A3 Project Management - Stanford Leadership Development Program – FY21 - Confidential QA Document

Oct 26, 2026

A3 Project Management training material for the Stanford Leadership Development Program (FY21) outlines how to improve clinical care, research, and education using A3 problem-solving methods. It covers core tools such as problem statements, SMART goals, fishbone and Pareto diagrams, key drivers, and PDCA, plus guidance for leading improvement project teams. The package also provides a case for change using US health care delivery system performance metrics and examples of guideline adherence gaps, including charts on defects per million operations, defects/accuracy signals, and NIH funding trends sources.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages114

Reading Time4 h 47 min

AccessFree to download

A3 Project Management

Case for change

A3 problem solving methods

Leading improvement project teams

Project work schedule

US Health Care Delivery System metrics

Guideline adherence examples

Defects per million operations

NIH appropriations trends

A3 Project Management Improving Clinical Care, Research & Education Stanford Leadership Development Program – FY21 Saturday, October 10, 2020 Joseph Hopkins, MD, MMM Clinical Professor of Medicine (PCPH) Associate Chief Medical Officer Senior Medical Director for Quality CONFIDENTIAL QA DOCUMENT PROTECTED BY SECTION 1157 CALIFORNIA EVIDENCE CODE 􀁠 To gain awareness of the need to achieve higher performance in patient care, research ad education 􀁠 To be able to apply all parts of A3 problem solving methodology in creating improvements 􀁠 To acquire useful skills & tools for leading a project improvement team 􀁠 To adopt a schedule for project work that can achieve reportable results by May 2021 Confidential– For Discussion Purposes Only 2 􀁠 Case for change 􀁠 A3 problem solving methods: − Problem statements − SMART Goals − Fishbones diagrams − Pareto diagrams − Key drivers − PDCA 􀁠 Leading improvement project teams 􀁠 Project work schedule Confidential– For Discussion Purposes Only 3 US Health Care Delivery System 􀁠 Cost: − Highest $$/capital and % GDP in the world: 18% vs 6-10% other countries 1 − $4 trillion 􀁠 Quality: − 28th of 44 countries in life expectancy 1 − 33rd of 44 countries in infant morality 1 − 37th of 44 countries in childhood immunization rates 1 − 3rd highest prevalence of diabetes 1 − 4th highest incidence of cancer 1 − Leading country where out of pocket costs is a barrier to needed medical care2 − Lowest patient satisfaction rate with the system among 11 countries 3 − Highest rate of medical mistakes, medication errors or lab errors among 7countries 1Source: Organization for Economic Co-operation & Development (OECD) Health At a Glance 2017 2Source: Commonwealth Fund 2010 3 SOURCE: Davis k, [et.al. Mirror](et.al. Mirror), Mirror on the Wall: How the performance of US HealthCare System compares internationally. Commonwealth Fund. June 2014 4 Source: Commonwealth Fund Confidential– For Discussion Purposes Only 4 Guideline Adherence – Recent Examples | Guideline | % | First Author/Journal/Year | | --- | --- | --- | | Test creatinine and K+ at onset and 1 yr after ACE/ARB Rx | 47% | Schmidt M, BMJ Open, 2017 | | Inpatient COPD management | 41% | Says D, COPD, 2017 | | Hepatitis A & B vaccines in chronic cirrhosis: Safety net hospital | 74% | Sclair SN, Dig Dis Sci, 2016 | | Facuty practice | 30% | | | Hepatocellular CA suveillance in cirrhosis: Safety net hospital | 79% | | | VA hopsital | 50% | | | Faculty practice | 42% | | | Chronic syst HF >50% of recommended dose: ACE | 72% | Chin KL, Heart Fail Rev, 2016 | | ARB | 51% | | | BB | 49% | | | Prescription of opioids to HIV patients: Treatment contract | 56% | Starrels JL, Subst Abus, 2016 | | Urine testing | 61% | | | Follow up uric acid test in Rx gout | 50% | Doghramji PP, Post Grad Med, 2016 | | Acute bacterial sinusitis-offers obervation as an option | 36% | Darrat I, Ear Nose Throat, 2014 | | AVERAGE OF STUDIES | 53% | | Confidential– For Discussion Purposes Only 5 DEFECTS PER MILLION OPERATIONS 1,000,000 100,000 10,000 1,000 100 101 IRS Phone-In Tax Advice Mammography Screening Antibiotic Overuse Inpatient Medication Accuracy Low Back Tx Airline Baggage Handling Post Heart Attack Medications Preventable Hospital Deaths Prescriptions Written By Doctors Anesthesia During Surgery Domestic Airline Flight Fatality Rate SIGMA LEVEL 􀃆 1 2 3 4 5 6 Confidential– For Discussion Purposes Only 6 NIH Appropriations SOURCE: [https://www.faseb.org/Portals/2/PDFs/opa/2019/NIH%20Funding%20Trends%20Slide%20Deck%202019%20Update](https://www.faseb.org/Portals/2/PDFs/opa/2019/NIH%20Funding%20Trends%20Slide%20Deck%202019%20Update) pdf Confidential– For Discussion Purposes Only 7 􀁠 New ways to make medical training more patient-centered. 􀁠 How to exclude redundant information from a redesigned curriculum. 􀁠 Strategies for increasing

FAQs

What A3 problem-solving methods are included in this material?

It lists problem statements, SMART goals, fishbones diagrams, Pareto diagrams, key drivers, and PDCA.

What kinds of outcomes does the document aim to achieve?

It focuses on creating improvements in patient care, research, and education by applying A3 methodology to project work and producing reportable results by May 2021.

How does the document justify the need for change?

It presents performance issues in the US health care delivery system, including cost, quality, life expectancy and mortality rankings, immunization rates, chronic disease prevalence/incidence, patient satisfaction barriers, medical mistake rates, and outpatient/inpatient error signals.

Oct 26, 2026

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