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Session 16: Introduction to A3 Thinking

Donna Whittaker, Ph.D.Lean Six Sigma Deployment DirectorDirectorate of Strategy Management, G-8/9US Army Medical Command/HQDA, Office of The Surgeon Generaldonna.s.whittaker.civ@mail.milOffice: 703.681.8031

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Disclosures

Presenter has no financial interest to disclose.

This continuing education activity is managed and accredited by Professional Education Services Group in cooperation with the MedXellence Program. PESG, and MedXellence Staff, and accrediting organization do not support or endorse any product or service mentioned in this activity.

PESG and MedXellence Program Staff have no financial interest to disclose.

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Learning ObjectivesAt the conclusion of this activity the participant will be able to:• Understand A3 as a management system and methodology for

problem solving• Employ tools and techniques to determine the Voice of the

Customer and Voice of the Business• Use measures and metrics to review performance

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Agenda

1. What is A3 Thinking?2. Seven elements of A3 Thinking3. Examples of A3 Templates4. A3’s Link to Lean Six Sigma5. Template Box Explanation…One by

One6. A3 Problem Solving examples

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• A Toyota invented problem-solving method– Executed on a single sheet of A3 sized piece of paper

– “A3” is the name for a metric paper size, similar to 11” x 17” typically used

What is A3?

The essence distilled on to one A3 sheet

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• *Managing to Learn – John Shook• Getting the Right Things Done – Pascal Dennis• A3 Thinking – Durward K. Sobek II & Art Smalley• The Toyota Way – Jeffrey Liker• The Toyota Product Development System –

Morgan/Liker• Decoding the DNA of the TPS – Spear/Bowen • www.lean.org – webinars, excerpts, downloads• Gemba Academy:

• http://www.gembaacademy.com/enterprise/DoD/• User ID: Army• Password: DoDLean

Key References

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• A3 is a Management Process• Enables and encourages learning through scientific method

• A3 Thinking• Team or individual application

• Fosters consensus building

• Simple systematic methodology

• Communication tool w/ logical narrative

• Makes problem solving visual

• Tells a story (on a single page)

A3 Thinking

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• Logical thinking process• Objectivity-Presenting information in a nonjudgmental

way• Results achieved and processes used• Synthesis, distillation and visualization - Using only

critical information• Alignment of the effort with strategy/objectives• Coherence with and consistency throughout the

organization• Systems approach to problem solving

Seven Elements of A3 Thinking

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• A3 work for all types of activities:– Strategic Planning

– Problem Solving/Decision Making

– Sharing Ideas/Proposing Change

– Process Mapping

– Value Stream Analysis

– Rapid Improvement Events

– Personal Development Plans

– IT System Requests

– Capital Appropriation Requests

A3 can become a key tool of making improvement at any level of activity

Where Does A3 Apply?

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• What is the problem or issue?• Who owns the problem?• What are the root causes?• What are the possible countermeasures?• How will you decide which countermeasure to

propose?• How will you get agreement from everyone

concerned?• What is your implementation plan --- Who,

What, When, Where and How?• How will you know if the countermeasures

work?• What followup issues can you anticipate?

What problems may occur during implementation?

• How will you capture and share the learning?

Goals of A3 are Guided by Set of Questions

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The A3 Thought Process Provides Complete StructureThe A3 Thought Process Provides Complete Structure

Relationship: A3 Thinking- LSS and PDCA

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PlanDo

Check &Act

Plan Do Check & Act

Plan Do

Check & Act

Template Examples

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1. Reasons for Action 4. Gap Analysis 7. Completion Plans

2. Initial State 5. Solution Approach 8. Confirmed State

3. Target State 6. Rapid Experiments 9. Insights

Example of A3 Template

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Example of A3 Template

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Army Medicine A3 Template

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Box 1—The Issue or Problem to be Addressed

• Key Items for Box 1• What is the issue or problem?• Who owns the issue?• What is the scope?

• Who, Where, Process Start/End Points• When was the issue or problem recognized• What are the impacts if the issue or problem

is not addressed

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• Key Items for Box 2• What circumstances brought the issue to

light?• How does the issue fit in the context of the

organization• What is the history? • Is the history clearly understood?• Why is the problem important

to the organization?

Box 2—Background

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Box 3—Gap/Current State and Target Condition

• Key items for Box 3• What is actually wrong with the current state or

process• Can the issue/problem be quantified?

• What measures indicate we are under-performing• What is target performance?

• How was information about the current state obtained?• Did you go to the Gemba?

• Actual place• Actual work• Actual people who do the work

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Box 4—Root Cause Analysis

• Key Items for Box 4• List the root causes of the issue or problem

• 5 Why Analysis• Are the root causes directly related to the

current state?• Are the root causes clearly understood?

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Box 5—Prioritized Solutions

• Key Items for Box 5• What are the prioritized solutions?• What are the measures of success?• What are the costs to implement the

solutions?• Are cost savings expected? How much?

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Box 6—Implementation Plan

• Key items for Box 6• Are the solutions expensive or risky?• Is a pilot needed?• Describe the resources requiredAction Responsible Due Date

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Box 7—Results and Follow Up

• Key items for Box 7• Compare the actual results with the expected

results • Operational and Financial Results

Target or Planned Result Actual Result

– How will gains be sustained?• Monitoring, reporting frequency• Checklists, job aids, SOPs

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A3 Example

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A3 Example

A3 Example

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A3 Example

A3 Example

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A3 Example

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A3 Example

A3 Example

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A3 Exercise

• Market Manager for the eMSMcontaining Valhalla, Olympus and Cisifus requested a Value Stream Analysis of three perceived problem areas in order to meet the eMSM goals.• Effectiveness of Care/Healthy Behaviors• Enrollment/Access to Primary Care• Recapture/Referral of Specialty Care

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Donna Whittaker, Ph.D.Lean Six Sigma Deployment DirectorDirectorate of Strategy Management, G-8/9US Army Medical Command/HQDA, Office of The Surgeon Generaldonna.s.whittaker.civ@mail.milOffice: 703.681.8031

Session 17: Introduction to A3 Thinking

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Obtaining CME/CE credit

• If you would like to receive continuing education credit for this activity, please visit:

http://medxellence.cds.pesgce.com