leanhealthcare_a3examplesBy rule of thumb, 20 percent of a Lean Healthcare organization’s work processes should be documented in standard work.  Does your organization come close to this amount?  A3 problem solving is one approach to surface processes that need new or improved standard work.

Consider the A3’s you’ve seen completed.  In the problem analysis section, what is the most common issue drilled down to by the 5 why’s?  A large percent of problem solvers arrive at a cause of, “There is no standard for this activity,” “There is no expected way to do this,” or, “Different staff do this different ways.”  In these instances, the root cause has been identified and there are no further “Whys” to be asked.  The root cause is that there is a need for standard work and there is no standard work in place.  The countermeasure indicated is development of standard work for the process in question.

Utilizing A3s is an excellent way to surface processes that need standard work because:

  1. The standard work is focused on processes that are known causes of problems in the work area.
  2. The problem solver is more prepared and capable of creating effective standard work after the rigorous completion of the investigative, left side of the A3.
  3. Worker input is deliberately solicited for each A3 section. This strengthens standard work due to:
    • Higher quality standard work: More worker input results in higher quality investigation of the problem and development of the standard work countermeasure
    • Better worker acceptance and compliance with the standard work due to worker input and shared ownership

The need for standard work for a given process can be identified in numerous ways.  Criteria for selecting processes should include frequency of occurrence and criticality of the process.  As you identify and prioritize candidates for standard work, deliberate attention to A3-driven standard work will improve your standard work effectiveness.


John DeVries, Senior Manager of Lean Healthcare and Process Improvement at HPPToday’s blog was written by John DeVries, senior consultant with HPP.

John has more than 30 years of experience in Lean Healthcare, Six Sigma, continuous improvement, and productivity improvement.  As a Master Black Belt and deployment leader, he has led Lean and Six Sigma skills transfers to a large organizations resulting in widespread, breakthrough, strategic improvements.  John also has experience assisting healthcare facilities integrating Malcolm Baldrige-based organizational assessments, Lean and Six Sigma.

John holds a Bachelor of Science in Industrial and Systems Engineering from the University of Alabama, Huntsville.

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