Based on the A3 tool, the project team:
- Problem definition: Reviews the reason for action stipulated by the Value Stream Steering Committee in the project charter and redefines it as a problem statement supported by summary data and highlighting the scope of the improvement project.
- Review and update data: Reviews and updates more detailed qualitative and/or quantitative data describing the problem statement in terms of current outcomes. Pareto, or "80/20," analysis is often used to reveal core sources of adverse outcomes.
- Goals: Reviews and confirms the qualitative and quantitative improvement goals that the value stream steering team has stipulated. The project team might modify improvement goals in consultation with the Value Stream Steering Committee.
- Gap analysis: Conducts a multistep gap analysis beginning with a Gemba walkcc followed by documentation of the current process ("current state map") with identification of points where adverse outcomes appear to originate. The project team then prioritizes barriers, conducts a root cause analysis, and completes its gap analysis by documenting an initial version of a new work flow (the "future state map").
- Verify solutions analytically: Verifies analytically that the changes proposed in the hypothetical new work flow are the actual solutions that will produce the target results.
- Rapid experiments: Sets up as much of the new work flow as possible and conducts rapid experiments to see if the solutions work in practice or if additional changes are needed.
- Completion plan: Develops a 90-day completion plan and assigns activities to specific staff.
- Confirmation: Confirms the new process flow by developing standard work documents to sustain it and by verifying its contribution toward the targets originally stipulated by the value stream steering team.
- Lesson learned: Documents insights and lessons learned from the event.
- Report-out: Reports results from the event and any future process changes to be implemented as part of the project on the final day of the RIE. Report-outs are open to anyone at Heights Hospital.
- Implementation: Implements the project widely within the department during the first 2 weeks after the event, with meetings scheduled as needed. The facilitator and team leadership work closely with team members to implement the project.
- Followup reporting: Submits 30-day, 60-day, and 90-day reports of project progress.
- Followup team meetings: Continues holding meetings with the project team as necessary.
cc An activity (similar to Management by Walking Around) that takes management to the front lines to look for waste and for opportunities to practice practical improvement in the direct service area.