Today we continue further into our “How to Create an A3” blog series.  Step 4 is Target Condition and Countermeasures.  In previous posts we covered defining the Problem Statement, Understanding the Current Condition, and Root Cause Analysis.

Target Condition is not the result you will achieve; it is an IDEAL state to strive for.  We do not just want to uncover solutions to problems; we want to design the work to create a new and better reality.  Bad systems beat good people, and our job is to change the system. Countermeasures are how you will change the work in order to get to the IDEAL state.  Toyota calls improvements countermeasures (rather than the ubiquitous “solutions”) because it implies:

a) We are countering a specific problem
b) It is what we will use now until we discover an even better countermeasure

When developing a Target Condition, you should strive to eliminate the work-arounds and re-work involved in the Current Condition.  Create a graphic of the IDEAL state (remember why we use graphics rather than text from our Current Condition explanation).  Rather than problematic storm clouds, we now have highlighted good features with fluffy clouds.  Remember, the IDEAL state should be defect free, no waste, and safe for all.

Applying this to our continued phlebotomy example, we can develop a target condition that might look like this:


The countermeasures address the root cause while moving the organization closer to an ideal state.  In other words, they specify what will be changed in order to get from the current condition to the target condition.  Countermeasures for our phlebotomy example could read:

  1. Consolidate the reference guides from four into one
  2. Update the guide to include pictures

This Target Condition has countered the problems in the current state and provides a very distinct process with minimal waste.  This is the IDEAL state and we will need an implementation plan in order to achieve this.  That will be the subject of the next blog.  Until then, happy problem solving!

Today’s blog was written by Dan Littlefield, Director at HPP.

Dan has 30 years of healthcare experience in many clinical and leadership roles. He leads Lean and process improvement consulting engagements for HPP.  His experience includes deploying Lean across numerous healthcare disciplines including Imaging, Laboratory, Nursing, Pharmacy, and Physician Offices.  Dan began his healthcare career as a nuclear pharmacist and has also served as Director of Operations, responsible for 13 facilities.  He has been a featured speaker at a variety of healthcare industry events.

Dan holds a Master’s Degree in Business Administration from the University of Pittsburgh, Bachelor’s Degree in Pharmacy from Purdue University and a Specialty Certification in Nuclear Pharmacy from Butler University.

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