Expert training for healthcare, with emphasis on the diagnostic laboratory.

Expert training for healthcare, with emphasis on the diagnostic laboratory.

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Welcome to the A3 Method for Problem Solving!

A3 Problem Solving is a team-based, data- and process-driven, structured method for finding root causes and implementing workable solutions in your work environment. The A3 Problem Solving method is carried out in 8 steps. Each step is recorded in a separate section on one large sheet of paper. Four sections, detailed in the four sections on the left-hand side of the page, define the Current State; the four right-hand sections define the Future or Desired State. In this course, you will learn how to execute the steps and record them in each of the sections. This problem solving method is proven to help teams make iterative improvements and solve problems permanently.

The course is presented in 7 lessons:

  • In the Introductory lesson you will learn the back story and logic behind using the scientific method for problem solving.
  • Unit 1 (Lesson 2) covers team development and the problem statement.
  • Unit 2 (Lesson 3) is devoted to describing the current state.
  • Unit 3 (Lesson 4) details finding and analyzing causes and is the longest lecture at 25 minutes.
  • Unit 4 (Lesson 5) includes describing the target condition and identifying solutions.
  • Unit 5 (Lesson 6) will help you develop an implementation plan and set up effectiveness checks.
  • Unit 6 (Lesson 7) is the final unit and covers techniques for holding your gains.

In this course, you will learn how to apply the A3 method to a process of your choosing and complete each section of the A3 form.  It would be helpful for you to print out the form using the template provided and practice each step as we proceed.

At the end of this presentation the learner will be able to:

  • Follow A3 background/logic
  • Evaluate/interpret each A3 element
  • Complete an A3 form, organizing each element of the A3 method
  • Integrate common A3 tools: process flow diagrams, five why problem solving, causal analysis tools, and Plan–Do–Check–Act (PDCA cycle)

The course will take approximately 2 hours and you complete the course at your own pace. Completion of a quiz is required to obtain a certificate of completion and credit hours. 

The following is included in this course:

  1.  Seven instructional videos (total time 1 hour, 36 minutes)
  2.  Quiz-10 questions

References and additional reading for this course can be accessed using the “Materials” tab at the top of the Course page.

References for A3 Problem Solving in Healthcare

All units: American Society for Quality. “Quality Glossary.” Retrieved from https://asq.org/quality-resources/quality-glossary.  Accessed August, 2020

All units: Drickhamer, D. “View from the hospital floor: how to build a culture of improvement one unit at a time.” Retrieved from https://www.lean.org/common/display/?o=3207.  Accessed March 2020.

All units: Institute for Healthcare improvement. “Quality improvement essentials toolkit.”  Retrieved from http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx.  Accessed March 2020.

All units: Tague, N.R. (2005) [1995].  The quality toolbox (2nd ed.). Milwaukee: ASQ Quality Press. pp. 390–392.


Introduction: Cusumano, M.A. (1985) The Japanese automobile industry: technology and management at Nissan and Toyota. Cambridge, MA: Harvard University Press.

Introduction: Deming, W. E. (1986) Out of the crisis. Cambridge, MA: Massachusetts Institute of Technology, Center for Advanced Engineering Study.

Introduction: Liker, J.K. (ed.) (1998) Becoming lean: inside stories of U.S. manufacturers. Portland, OR: Productivity Press.

Introduction: Sobek II, D. K. and Smalley, A. (2011) Understanding A3 thinking: a critical component of Toyota’s PDCA management system. New York: Productivity Press.

Introduction: Sobeck II, D.K. “The A3 Report.” Retrieved from http://www.montana.edu/dsobek/a3/report.html.  Accessed August, 2019.

Introduction and Unit 4: Womack, J.P. and Jones, D. (1996) Lean thinking: banish waste and create wealth in your corporation.  New York: Simon & Schuster.

Introduction and Unit 4: Womack, J.P., Jones, D. and Roos, D. (1990) The machine that changed the world: the story of Lean production.  New York: Harper Colins.


Unit 1: US Department of Veteran’s Affairs.  “43. SIPOC (suppliers, inputs, processes, outputs, customers)”  Retrieved from https://www.queri.research.va.gov/implementation/quality_improvement/methods.cfm?method=43.
Accessed March, 2020.


Unit 2: Millard, M.  Krainexus. The top ten worst things you could do on a Gemba walk.  Retrieved from https://blog.kainexus.com/improvement-disciplines/lean/gemba-walk/the-top-ten-worst-things-you-could-do-on-a-gemba-walk. Accessed March, 2020.

Unit 2: Institute for Healthcare improvement. “Quality improvement essentials toolkit —Pareto Chart.pdf”  Retrieved from http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx.  Accessed March, 2020.

Unit 2: Institute for Healthcare improvement. “Quality improvement essentials toolkit—run chart and control chart.pdf”  Retrieved from http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx.  Accessed March, 2020.


Unit 3: Balle, M and Jones, D.  “10 signs you respect me as an employee.”  Retrieved from https://www.fastcompany.com/3036623/10-signs-you-respect-me-as-an-employee. Accessed March, 2020.

Unit 3: Dekker, Sidney. (2002) The field guide to human error investigations. Aldershot, UK: Ashgate Publishing.

Unit 3: Leape, L. "Error in medicine." Journal of the American Medical Association 272(23): 1851-57.

Unit 3: Reason, J.T,  “Human error: models and management.”  BMJ. 2000 Mar 18; 320(7237): 768–770.

Unit 3: Reason, J.T. (1990) Human error. Cambridge: Cambridge University Press.

Unit 3: Reason, J.T. (2001) "Chapter 1: Understanding adverse events: the human factor." In Charles Vincent, ed., Clinical risk management, 2nd ed. London, UK: British Medical Journal Books.

Unit 3: Wilson, B, “Causal factor tree analysis.” Retrieved from https://www.bill-wilson.net/root-cause-analysis/rca-tools/causal-factor-tree-analysis.  Accessed March, 2020.


Unit 4: DeBono, E. (1993) Serious creativity: using the power of lateral thinking to create new ideas. New York, Harperbusiness.

Unit 4: Godfrey AB, Clapp TG, Nakajo T, et al. (2005) “Application of healthcare-focused error proofing: principles and solutions directions for reducing human errors.” Paper delivered at the ASQ World Conference on Quality and Improvement Proceedings, vol 59, Seattle.

Unit 4: Infinite Innovations, Ltd.  “Brainstorming.”  Retrieved from http://www.brainstorming.co.uk/tutorials/definitions.html.  Accessed March, 2020.


Unit 5: Institute for Healthcare improvement. “Quality improvement essentials toolkit—run chart and control chart.pdf”  Retrieved from http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx.  Accessed March, 2020.

Unit 5: Solberg L, Moser G, McDonald S. 1997. “The three faces of performance measurement: improvement, accountability, and research.” Jt Comm J Qual Improv. 23(3):135-47.


Unit 6: Institute for Healthcare Improvement.  “Huddles.” Retrieved from http://www.ihi.org/resources/Pages/Tools/Huddles.aspx.  Accessed March, 2020.

Supplemental Reading

Drickhamer, D. “View from the hospital floor: how to build a culture of improvement one unit at a time.”  Lean Enterprise Institute.  Retrieved from https://www.lean.org/common/display/?o=3207.  Accessed March 2020.

Mayo, AT and Wolley, AW. “Teamwork in healthcare: maximizing collective intelligence via inconclusive collaboration and open communication.”  Journal of Ethics from the American Medical Association.  Retrieved from https://journalofethics.ama-assn.org/article/teamwork-health-care-maximizing-collective-intelligence-inclusive-collaboration-and-open/2016-09. Accessed March 2020.

Millard, M.  “The top ten worst things you could do on a Gemba walk.”  Krainexus.  Retrieved from https://blog.kainexus.com/improvement-disciplines/lean/gemba-walk/the-top-ten-worst-things-you-could-do-on-a-gemba-walk. Accessed March, 2020.

Patient Safety Network. “Systems approach.” Agency for Healthcare Research and Quality.  Retrieved from https://psnet.ahrq.gov/primer/systems-approach.  Accessed March, 2020.
 
Godfrey AB, Clapp TG, Nakajo T, et al. (2005) “Application of healthcare-focused error proofing: principles and solutions directions for reducing human errors.” Paper delivered at the ASQ World Conference on Quality and Improvement Proceedings, vol 59, Seattle.  Retrieved from https://elsmar.com/elsmarqualityforum/attachments/healthcare-focused-error-proofing-pdf.12984/.  Accessed March, 2020.
 
Solberg L, Moser G, McDonald S. 1997. “The three faces of performance measurement: improvement, accountability, and research.” Jt Comm J Qual Improv. 23(3):135-47.  Retrieved from https://bcpsqc.ca/wp-content/uploads/2018/03/Solberg-Three-Faces-of-Measurement.pdf.  Accessed March, 2020.
 
Astion, M. “A new model for patient safety: daily laboratory huddles—what a great idea!”  Clinical Laboratory News. April 1, 2013.  Retrieved from https://www.aacc.org/publications/cln/articles/2013/april/psf-huddles.  Accessed March. 2020.
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