A3 Template

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r
o
b
l Title Start Date Estimated Completion Date
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m
Problem Description Problem Category
D Fitness Weight control
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f Nutrition Other
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n Diabetic
i Cholesterol
t
i
o Goal Expected Benefits
n

C Cause and Effect Cause Analysis Summary (Prioritize in order of importance)

a
u
s
e

A
n
a
l
y
s [ ]
i
s

C Actions and Quick Wins Team members

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u Priority Name Role
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t
e
r
m
e
a
s
u
r
e
s

Implementation Plan
Activity Who? Start Date Due To Status

R Result Summary (Including benefits obtained) Follow-up Actions

e
s What? Who? When? Status
u
l
t
s

Continuous Improvement Toolkit . www.citoolkit.com

 Reference #: Process owner: Leader/facilitator: Note taker: Revision #: Date:

A3 Problem Solving
P
r
o
b
l Title Scope (Location, area, line, department, boundaries, etc.)
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Process Name Process Map Exist? Start Date Estimated Completion Date
D
e
f Problem Description (Initial condition) Problem Category
i
n Quality Waste and efficiency
i Cost Health and safety
t
i Delivery Customer satisfaction
o
n Moral Other

Goal (Target condition) Expected Benefits (Hard savings and soft savings)

Key Metrics (Include baseline and improvement goals)

Additional documents can be attached to this form including before photos, drawings and a more detailed cost benefit analysis. Attachments?

C Cause and Effect (Brainstorming - Prioritize the causes) 5 Whys (Brainstorming - Ask, why did this occur?)
a
u Why 1
s
e Why 2
A Why 3
n
a Why 4
l Why 5
y
s [ ] Cause Analysis Summary (Prioritize in order of importance - % Contribution)
i
s

Will addressing this cause(s) solve the problem permanently?

Additional documents can be attached to this form including a more in-depth root cause analysis and the prioritization method used. Attachments?

C Proceed with solving the problem? List of Countermeasures and Quick Wins (Brainstorming - Relate to the root causes)
o
u Decision and Agreements (Explain the reasoning behind the decision) Priority Ease Cost Impact Score
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t
e
r
m
e
a Solution Description
s
u
r
e
s

Team Members
Name Role Name Role

Implementation Plan (Implement countermeasures)

Activity Who? Start Date Due To Status

Additional documents can be attached to this form including a more detailed implementation plan. Attachments?

R Improvement implemented? Results verified? Key Metrics

e
s Target achieved? Can the solution be deployed? Metric Baseline Goal Current Variance %
u Result Summary (Including benefits obtained)
l
t
s

Verification Comments (Assess countermeasures) Follow-up Actions (sustaining actions to be taken - actions for establishing controls)
What? Who? When? Status

Controls Required (SOP, training, audits, SPC charts, visual controls, mistake proofing, PM, etc.)

Additional documents can be attached to this form including the after photos Attachments?

Signatures: Leader: Analyst: Process Owner: Champion:

Continuous Improvement Toolkit . www.citoolkit.com