Introducing the A3 – part 8: more tips and caveats

Below I review previously mentioned pitfalls and list additional ones that A3 practitioners in healthcare would do well to guard against if they set on a path to producing better A3s over time, which really means focusing on self-improvement by becoming better thinkers and communicators.

From raw A3 beginner to qualified practitioner

Paying diligent attention to these items will go a long way towards increasing your proficiency in A3 development.

  • Tool-to-task mismatch: as stated in one of the early posts on this PI theme, the A3 is best suited to targeting operational, narrowly-focused process issues. An experienced practitioner can elevate the A3 into the tactical and even strategic realm, but the best match for the A3 remains a well-defined issue that can be tackled in a reasonably brief time-frame by a small team.
  • Lack of buy-in: this advice does not apply to A3 development alone. Do not attempt to fix other people’s problems without their involvement and support from before you start collecting data.
  • Failure to collaborate: although the smallest PI projects may involve only one analyst, the most common team size for A3 work is up to half a dozen people, including one or two customers.  Wanting to develop an A3 without effectively sharing the results of every stage and getting consensus before moving on to the next step is a mistake that will likely doom the outcome of the entire effort to failure by non-adoption of the suggested fixes or even derail it on short notice while being worked on.
  • Lack of focus: a well defined problem is something that can be worked on.  Too broad or fuzzy a statement of what an issue is will only lead to spinning of wheels and little traction in a positive direction.
  • Lack of clarity in expression: this often results not from being a poor writer but from lack of clarity as to ideas.  If one is clear as to one what one wants to say, it is much easier to articulate it and make onself understood. Writing concisely and clearly is of course a skill to be polished.
  • Failing to dig deep, and knowing it all: in the rush to complete an A3, one is sometimes tempted to skip or not drill deep enough in the root cause analysis stage. Or, one may simply feel that, with one’s years of experience, one really “knows” not only what’s wrong but also how to fix it.  This is rarely the case.  People become experts by engaging in analysis every time, not by reaching some plateau of imagined proficiency and taking the easy way out of diagnosing without questioning from there onward.  Humility is required, as is keeping an open mind.
  • Emphasis on form rather than content: beginners will occasionally worry more about the presentation or look of the A3 than its content. People concern themselves with pretty figures, uniformity of fonts, neatness of graphs, and color printing, whereas these are concerns that can only distract the practitioner from the core of the effort and are best left to the end.  There are reasons why developing A3s longhand and in pencil is encouraged, and they include the avoidance of speedy, glossy presentation as a focus in favor of content of better quality.
  • Failure to iterate, and reluctance to revise and rewrite: not many people like to write, or take the time to do so.  Rewriting is often viewed as a chore, whereas it is really a process of refining ideas and a means of communicating better.  Embrace rewriting. Hemingway said the first draft of anything wasn’t worth what it was written on, and most of us are not Hemingway.
  • The rush to “be done”: impatience is an all too common human foible. A3s cannot be turned out in serial fashion to meet some “quota” of improvements per management’s mandate, and a typical A3 is not meant to be cranked out in a matter of minutes. A solid A3 documents the interaction between a mentor, an analyst, and a customer, as a process of group discovery occurs concerning an issue. Achieving this level of understanding takes time and effort.
  • No discovery, just documentation: occasionally, beginning practitioners will use the A3 to document work already done.  The truth is that, although this seems harmless enough in principle, one should use the A3 as a means of discovery and to help one understand an issue and how to go about solving it. It goes against the grain to retrofit an A3 to work done earlier unless, once again, the practitioner is truly an expert and essentially has already covered all the A3 bases. But then, why not just document the work as it is being done? Documenting while working is needed to share partial results and decide what to do next, which is why the excuse of not having had time to document but having done the work does not hold water.

Healthcare-specific caveats include being in awe of physicians or executives, or wanting to defend one’s fiefdom to the point where an objective, collaborative analysis of an issue is not possible. This makes getting early buy-in and continued sponsorship even more important in what is typically a politically-charged environment rife with easily bruised egos.



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