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!

A3 Toolbox

A3 Toolbox

The purpose of this page is to support leaders and trainees with our current best thinking about templates and tools.

 

1. A3 and PDSA Templates
2. A3 Worksheets
3. Left Side Tools
4. Right Side Tools

5. A3-Status Reports and PIPS Templates
6. Personal Development Plan A3s
7. Other Tools and Templates

 

A3 and PDSA Templates

A3 Workshop Worksheets

 

A3 Tools - Left Side - Current Conditions & Analysis

A3 Tools - Right Side - Countermeasures, Implementation and Follow-Up

 

A3 Status Reports

Personal Development Plans - PDP A3

Other Improvement Tools

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 Workshop & Learning Lab

A3 Workshops and Learning Labs

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How to Register for the A3 Thinking Workshop (2-Day Class):

  • Goal: To support departmental leaders with learning and practicing A3 Thinking
  • Who: ZSFG and DPH Leaders nominated by supervisors to lead important improvement work aligned with organizational priorities. (Maximum 25 attendees/Day)
  • What is required once you have enrolled:
    • Pre-Read Managing to Learn and Humble Inquiry 
    • Selection of an Important Problem with Supervisor
    • Attendance in BOTH Day #1 and Day #2 trainings (8-4:30), 30 days apart
    • Attendance in two Learning Labs (1.5 hours each)
    • Completion of mid- and post-workshop homework
    • One complete A3 Draft due at 30 days after Day #2
  • New Features: Day 1 & 2 30 days apart, learning labs, workbooks, templates, tools, examples, 14.25 CME   
  • To add a leader to the wait list, please share the following on this link:
    • Name: 
    • Role/Title/Dept: 
    • Proposed Problem: 
    • Executive Sponsor:
  • Please Note: Due to training constraints, and to maximize the likelihood of practicing and applying applying course material, we prioritize with ZSFG and DPH Leaders based on the above information. 

"Great mix of teaching, practice, small and large group discussions and support!"

 

"100% of attendees report I would recommend this course to a colleague."

 

How to Register for the A3 Learning Lab: 

  • Goal: To support your completion and implementation of A3 improvement plans 
  • Who: ZSFG and DPH Leaders familiar with A3 Thinking
  • What: Our KPO/QM Teams offers once to twice weekly Learning Labs (10:30-12, Wed,+/- Fridays) to support leaders familiar with A3s
  • Agenda: 1) Review A3 Thinking teaching (20 min), followed by coaching/practice/catchball of A3s (50 min)
  • Topics
    • Background/Current Conditions/Problem Statements (toolbox: swimlanes, process maps)
    • Analysis (toolbox: fishbone, 5 whys problem trees, stratification, pareto)
    • Countermeasures  (toolbox: PICK charts)
    • PDSA  (toolbox: PDSA, Gantt charts) 
    • A3-Status Reports (see PIPS Labs)
  • To Sign up, please use this A3 Thinking Learning Lab link

“Incredibly valuable to have this time, and a personal coach helping to think it through!” - A3 Lab Attendee

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

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