience?
I feel the answer to the first is yes. Experience, as applied to the auto repair trade, is I feel, a continuation and refinement of learning. As such, I feel it could be considered a “non-value added” step. That is, something that is necessary, because something else is not working as well as it might.
That being said, I also feel it may be necessary, because shops do not have the means to totally revamp or develop a superior means of training.
To me this brings the second question, which I feel must also be yes, at least at this time. Unless someone disagrees or has better knowledge, let’s move on.
Accepting that good experience might help mis-diagnosis, how might a manager achieve or increase experience in their work force?
The obvious method of waiting for it to occur is hardly helpful as this could take many years. How else might the good experience level of a shop’s techs be increased in a time effective manner?
Joined: 17 May 2007 Posts: 38 Location: New Iberia, La.70560
Posted: Tue Mar 25, 2008 9:26 pm Post subject:
Please excuse the lack of a timely response. The more one thinks about what has been posted concerning experience the less confident of it as a tool.
I agree that in a field changing very quickly expiernce seems inefficient.
Quote:
Is the term "experience" being used interchangeable with competently trained?
If we consider training as complete and inclusive, then the questions arises where or how could such training be had.
Quote:
I also feel it may be necessary, because shops do not have the means to totally revamp or develop a superior means of training.
Is it possible to initiate a “Completely Trained” process with limited funds and time?
Quote:
It is said, given an infinite amount of time, an infinite amount of typewriters, paper and an infinite amount of monkeys, they would eventually type every great novel that has ever been written.
So, I see you have an understanding of our current methods; maybe this would explain my interest in this post.
Being honest, I am trying to understand what is being said.
Although, we can agree concerning the downfalls of experience, beliefs are not shed easily.
Maybe bringing this up has taken us of track, if so I apologize. The questions of your original post remain.
Quote:
· Are there ways any of these root causes can be prevented [lessened] by changes to he system?
· Are there root causes not listed here?
· How might PDSA be used?
· How might SPC be used to track the results?
Don't assign work to techs that don't have the training to do the diagnosis.
Quote:
Accepting that good experience might help mis-diagnosis, how might a manager achieve or increase experience in their work force?
The obvious method of waiting for it to occur is hardly helpful as this could take many years. How else might the good experience level of a shop’s techs be increased in a time effective manner?
In an attempt to stay up with the post, you could break the diagnosis up into do-able pieces, insuring the chances of success. An example might be to allow a tech to retrieve Data with a scan tool and then supply assistance with analysis.
Thanks
Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Tue Mar 25, 2008 9:44 pm Post subject:
Hi Mike,
slimmv wrote:
Please excuse the lack of a timely response. The more one thinks about what has been posted concerning experience the less confident of it as a tool.
I agree that in a field changing very quickly expiernce seems inefficient.
Quote:
Is the term "experience" being used interchangeable with competently trained?
If we consider training as complete and inclusive, then the questions arises where or how could such training be had.
Quote:
I also feel it may be necessary, because shops do not have the means to totally revamp or develop a superior means of training.
Is it possible to initiate a “Completely Trained” process with limited funds and time?
Quote:
It is said, given an infinite amount of time, an infinite amount of typewriters, paper and an infinite amount of monkeys, they would eventually type every great novel that has ever been written.
So, I see you have an understanding of our current methods; maybe this would explain my interest in this post.
Being honest, I am trying to understand what is being said.
Although, we can agree concerning the downfalls of experience, beliefs are not shed easily.
Maybe bringing this up has taken us of track, if so I apologize. The questions of your original post remain.
Quote:
· Are there ways any of these root causes can be prevented [lessened] by changes to he system?
· Are there root causes not listed here?
· How might PDSA be used?
· How might SPC be used to track the results?
Don't assign work to techs that don't have the training to do the diagnosis.
Quote:
Accepting that good experience might help mis-diagnosis, how might a manager achieve or increase experience in their work force?
The obvious method of waiting for it to occur is hardly helpful as this could take many years. How else might the good experience level of a shop’s techs be increased in a time effective manner?
In an attempt to stay up with the post, you could break the diagnosis up into do-able pieces, insuring the chances of success. An example might be to allow a tech to retrieve Data with a scan tool and then supply assistance with analysis.
Thanks
You are not taking the post off track at all. To the contrary, this is the value of such an exercise. It would be very difficult [impractical] to do a PDSA with experience. Rather, the topic is discussed and better choices may come from the discussion. This is totally in keeping with our objectives.
Many times we cannot readily change things we realize are not optimal. The current training system may be such a thing. This does not mean it shouldn't be worked at. It does mean there are often ways to accomplish our ends though other methods.
louis wrote:
Accepting that good experience might help mis-diagnosis, how might a manager achieve or increase experience in their work force?
The obvious method of waiting for it to occur is hardly helpful as this could take many years. How else might the good experience level of a shop’s techs be increased in a time effective manner?
Please continue to add your ideas so we can explore solutions. I feel just by participating a great deal can be realized. The task of improving diagnostics is immense, so are the rewards. My hope is that we can gain further input from other members as well.
Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Tue Apr 01, 2008 12:41 pm Post subject:
louis wrote:
Accepting that good experience might help mis-diagnosis, how might a manager achieve or increase experience in their work force?
The obvious method of waiting for it to occur is hardly helpful as this could take many years. How else might the good experience level of a shop’s techs be increased in a time effective manner?
How else might a manager effect good experience in their workforce?
They might hire only experienced help, but again, this would take some time to implement.
Certainly they could limit the number of vehicle types worked on. I feel this can be detrimental to many businesses and don't see it as a practical alternative.
Suppose each technician was allowed to specialize in a particular facet of the repair process? For instance one tech primarily performed automatic transmission repair. Another might do domestic drive-ability and body controls. Another Japanese drive-ability and body control and so on.
In this way a shop would become a team of specialist. Each person does what they do best and is available to consult with any other team member. This might quickly increase the individual experience level on any tech. The "collective experience" level should also greatly increase.
With a team of specialist, the effective experience of each member may be greatly amplified.
In order to make such a concept work, I think other thinks would have to first be in place. Thoughts?
Joined: 19 May 2007 Posts: 206 Location: Camp Verde, AZ
Posted: Tue Apr 01, 2008 10:11 pm Post subject:
louis wrote:
In this way a shop would become a team of specialist. Each person does what they do best and is available to consult with any other team member. This might quickly increase the individual experience level on any tech. The "collective experience" level should also greatly increase.
With a team of specialist, the effective experience of each member may be greatly amplified.
In order to make such a concept work, I think other things would have to first be in place. Thoughts?
The concept will work as long as everybody plays well together. There would have to be an attitude of trust, openness and sharing. The whole shop would have to be “looking out for the greater good”, rather than each person for themselves.
I would think that it would work easier in a larger shop than in a small one. The more people there are to be specialists the less each person has to specialize in.
This concept could be carried a step further and have several shops that worked together.
But, if we can not work together within our own shop how can we ever expect to work with other shops.
_________________ David Wittmayer
Owner / Manager
Hansen Enterprises Fleet Repair, LLC
Camp Verde, AZ
www.hefrshop.com
Joined: 15 May 2007 Posts: 774 Location: Baton Rouge, LA
Posted: Wed Apr 02, 2008 1:19 pm Post subject:
Dave wrote:
louis wrote:
In this way a shop would become a team of specialist. Each person does what they do best and is available to consult with any other team member. This might quickly increase the individual experience level on any tech. The "collective experience" level should also greatly increase.
With a team of specialist, the effective experience of each member may be greatly amplified.
In order to make such a concept work, I think other things would have to first be in place. Thoughts?
The concept will work as long as everybody plays well together. There would have to be an attitude of trust, openness and sharing. The whole shop would have to be “looking out for the greater good”, rather than each person for themselves.
Hi Dave,
I think you are right, an atmosphere of internal competition will kill this very quickly. Then again, such an atmosphere kills many desirable things, in my opinion.
Dave wrote:
I would think that it would work easier in a larger shop than in a small one. The more people there are to be specialists the less each person has to specialize in.
This concept could be carried a step further and have several shops that worked together.
But, if we can not work together within our own shop how can we ever expect to work with other shops.
Good points! I adopted such a concept about five years ago and it has worked remarkably well. An added benefit is the increase in "prestige" each tech seems to feel. By being the "go to guy" on their specialty, they seem to want to know all they can about their field. It's sort of like having five specialty shops all cooperating.
One important thing I feel is fairly clear by now is how much management has to do with diagnosis. Something many shops never consider. Diagnosis wrong? "Must be the guy doing it." "You just can't find good people!"
Rather than persecuting employees, few shops consider making it easier for every person to get better diagnosis. A very few people can deal with all the chaos and still get fair results. Shops spend their lifetimes looking for these people. Making the system better would mean many, many more people could now get good results and the blessed few could get supurb results.
Any thoughts on all of the other factors that influence diagnosis?
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) hinders flexibility.
