A strong management system is supported by an active continuous improvement culture. Below are the components of a management system noting the core which is improvement activity:

  1. Strategy Deployment
  2. Standard Work
  3. Continuous Improvement (A3 Problem Solving & Deployment)
  4. Visual Management
  5. Daily Management & Single Point of Accountability
  6. Leadership Standard Work

As with any improvement activity, we sometimes get caught up in how to scope the work. Below is a guide that can help with scope and expected timing commitment to successfully complete the work driven by A3 thinking:

Rapid Improvement Event

A3 Problem Solving

Just Do It

Solution is not known Solution is not known Solution is known
Metrics needed to confirm success Metrics needed to confirm success Metrics not needed – PDSA cycle completed through anecdotal evidence
Requires a team, often cross-functional of 7-9 members Scope is small and specific to one area or discipline – could require small team No coordination required and very few people involved
Executive level sponsor or process owner needed Process owner obtains input and is oversight for change Process owner has oversight of change
Event is 3-5 days in length but prep occurs before and follow-up occurs after Completed during regular work time Completed during regular work time with target of 8 hours or less to complete
Changes made and tested during event.  Changes reviewed with stakeholders Changes tested during normal work time with those involved in the process Easy to reverse changes if issues arise

Remember that A3 problem solving is a distributed means of problem solving that is good for daily use by everyone with all the types of activity noted above.


Ken Lowe, Senior Consulting Director at VizientToday’s blog was written by Ken Lowe, Senior Consulting Director with Vizient.

Ken has seven years of healthcare experience in leading hospitals, clinics and healthcare related organizations through Lean transformations and specialized consulting for Vizient. Prior to Vizient, Ken was Director Continuous Improvement for Cummins Filtration. He has over 20 years’ experience leading lean in a manufacturing environment. Within the healthcare industry he has worked with prominent academic medical centers, large clinic systems and community hospitals across the United States. He has a proven background to be a change agent, utilizing business metrics to analyze and develop lean strategies that address the voice of the customer. Ken has experience accomplishing improvements in hospital capacity resulting in overall LOS reduction, inpatient Care Optimization with focus in Case Management and Transition of Care resulting in reduction of readmissions, Surgical Services resulting in improved inventory management, surgical case management and improved throughput, Outpatient Care Optimization with focus on clinic throughput and patient satisfaction/safety as it relates to medication management and implementation of Lean Management Systems to achieve sustainment in overall system performance. He is an instructor in a lean certificate program and has been a featured speaker at a variety of healthcare industry events. Ken has a Bachelor’s degree in Accounting and Business Administration from Bethel College.

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