So what’s the problem – A3 thinking

If you don’t know what an “A3” is, don’t worry. When I started at University of Michigan Health System, I didn’t either.  When I first saw an A3 meeting on my calendar, I asked “What group is that?”

Plan, do, check, act. PDCA on white isolated background. 3d

There were so many groups with different acronyms!  Turned out it was a meeting with a few colleagues to update our status report on major UMHS IT initiatives. We were using an A3 format for our report.

So what is an A3? It is a tool used as part of Plan-Do-Check-Act (PDCA).  The A3 name actually comes from the paper size (11 x 17 sheet) that tells a story laid out from the upper left-hand side to the lower right.

Telling the story of a problem on an A3 includes looking at the background (why and what), describing its current condition (where things stand), and doing a root cause analysis. And then, establishing goals and targets, proposing countermeasures, making an action plan and determining success metrics.   Continue reading

Making time for reflection

“Hansei” is the Japanese word for reflection. One of my UMHS colleagues, Dr. Jack Billi, told me he’s impressed that I am writing a blog and sees it as an example of Hansei. He says as leaders we don’t take enough time to reflect. I agree.

A typical day for me is running from one meeting to the next, driving back and forth from my office to the hospital campus, and squeezing in email when and where I can. Evenings are more email and prepping for the next day’s meetings.

The practice of writing a blog has indeed caused me to be more thoughtful about a range of topics. I find myself observing things differently. I reached out to one of my industry colleagues, Anthony Guerra, Editor-in-Chief of, for advice when I first considered writing a blog earlier this year. He encouraged me to do so. He told me that through the practice of writing a blog I’d start looking at things differently, observing things in new ways. He was right. Continue reading