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. 

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?

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

Sharepoint (DPH/UCSF Outlook 365 Login): https://sfgov1.sharepoint.com/sites/DPH-ZSFGWay

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. 

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?

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

Sharepoint (DPH/UCSF Outlook 365 Login): https://sfgov1.sharepoint.com/sites/DPH-ZSFGWay

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

Sharepoint (DPH/UCSF Outlook 365 Login): https://sfgov1.sharepoint.com/sites/DPH-ZSFGWay

Please Note: Although we are not able to hold in-person workshops or learning labs, our problem solving has not stopped.  We are testing a virtual learning series using sharepoint, teams and online video coaching. Please contact us directly for more information! 

Registering for A3 Thinking 2-Day Workshops :

• Goal: To support leaders with learning and practicing A3 Thinking
• Who: UCSF and DPH Leaders nominated by supervisors to lead improvement work aligned with organizational priorities.  
• What is required once you have enrolled:
  • Pre-Read Managing to Learn and Humble Inquiry 
  • Select an important, focused Problem with Supervisor
  • Attend BOTH Day #1 and Day #2 trainings (8-4:30, ~30 days apart
  • Attend two Learning Labs (1.5 hours each)
  • Complete mid- and post-workshop homework
  • One complete A3 Draft 30 days after Day #2

• Features: Day 1 & 2 30 days apart, learning labs, workbooks, templates, tools, examples, 14.25 CME   
• When: We generally offer six cohorts to 25 trainees each, divided three times per year
• To add a leader to the wait list, submit this link:
  • Name: 
  • Role/Title/Dept: 
  • Proposed Problem: 
  • Sponsor: 

"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 contact aldon.mendez@sfdph.org

“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

Sharepoint (DPH/UCSF Outlook 365 Login): https://sfgov1.sharepoint.com/sites/DPH-ZSFGWay

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

Sharepoint (DPH/UCSF Outlook 365 Login): https://sfgov1.sharepoint.com/sites/DPH-ZSFGWay