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Quality control measures like Lean manufacturing and DAMAS can increase your efficiency and productivity.
Quality control measures like Lean manufacturing and DAMAS can increase your efficiency and productivity.
No one likes to be told what to do. As kids, your parents told you to clean up your room and eat your veggies. In school, your teachers instructed you to write neatly and follow directions. On the job, your bosses demanded that you do it their way because that’s the way it’s done. They might have told you it’s all for your own good, but you didn’t really believe it and vowed that someday you’d be your own boss, and no one would tell you what to do.
Then you opened a dental laboratory and faced myriad commands and regulations that you couldn’t say no to. The funny thing is, all those demands from parents, teachers, and bosses turned out to actually be for your own good in a way and now can help you make your business stronger and more profitable.
The skinny on Lean
While there are official regulations mandated by the U.S. Food and Drug Administration that dental laboratories must adhere to as a manufacturer of medical devices, having a basic in-lab system of quality assurance and standard operating procedures just makes practical business sense. Any system where the laboratory regularly reviews standards and practices and then establishes working guidelines will only move operations to a higher level of efficiency by flagging areas of weakness and showing areas needing modification.
“When you have a quality system, it allows you to catch [problems] quicker and take corrective action rather than waiting for a firestorm to hit where you can’t really recover,” NADL Executive Director Bennett Napier said. “The damage is done, and you have hundreds of cases that have been affected rather than a few.” With a quality system in place, the lab can trace the problem back to the source and take corrective measures to help ensure the problem does not reoccur.
One system of setting benchmarks for quality standards that is widely used in many industries is known as Lean manufacturing. Although it isn’t a formal certification or regulation process, Lean manufacturing is more of a philosophical way of looking inward to advance the current of things moving forward.
The heart of Lean is the fundamental concept of eliminating waste and excess and streamlining procedures, said Anne Steinbock, Whip Mix Corp., Vice President of Sales & Marketing. “In the dental lab, it’s the flow of the work,” she said. “You are determining how you can improve workflow and make sure each of the steps you are taking is providing the maximum amount of value.”
Bob Long, Whip Mix Lab Relations Manager, said many instances of lab waste would seem common sense, but need to be observed and noticed through impartial eyes. “The biggest thing we try to do is get rid of the clutter, confusion,and chaos,” he said. “I’ve watched guys sit there and fumble with all these burs on their bench. They pick one up, put it in the handpiece, throw it back down, right back into the stack because it’s broken.”
The idea of eliminating waste goes beyond just squandering materials and supplies but permeates through many overlooked areas, Steinbock added. “Anytime someone has to wait for something to move through the process. Any time someone has to wait for a machine to become available. Any time they have to wait on materials to become available. Any time they have to wait on instructions. We’ve looked at that and tried to eliminate all those things that we call waste,” she said. “Those are basically just delaying the process and adding costs to the operation.”
Practicing what they preach
Not one to just talk the talk, Whip Mix also walks the walk of Lean manufacturing. A certified ISO 9001:2008 manufacturer, it is accountable for its own quality systems from producing materials, supplies, and equipment, which, in turn, help labs with their own Lean operations.
“Lean is really an integral part of our DNA,” Steinbock said. “Everything we make is with this mission in mind. We practice it here, and we certainly try to build that into the products that we make.”
Part of that genetic makeup is in what Long refers to as “cellular design” in the company’s facilities layout. “We haven’t added on in space, but we’ve made three acquisitions. We’ve been able to fit new product lines and production into our existing square footage by putting all the equipment into a cellular organization so the machine operators don’t take steps to work different machines. It’s all much more condensed in the space. We can put more product line manufacturing in the same space,” Steinbock said.
Long said he has heard from lab owners who have implemented a cellular design into their own production workflow schemes with exceptional results. The only complaint he has heard from the labs is they had expanded their footprint before incorporating the cellular design. “Now they have all this extra space they don’t need,” Long said. “They could have saved themselves money,” if they had used Lean cellular strategies instead of expensive construction.
Growing on lean
For many smaller labs, implementing and maintaining Lean manufacturing processes or similar quality assurance standards is as far as they need to go. They are able to improve efficiencies through an informal internal audit of their operating procedures and make adjustments when necessary without outside involvement. However, a handful of labs have decided to make the extra effort beyond basic compliance and on to third-party certification, and have seen additional benefits as well.
One such system is the Dental Appliance Manufacturers Audit System (DAMAS), which was created in Europe in the 1990s as a quality control standard geared specifically for dental laboratories that did not need full-scale ISO certification meant more for industrial mass manufacturers. The NADL modified DAMAS to fit the North American industry and to closer fit FDA regulations.
“DAMAS is really a boiled-down version of ISO for labs who can’t afford or don’t need ISO certification,” said Nick Azar, Founder of Azar & Associates (azarandassociates.com), an NADL-approved DAMAS trainer and consultant based in Santa Clarita, Calif.
Napier said lab owners are turning to the systematic format of DAMAS for different motives. “The primary reason, the driver for them, is they finally understand that if you implement something like this, it makes you more productive, reduces your waste, and in essence will make you more profitable, which allows you to be more competitive, in terms of turnaround times and consistency of product.”
In addition to the benefits of increased efficiency, consistency and reliability to a lab’s everyday production advantage, DAMAS certification provides the bonus of long-term marketability.
“Dentists want to do business with a lab that has a quality system,” said Mary Borg, Co-Founder and President of SafeLink Consulting Inc. of Cumming, Ga. “And having been certified toward that or registered, that’s an assurance to that dentist, who is ultimately responsible for that device going into that patient’s mouth.”
“There’s a lot of quality-minded dentists out there,” Azar said. He sees the demand for quality as coming not just from the dental practice, but eventually from savvy consumers who may even ask for specific products, brands, materials, and labs based on strategic consumer-based marketing and advertising. “Ultimately, the consumer is going to ask the dentist, ‘Who made my product?’”
Azar said it might be a few years down the road, “But many people who are at the forefront, they are always thinking 2 or 3 years ahead. They have a good vision of where their company’s going to be 5 years from now, and they are positioning themselves to be at the front.”
Other labs may be positioning their business for a different consumer. With a growing percentage of lab owners nearing retirement age, growing fatigued by overwhelming competition from more and more supersized labs and chains, or worrying about uncertainty from overseas, the idea of merging or selling has become an attractive option.
Napier said labs that have a quality system in place will be more eye-catching to purchasers. They recognize that if they incorporate some of these systems, it’s going to make them more attractive because people will know that there are systems in place. They aren’t going to have to completely go in and start from the ground up to build an operational structure. All these forces that have taken place, the light bulb has finally gone off for people to see that this is just good business,” he said. Napier added that the labs that have systems in place also are seeing a higher payout at the time of purchase than those where the buyer has to start from scratch with their own quality system.
In spite of all the benefits to a lab’s workflow and cash flow, less than 50 labs in the United States are DAMAS certified. The primary reasons cited are the burden of paperwork, the shortness of manpower, overregulation, staff reluctance, and the long-term commitment, Azar, Borg and Napier said. However, each is clear that the positives will outweigh any such negatives, which aren’t as difficult or time- and money-consuming as often perceived.
“Once you get a system in place and it becomes part of the protocol, it gets instinctual,”Napier said. “The mechanics of managing a quality system, to some extent some part of the process is going to touch every point in the lab so it’s layered out. It’s not like one person now has a 40-hour-a-week job; it could be five minutes at this particular task at this particular production department are now in the mix. Everybody now is involved in managing the process.” He goes on to caution that labs will need to have one person to monitor and oversee the entire process, but who is not responsible for all the details involved.
Of course, having a specialized DAMAS consultant like Azar or Borg onboard to help implement the process never hurts. But ultimately, it will be up to the owner or manager to keep things going.
“Top management needs to show their commitment that this is a priority, that this is important to the organization,” Borg said. “If you’re not supporting it from the top, all it’s going to be is paperwork.”
With administration backing the quality system, staff at the bench are more likely to be behind it as well. “We’re hearing less if they can sell this to the workforce in terms of the benefit,” Napier said. “The benefits are more clear now.”
“It’s about employees having a better understanding of why they’re doing things the way they’re doing them,” Borg said. “It gives a reason for the accountability. This Generation Y and now the Millennials, you’re bringing in a workforce that wants to know why. What’s in it for me? You have to deal with that.”
Richard Palmer is a former editor for Dental Lab Products and has years of experience covering the dental and dental lab fields.