A3 Thinking

Denver Health Lean Training

Created by: Katie Stanek, Lean Facilitator © 2012 Denver Health and Hospital Authority. All Rights Reserved

What is A3 Thinking?

  A3  Metric nomenclature for a paper size, equal to 11” x 17” A3 Thinking  Consensus building process utilizing a systematic, documented methodology  Communication tool that follows a logical and standard structure © 2012 Denver Health and Hospital Authority. All Rights Reserved

Why Promote A3 Thinking?

     A structured cycle of improvement A framework for organizing thinking & work  For individuals and teams Promotes transparency of issues, problems and thinking Makes work and opportunities visible Tells the story © 2012 Denver Health and Hospital Authority. All Rights Reserved

How to Achieve A3 Thinking?



Do an A3 for all types of activities

 Strategic planning  Problem solving/Decision making  Sharing good ideas/Proposing change  Value Stream Analysis/Rapid Improvement Events  Reporting progress/Policy deployment © 2012 Denver Health and Hospital Authority. All Rights Reserved

Creating an A3

   Define the purpose Tell the story visually and logically    Beginning – Strategy/Problem identification - Reason for Action Middle – Gap analysis, Solution Approach, Rapid Experiments End – Completion Plans, Confirmed State Updating A3s “living document”    At the Start (Proposal, comparison with similar events, charter etc.) During the process (to maintain consensus, get support, guidance or verify the actions/hypothesis) When completed (to communicate and celebrate success) © 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 2. Initial State 5. Solution Approach 8. Confirmed State 3. Target State 6. Rapid Experiments 9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 4. Gap Analysis 1. Reason for Action Why are we doing this?

What is the burning platform?

What is the chief complaint?

2. Initial State 5. Solution Approach Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 8. Confirmed State 3. Target State 6. Rapid Experiments 9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 2. Initial State Describe attributes of the initial state – Quantitative & Qualitative Graphically present picture of Initial State 3. Target State 5. Solution Approach 6. Rapid Experiments 8. Confirmed State 9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 2. Initial State 5. Solution Approach 8. Confirmed State 3. Target State Describe attributes of the target state – Quantitative & Qualitative Graphically present picture of Target State Are metrics defined and achievable?

6. Rapid Experiments 9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 4. Gap Analysis What holds us back from the Target State?

What are the root causes of these road blocks?

2. Initial State 5. Solution Approach 8. Confirmed State 3. Target State 6. Rapid Experiments 9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

Gap Analysis

 Affinity diagrams  Scatter diagrams  Pareto charts  5 Whys 

Fishbone diagrams

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Fishbone

People

Major Problem or Issue

Procedures

Communication

Patients & Families Policy © 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 2. Initial State 3. Target State 5. Solution Approach Does solution approach link well with the root cause identified in the Gap Analysis?

Does the Solution Approach express the hypothesis to be validated or adjusted through Rapid Experiments?

6. Rapid Experiments 8. Confirmed State 9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 5. Solution Approach 8. Confirmed State 2. Initial State 3. Target State 6. Rapid Experiments Expect the Solution Approach to not be perfect- Run the tests of change!

Are Rapid Experiments achieving desired results and learning?

9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

Rapid Experiments

 Observe what works  Observe what doesn’t work yet  Record the new process performance  Collect data based on observation  Document issues and begin to resolve problems  Do not talk or think yourself out of trying new ideas © 2012 Denver Health and Hospital Authority. All Rights Reserved

Start Making Meaningful Change

     There is no time like the present Don’t over analyze Resist the temptation for delayed implementation “until we make things perfect” Seek buy-in from people in work area by explaining why we are making change (Reason for Action) and by asking them their thoughts on improvement Break into smaller sub groups to get many things done quicker © 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis 2. Initial State 5. Solution Approach Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans Is Completion Plan in place with names, dates, & outcomes?

Is Completion Plan on track?

8. Confirmed State 3. Target State 6. Rapid Experiments 9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

Completion Plans

Action Item Responsible Date Completed

© 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 2. Initial State 3. Target State 5. Solution Approach 6. Rapid Experiments 8. Confirmed State Are Confirmed State metrics in place and do they validate the target state?

Does confirmed state show what “good” looks like in a way that cannot be misunderstood?

9. Insight

© 2012 Denver Health and Hospital Authority. All Rights Reserved

TITLE:_________________________________ Date Started:_______Current Date:_________ 1. Reason for Action 4. Gap Analysis Team:___________________________ Executive Sponsor: Process Owner: 7. Completion Plans 5. Solution Approach 8. Confirmed State 2. Initial State 3. Target State 6. Rapid Experiments 9. Insights Do insights show key lessons learned and identify future opportunities?

© 2012 Denver Health and Hospital Authority. All Rights Reserved

Questions?

© 2012 Denver Health and Hospital Authority. All Rights Reserved

A3 Activity

 Pick a problem in your area  Complete the A3 © 2012 Denver Health and Hospital Authority. All Rights Reserved