Introducing the A3 – part 9: developing A3s with Lean flavor

In developing A3s, you may want to think of how to do so with a Lean flavor.

A3 thinking and Lean

A3 thinking and Lean complement each other quite well.  Whereas value-stream mapping (VSM), an important part of the Lean toolbox, strives to give a “big picture” understanding of operations and waste at a facility, A3 development can use VSM as a springboard from which to formulate and carry out improvements to well-chosen aspects of the process that promise to deliver the biggest bang for the buck.

For example, if a patient’s ambulatory visit can be thought of conceptually as consisting of registration, treatment, education, and discharge, and if a current-state VSM shows that it is the education part that is impacting visit length the most and affecting clinic throughput, then one or more A3s can be used to zero in on specific aspects of when and how education is imparted and propose changes at a more granular level. Once implemented, these fixes will eventually translate into an improved VSM showing less waste, greater throughput, and so on.

As you know, Lean is all about waste, and how to eliminate it. For A3s, you may want to keep in mind the preferred sequence for eliminating waste as it relates to steps in a process:

  1. Eliminate that which is obsolete, or useless. Doing away with unnecessary steps also leads to eliminating the potential errors arising from them, a double whammy.   Do this first.
  2. Next, re-sequence and streamline the remaining (useful) process steps. Always aim to do early setup, separately from the actual task.
  3. Last, look for opportunities to automate the streamlined process.

Ignoring this sequence is one of the main reasons why many “improvements” are soon discredited and abandoned. Frame your thinking using the framework in going from the current state to a more desirable target state.


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