✦ Does your baseline data fully explain the performance of the process and the problem?
✦ What do your customers say about the problem?
✦ Who owns the process?
✦ How does the problem relate to the pathway it sits within?
✦ How do staff perceive this problem or feel about it?
Whose knowledge about how the work actually happens hasn't been captured yet? Have you gone to the gemba and spoken to the people doing the work?
What upstream inputs and downstream dependencies does this process have? If you fix this process, what happens to the processes it feeds into and receives from?
Was this process deliberately designed, or did it evolve by accident? Are the physical layout, equipment, and information systems helping or hindering the work?
What workarounds are people using to cope with the current state? What risks do those workarounds create that aren't being measured?
✦ Is the goal based on data from your current state analysis?
✦ Is it achievable within your circle of influence?
✦ Does achieving this goal resolve the problem?
Who needs to agree that this is the right goal? Are the people who do the work involved in setting the target, or was it set for them?
Does this goal optimise the whole system, or could it improve one part while making another worse? Have you checked for sub-optimisation?
Does achieving this goal require redesigning the process, or just improving execution of the current design? If the design is the problem, an execution target won't fix it.
What could go wrong if you hit this target? Are there unintended consequences of success that you haven't considered?
✦ Have you identified waste through direct observation at the gemba?
✦ Can you link each waste category to specific evidence?
✦ Which are the vital few? (Pareto principle)
Enter defect or waste categories with observed frequencies to prioritise which problems this A3 should focus on.
If you remove your root cause(s), does the problem completely disappear? If not, keep digging.
✦ Have you identified the real problem?
✦ Did you go to the gemba, observe, and talk to the people who do the work?
✦ Do your results explain the gap between the target and the current condition?
✦ Check back — if you remove your root cause(s), does the problem completely disappear?
✦ Check back — is your current state analysis in-depth enough?
Human error is not a root cause. What factors in the system guide behaviour — selection, training, instructions, environment, workload? Is the individual adequately prepared and supervised for the work required by the system and process?
Do any of the root causes originate outside your span of control — in another department, organisation, or regulatory requirement? If so, who owns that part of the system?
Are any root causes traceable to decisions made when this process was originally designed or last changed? What assumptions were built into the design that are no longer valid?
Which root cause, if left unaddressed, poses the greatest risk of harm? Are you prioritising by frequency or by severity?
Record who has been consulted about this A3. Building consensus is how authority to act emerges.
Full Record exports a Word document (.docx) containing the complete A3 evidence trail — all section content, revision history, memos, nemawashi log, action items, and standardisation checklist. Suitable for NHS M365 workflows and audit purposes.