Guide to A3

Title: Fresh Eyes: Subject Start Date:

Owner: Person creating the A3 Team: Expert(s): Revision Date: Sep-11
PDSA Revision #: 4
Coach:
Countermeasures to Root Causes (Action Items)
Background / Current Conditions
Select a change to make that you believe will lead to improvement. Plan the change with who, what, when, where, how:
Of all of our problems, why are we talking about this one? The UGLY truth
* Why are you talking about it? - What activities will be required for implementation and who will be responsible for what and
* What is the business case? What business problem are you trying to solve or analyze? when?
* Be very concise - communicate WHY you are addressing this issue - can begin with: Ideally the patient {insert
detail here} but in this case {insert problem here} Action items to move to target condition (future state)
* Document high level current state condition - Make sure the countermeasures connect to each identified actionable root cause

CURRENT SITUATION: Make the change

DO
* Where do we stand? Plan for data collection -Collect data as you go
* Trend Charts, Value Stream Map -Get input from the staff throughout the change
*Jot down ideas, pictures, etc.
Document problems; unexpected observations
What's going on? - can also draw out future state
*Use facts and Dates
*Start wtih the identified problem and keep asking..."therefore what"... This will help you establish a link b/w the
problem and key strategic concerns. Document the answers to "therefore what".

Problem Statement (that reflects how the problem affects the patient or process) Follow Up
PLAN

General restatement from background but condensed into a sentence. Analyze the results
The problem statement reflects how the problem affects the patient -What did you learn?
- Did it improve the process you were working on?

STUDY
-Did it improve the outcome?
Goals/Targets How do we know it was a success?
What is the specific change you want to accomplish now? 1) ID all tasks (WHAT) required to realize & implement (HOW) proposed countermeasures
- State in measureable, or identifiable terms - Quantifiable and timebound. (i.e. improve X by 50% by January 2) Document (WHO)individual respnsible to implement/lead the action
1st, 200X) 3) Document WHEN it will occur
- SMART Goals (Specific, Measureable, Attainable, Realistic, Timely)
Analysis / Root Cause: Act/Adjust
Root Cause= cause of the problem (if taken care of & fixed) eliminates the majority of occurences in the Expand the scope if successful
problem. Five "whys" equal one "How" -Abandon the change if it did not work (celebrate finding mistakes!)
• Use the simplest problem-analysis tool that will suffice to find the root cause of the problem: Five whys; -Plan the next change

ACT/ADJUST
fishbone diagram, problem or process analysis tree, data with trend information -Re-Use CAP tools if needed to mobilize commitment
*By analyzing deeply the root cause, you expose other issues to surface...or resurface
- What remaining issues can be anticipated?
-Make predictions about what you think will happen
- What requirements, constraints, alternatives need to be considered?

Stakeholder
Signatures:
CF GLMC
PDSA A3 Guide