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Introduction to A3
Thinking

Agenda

• What is A3 thinking
• Why use A3 thinking
• How to use A3 thinking

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What is A3 Thinking?
• Structured thinking way - thinking deeply
• Follows a series of standard steps to solve a
problem
• Rigorous application of Plan Do Study Act
(PDSA) cycle
• Output is a concise, consensed document -
A3 Report (11 x 17 inch paper)

Why use A3 Thinking?

• Problem solving methodology:
– Visual
– Simple
– Logical
– Countermeasure, not containment (“Band aid”)
– Move towards Ideal System
• Document & share the learning
• Standardise new methods

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How to use A3 Thinking

• Gain consensus on initial problem perception
• A guide for:
– Understanding the problem
– Identifying the root cause
– Developing countermeasures
– Creating an action plan
• Good A3 report should convey the problem &
analysis of it without any explanation

ACT PLAN
Standardize Understand the problem
5. Has a plan been identified 1. Is the problem statement
to STANDARDIZE and take CLEAR and ACCURATE?
all lessons learned across
products, processes, 2. Has the SYSTEMIC
functional areas, etc.? root cause(s) been
identified for all parts of process?

STUDY DO
Follow-up Execute the Plan
4. Has a plan been 3. Has IRREVERSIBLE
identified CORRECTIVE ACTION(s)
to verify the been implemented for
EFFECTIVENESS ALL root causes?
of all corrective actions?

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Title: Version: Date:

Author: Team:
Problem: Future state:

Current state:

Action plan:

Goal:

Waste identified:
Results and measures:

Root cause analysis:

Next Steps:

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Version: Date:
Title:
Author: Team:
Problem: Future state:

PLAN DO
Current state:

PLAN
Action plan:

Goal:

Waste identified:
Results and measures:

STUDY /
ACT
Root cause analysis:

Next Steps:

Version: Date:
Title:
Author: Team:
Problem: Future state:
• Basic problem
• Customer/patient value
Current state:
• What is happening now?
Use data/graphs, photos, current state
value stream map, demand & capacity
Action plan:

Goal:
• Set SMART Goal
Waste identified:
• Transport, Inventory, Motion,
Results andWaiting,
Automation, measures:
Over processing,
Overproduction, Defects, Skills
Root cause analysis:
• Investigate why the
Next Steps:
problem is happening

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SMART Goals

Fishbone / Cause and Effect Diagram

Identify possible
causes

Possible Investigation How Result

Cause
Investigate most likely causes
further through data collection

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a b Booking
Roles

No clear roles Complex system

No standard work Repetition of work

No structure Don’t know demand

Unsustainable
Service

Duplicate paper Clutter

records
More staff than rooms

Keeping old information

and products Lack of equipment in
each room

c d Equipment and
Recording
Information Space

5 Whys Analysis
Problem Root Cause Countermeasure

Why?
Reason
Why?
Reason
Why?
Reason
Why?
Reason
Why?

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5 Whys Analysis

Patients must
Raise awareness
High DNA think follow –
of importance of
Rate up isn’t
Follow - up
important

ASSUMPTION

5 Whys Analysis
ASK PATIENTS
WHY?
WHY?
WHY? Patients can’t Not enough
get through on admin staff / Admin
High DNA the phone to Phone not nobody
Rate answered vacancies
cancel or designated to
change appt WHY? cover WHY?

Ask Pts No choice Call log Ask admin staff Ask Manager

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Version: Date:
Title:
Author: Team:
Problem: Future state:
• Investigate how to solve
root cause(s)
• What
Currentdoes
state: the patient

need?
Action plan:
• Agree
Goal:
action plan
What / How / Who / When
Waste identified:
Results and measures:
• Is the problem solved?
• HasRootthe goal
cause been met?
analysis:

• Can the new process be Next Steps:

standardised?

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A3 Example

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A3 Example

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