Today’s blog continues our A3 Problem Solving Series.  We started this series last year and due to busyness and other priorities, never posted the final blogs of the series – sorry for the delay!  After hearing from readers we realized we needed get in gear and get posting!  If you missed the first part of the series or are a new Lean Healthcare Exchange follower, catch up by reading the beginning of our Lean Healthcare A3 Problem Solving Guide.

At this point, we’ve determined our problem statement, drawn the current state of the issue, completed a root cause analysis of the problem, creating our ideal future state and written countermeasures to help achieve the ideal state. Now we need to implement the countermeasures.  The implementation plan outlines the steps that must be accomplished in order to realize the target condition.  The A3 author lists the steps, when they need to be done, and who is responsible for completing them.  When creating the implementation plan it is important to specify the content, sequence, timing, location and outcome (a la our 4 rules) of each step.

Perhaps the most important part of the implementation plan is a pilot test.  You must complete a real time trial with front line employees to validate the new process and gain their feedback.

Applying this to our phlebotomy example, the implementation plan will look like this:

A3 Blog Part 5 FINAL

  1. We must first consolidate the various laboratory guides into one and update it to include pictures of the different tubes used to draw blood.
  2. Ask the nursing supervisor of one unit in the hospital if they would be willing to test the new procedure using the updated guide for one week.  Train the staff on the new process in exact sequence and timing detailed in the target condition.  Provide them with the “why this needs to be done” by showing the data on the number of re-draws.
  3. Run the pilot and ask the laboratory to collect data reflecting the number of re-draws due to the wrong tube being used from this unit only.  Ask the staff to provide feedback and suggestions for improvement.
  4. Review the data and the nursing staff suggestions and finalize the process.
  5. Create a plan to train all of the nursing staff.

Now that you’ve rolled out a new process, how do you ensure that it will not revert back to the old way?  We’ll discuss a follow-up plan in the final blog of this series next week.  Until then, happy problem solving!


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