Abstract
The purpose of this study was to illustrate the application of A3 Problem Solving Reports of the Toyota Production System to our research vivarium through the methodology of Continuous Performance Improvement, a lean approach to healthcare management at Seattle Children's (Hospital, Research Institute, Foundation). The Report format is described within the perspective of a 10-step scientific method designed to realize measurable improvements of Issues identified by the Report's Author, Sponsor and Coach. The 10-step method (Issue, Background, Current Condition, Goal, Root Cause, Target Condition, Countermeasures, Implementation Plan, Test, and Follow-up) was shown to align with Shewhart's Plan-Do-Check-Act process improvement cycle in a manner that allowed for quantitative analysis of the Countermeasure's outcomes and of Testing results. During fiscal year 2012, 9 A3 Problem Solving Reports were completed in the vivarium under the teaching and coaching system implemented by the Research Institute. Two of the 9 reports are described herein. Report #1 addressed the issue of the vivarium's veterinarian not being able to provide input into sick animal cases during the work day, while report #7 tackled the lack of a standard in keeping track of weekend/holiday animal health inspections. In each Report, a measurable Goal that established the basis for improvement recognition was present. A Five Whys analysis identified the Root Cause for Report #1 as historical work patterns that existed before the veterinarian was hired on and that modern electronic communication tools had not been implemented. The same analysis identified the Root Cause for Report #7 as the vivarium had never standardized the process for weekend/holiday checks. Successful outcomes for both Reports were obtained and validated by robust audit plans. The collective data indicate that vivarium staff acquired a disciplined way of reporting on, as well as solving, problems in a manner consistent with high level A3 Thinking.
Highlights
Problem solving tools come in many shapes and sizes
Multipage research grant application designed to unravel the molecular mechanisms of human disease [1,2], to the one-page A3 Report developed by the Toyota Motor Corporation [3,4], problem solving tools typically have the scientific hypothesis as the one common attribute
Details that cannot be described in the Current Condition drawing and useful baseline metrics may be included
Summary
Multipage research grant application designed to unravel the molecular mechanisms of human disease [1,2], to the one-page A3 Report developed by the Toyota Motor Corporation [3,4], problem solving tools typically have the scientific hypothesis as the one common attribute. Based on the 13th Principle of the Toyota Way (‘‘Make Decisions Slowly by Consensus’’) [3], the A3 Problem Solving Report is a tool that describes how consensus on complex decisions can be efficiently reached. A quantitative statement that will form the basis for how improvement will be measured is provided . In many ways, this statement is the hypothesis for the experiment. Goals in this context are equivalent to Targets, which need to be SMART (specific, measurable, attainable, relevant and timely) [17]
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