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Using the A3 To Solve Problems

by Cindy Jimmerson

 

The A3 Problem Solving Method and Document (A3) in combination with the Value Stream Map (VSM), both borrowed from the Toyota Motor Company and Lean leaders in industry, and adapted to manufacturing in the US and elsewhere, have been demonstrated to be of value in reducing waste and errors and retaining good employees when implemented and made an integral part of the organization.

Bolded below are specific features unique to the A3 process and A3 thinking.

The objective nature of the A3 creates safe and acceptable problem solving; it is never critical of an individual’s work.

The left side of the A3 Problem Solving Document:

The A3 is a way to look with “new eyes” at a specific problem identified by direct observation or experience. It offers a structure that begins by always defining the Issue through the eyes of the customer.  In itself this way of stating the problem makes resolution of the problem indisputable.  After all, why are we all here if not to produce an Ideal service or product for the customer?

Objectivity is further reinforced by deeply understanding the current condition before jumping to a solution. When we observe and draw the current condition, we realize that this is the way the current process works; not assigning blame to anyone but to acknowledge that this is the way the work happens now, with or without flaws.  Once that first view of the problem is made, we can move on to ask ourselves, “What about the way this work is happening is not Ideal?” 

The graphic nature of the A3 contributes to deep understanding of the current condition and the target condition.

With the simple graphic representation of a system problem in the current condition drawing, the problem solver is able to see redundant work quickly and clearly and share the realization with whomever he/she involves in the resolution of the issue.  Simple stick figure drawings and lines and arrows demonstrate loops in work that create work-arounds and re-work.   By drawing storm clouds on the graphic it is clear where the problems reside in the current condition.  Also, because A3s, and in particular the drawings, are done in pencil, it is safe for a problem solver to take the drawing to other affected workers or departments and say,   “Here is my understanding of how this work happens now…did I get it right, are there steps I may have left out?”.  This offers all of the involved problem solvers the chance to erase, redraw and correct any wrong assumptions that may have been made about the work.  Because everyone knows how to use a pencil and it can be done immediately, problem-solving progress is rapid and accurate, and the affected workers are able to participate in creating the essential understanding.

Root cause analysis is not new to problem solving, but the A3 offers a simple and consistent way to achieve and document it. 

Toyota’s “5 Why?” approach to getting to the root cause of the problems identified as storm clouds is easy to remember and easy to execute.  When the final Why? reveals the root cause, we have concluded what must be addressed to remove the storm cloud and move the process closer to Ideal.

The right side of the A3 Problem Solving Document: 

Creating the Target Condition is easy because we so deeply understand what’s wrong with the Current Condition. 

The right side of the page is the creative and fun half of the A3. Because we enter it with such a deep understanding of the current work, a better way to work comes easily.  It is also drawn in pencil and we should see the simpler, cleaner process appear on paper, with fewer or no loops of rework or work-arounds.  We can compare the target condition drawing to the current condition drawing and ask the essential question, “Does this new proposed way to work move us closer to Ideal?”.  If the answer is yes, then we can move forward to clearly defining Countermeasures, or changes that we need to make in the process to move from the current to the target condition.

Building accountability with a specific Implementation Plan occurs naturally as we outline the specifics of what needs to be done to make the countermeasures a reality.

By defining what needs to happen, by whom, by when and with what expected outcome, we very clearly and realistically specify the work for the problem solvers involved. This is our work list; this is how the A3 team can check progress. Again, it specifies the work and everyone involved knows exactly what’s expected of him/her.

The Test allows us to try out the proposed better way to work with a safe, experimental attitude and environment. 

Simulating the situation or creating a test environment to challenge and experience the proposed way to work, with a defined test timeline, makes it safe for problem-solvers to be creative and to experiment.  Because of the deep understanding of the process that has been achieved on the left side of the page, the risk is minimal, but the ability to tweak the system before implementation is built in.  Once the test is done and the authorization to implement is granted, full initiation of the newly designed work can occur.

The responsibility for Follow-up to assess the new process over time is assigned to one or more individuals with specific dates for re-evaluation noted on the A3. The follow-up report becomes the new current condition.  If it’s not perfect, that’s OK! We initiate another A3 and ask again, “What about our new current condition isn’t Ideal?” hence, generating ongoing adaptation to the inevitable changes in our work. This again demonstrates the “safety” of the A3 process; an A3 would be deemed successful if the efforts moved us closer to Ideal, even if there was yet more opportunity to improve that we could continue to achieve. No one is chastised for not making it perfect on the first round.

OTHER VALUABLE FEATURES OF THE A3:

There is tremendous power in having one problem solving method in which management and staff members develop confidence. 

When staff and management have been involved with the A3 process and an issue arises for which the A3 approach is suggested, everyone knows the steps that will be employed, believes that they will be either involved or represented in the work redesign and that there will be a timeline and accountability for completion developed. They believe that the experimental environment will be safe.  They know that when problem solving is reported, it will be easy to understand and consistent. When management says, “I think we should do an A3 on this”, everyone knows what that means.

The A3 is done on the front side only of an 11×17” (thus the name, A3) sheet of paper.

With only a small area for problem analysis, the A3 forces the problem solver to choose issues that are specific enough to complete on one sheet.  This assures that the work is of a scope that can be realistically completed, quickly demonstrating successful change and motivating workers to do even more problem solving.

A3 problem solving occurs in the course of work.

Large numbers of staff do not have to be gathered for extended times to do speculative problem solving. Coaches can be recognized and easily trained to help staff validate and participate in the A3 process without leaving their work site.

A3 problem solving is intuitive and easy to learn and remember.

The A3 process is logical thinking based on the familiar scientific method of problem solving that is easy to learn and teach and requires no technical training.

A3 Thinking can be used to create better and fewer meetings.

Conducting a lean meeting using the A3 process can greatly reduce the time and numbers of meetings required to achieve the work of the agenda.  A3s are ideally done by a focus group of 2-3 people who represent the affected parties and can procure validation of the current condition and the target condition from their peers, in the course of work.

Measurement of the cost of implementation and the cost benefit is documented on each A3.

The cost of the implementation plan is documented on every A3 and can then be compared to the benefit, which may be measured in hard or soft dollars saved, or in a measure of quality of service.  This information creates objective information for leadership to use in authorizing the implementation plan presented on the A3 document.

Last, but certainly not least, the A3 process is satisfying to everyone who uses it, particularly frontline workers. 

The A3 is an easy to learn and easy to teach method that staff can use to remove the frustrations of their daily work that are created by weak and un-supportive processes.

 
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About the Author:

Cindy Jimmerson is a pioneer of lean healthcare, having initiated her work with a grant from the National Science Foundation 2001-2004.  She is the founder and president of Lean Healthcare West (LHW), an affiliate company of The ACCESS Group (TAG) and Healthcare Performance Partners (HPP).  LHW consists of healthcare and industry professionals offering education and implementation of TPS/lean principles in hospital, clinic and long term care facilities. She is the author of the reView© course and workbook and many journal publications. Although she travels both domestically and internationally for work, she prefers not to budge from her office on the beautiful Blackfoot River in Missoula, Montana.

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