New A3 and Analysis Tool Templates

In the A3 Toolbox, we have added a refreshed A3 Template and a Powerpoint document with several analysis tools that can be included into the A3.  Our KPO is testing a number of similar templates and guides, and we welcome you to share your successful tools with us as well! 

We hope you find this useful and welcome your feedback, questions and ideas!

Updates to ZSFG A3 Thinking

For further information not answered here, please contact:

William Huen MD, MS, MPH

Associate Chief Medical Officer
Medical Director, Quality Management and Kaizen Promotion Office
Associate Clinical Professor, UCSF Department of Medicine

A3 Thinking Home Page

Welcome to A3 Thinking at ZSFG

Supporting Leaders to Learn and Practice Problem Solving

For further information not answered here, please contact:

William Huen MD, MS, MPH

Associate Chief Medical Officer
Medical Director, Quality Management and Kaizen Promotion Office
Associate Clinical Professor, UCSF Department of Medicine

A3 Thinking Overview

A3 Thinking Overview

The A3 is a structured, one-page improvement plan, often printed on A3 or 11x17 paper.  

A3 Thinking is a term we use to describe our standardized language and approach to problem solving, which reinforces: 

"What is important is not the format, but the process and thinking in creating the A3."

  • Critical thinking, not reactivity or assumption
  • Humility and respect
  • Problems as opportunities
  • Learning through data, facts, observation
  • Process & systems thinking
  • Engagement and alignment
  • Execution by iterative improvement (PDSA)

Zuckerberg San Francisco General Hospital and the San Francisco Department of Public Health have adopted A3 Thinking as a common approach to problem solving, with the goal of supporting an organization of problem solvers aligned to True North. 

Brief Anatomy of an A3

Left Side: What problem is currently happening and where do we want to be?

Background: What problem are you talking about and why focus on it now?

Current Conditions: What is happening today and what is not working?

Problem Statement: What specific, measurable problem will serve as your baseline performance?

Targets and Goals: What specific measurable outcomes are desired and by when?

Analysis: Why does the problem exist, in terms of causes, constraints, barriers?

Right Side: How will we work together to improve?

Possible Countermeasures: What countermeasures do you propose to address your causes and why?

Plan: What, where, how will you implement, and by whom and when?

Follow-Up: How will you assure ongoing improvement through PDSA (Plan-Do-Study-Adjust)?

For further information not answered here, please contact:

William Huen MD, MS, MPH

Associate Chief Medical Officer
Medical Director, Quality Management and Kaizen Promotion Office
Associate Clinical Professor, UCSF Department of Medicine

A3 Thinking Update – June/July Cohort

On July 25 and 27th, we had a great class of 49 ZSFG and SFDPH Leaders complete our A3 Thinking Course. In the next 30 days, trainees are asked to: 

  • Catchball A3s
  • Attend Learning Labs on Analysis or Possible Countermeasures
  • Continue to map or collect data 
  • Catchball A3 with sponsor
  • Submit one complete draft to the KPO by September 1!

Introducing Our A3 Thinking Website

We are excited to announce this pilot website.  Our goals are to support leaders to continue learning, practicing and implementing A3 Thinking.  We will attempt to keep this site updated to share our best thinking about:

  • What is A3 Thinking and why is it important?
  • What are we currently doing to support new and existing A3 practitioners?
  • What are the templates and tools we are using?
  • What are we doing to continuously improve our use of A3 Thinking to achieve True North?

Thanks for checking us out. We welcome your feedback, questions and ideas!