Abstract
Introduction: Delivering high-quality care and achieving optimal outcomes rely on efficient clinical processes. Continuous improvement enhances care (Endalamaw et al., 2024), and staff should identify evidence-based solutions to drive change.
At this 350-bed Magnet-recognized hospital, clinical and operational teams worked in silos despite shared goals. Clinical staff used gap analyses, while operational teams applied A3 problem-solving to determine whether issues required kaizen events or quick fixes. A3 supports root cause analysis, targeted interventions, and outcome evaluation (Brennan & Wendt, 2021).
However, no standardized process existed for submitting or tracking gap analyses or A3s. In Q1 2025, only two A3s and two kaizen events were documented, underscoring the need for a more coordinated, high-impact strategy.
Aims: The aim of this initiative was to streamline and standardize continuous improvement efforts to maximize impact and breakdown silos.
Methodology: Leadership endorsed a unified approach using A3 problem-solving in place of gap analyses. A3s offered a more structured framework for identifying root causes and implementing targeted solutions.
To support adoption, A3 problem-solving was introduced through town halls, huddles, departmental meetings, and training platforms. These included process coach classes, nursing leadership retreats, and Magnet Champion meetings. Active learning sessions allowed staff to collaboratively address real-world challenges, referred to as “pebbles in their shoes,” by identifying the who, what, when, where, and how questions with real-time feedback. All completed A3s are now stored in a centralized database, enhancing visibility, prioritization, and coordinated support across teams.
Results: Since Q1 2025, A3 submissions increased from 2 to 24, a 400% rise. kaizen events (rapid process improvement) grew from 2 in 2024 to 7 by July 2025, a 250% increase. Sustained improvements include a 67.8% reduction in discharge response time (from 2.8 to 0.9 hours) and a 46.0% reduction in time to first documented vital signs (from 37 to 20 minutes).
Conclusion/Implications for Practice: Standardizing A3 problem-solving reduced silos, minimized duplication, and aligned teams around shared goals. It eased workloads, encouraged collaboration, and empowered staff to implement targeted, evidence-based solutions. Integrating quality improvement, EBP, and research fosters excellence, engagement, and better outcomes.
Notes
Presenter notes available in attached slide deck.
Sigma Membership
Alpha Gamma Gamma
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Implementation Science, Interprofessional Initiatives, Interprofessional, Interdisciplinary, Interprofessional Relations, Problem Solving
Recommended Citation
Muoki, Deltra; Fleming, Sarah; Faz, Eliud; Hootman, Dan; and Adams, Whitney, "Integrating A3 Thinking to Drive Collaborative Clinical and Operational Improvements" (2026). Creating Healthy Work Environments (CHWE). 24.
https://www.sigmarepository.org/chwe/2026/presentations_2026/24
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-04-24
Integrating A3 Thinking to Drive Collaborative Clinical and Operational Improvements
Washington, DC, USA
Introduction: Delivering high-quality care and achieving optimal outcomes rely on efficient clinical processes. Continuous improvement enhances care (Endalamaw et al., 2024), and staff should identify evidence-based solutions to drive change.
At this 350-bed Magnet-recognized hospital, clinical and operational teams worked in silos despite shared goals. Clinical staff used gap analyses, while operational teams applied A3 problem-solving to determine whether issues required kaizen events or quick fixes. A3 supports root cause analysis, targeted interventions, and outcome evaluation (Brennan & Wendt, 2021).
However, no standardized process existed for submitting or tracking gap analyses or A3s. In Q1 2025, only two A3s and two kaizen events were documented, underscoring the need for a more coordinated, high-impact strategy.
Aims: The aim of this initiative was to streamline and standardize continuous improvement efforts to maximize impact and breakdown silos.
Methodology: Leadership endorsed a unified approach using A3 problem-solving in place of gap analyses. A3s offered a more structured framework for identifying root causes and implementing targeted solutions.
To support adoption, A3 problem-solving was introduced through town halls, huddles, departmental meetings, and training platforms. These included process coach classes, nursing leadership retreats, and Magnet Champion meetings. Active learning sessions allowed staff to collaboratively address real-world challenges, referred to as “pebbles in their shoes,” by identifying the who, what, when, where, and how questions with real-time feedback. All completed A3s are now stored in a centralized database, enhancing visibility, prioritization, and coordinated support across teams.
Results: Since Q1 2025, A3 submissions increased from 2 to 24, a 400% rise. kaizen events (rapid process improvement) grew from 2 in 2024 to 7 by July 2025, a 250% increase. Sustained improvements include a 67.8% reduction in discharge response time (from 2.8 to 0.9 hours) and a 46.0% reduction in time to first documented vital signs (from 37 to 20 minutes).
Conclusion/Implications for Practice: Standardizing A3 problem-solving reduced silos, minimized duplication, and aligned teams around shared goals. It eased workloads, encouraged collaboration, and empowered staff to implement targeted, evidence-based solutions. Integrating quality improvement, EBP, and research fosters excellence, engagement, and better outcomes.
Description
In Q2 2025, a Magnet-recognized community-based hospital reintroduced A3 problem-solving through huddles, meetings, retreats, and active learning with real time feedback. Strong teamwork and collaboration between clinical and operational leaders led to a 400% increase in A3 submissions (24 total) and a 250% rise in kaizen events (7 YTD), driving sustained improvements in discharge response time and vital sign documentation.