INTERVIEW - We are used to seeing A3s primarily as a problem-solving tool. In this Q&A, read about the experience of a San Francisco hospital using A3s for personal development.

Interviewees: Margie Hagene and William Huen

Roberto Priolo: The A3 is an incredibly versatile tool. It is generally used for problem solving, but it has many other uses. You two specialize in using the A3 for personal development. How can you best describe this approach?

Margie Hagene: I'm always learning new ways to think about this, but the best way to describe A3 thinking that I've come across is Zuckerberg San Francisco General Hospital CEO Susan Ehrlich's: improvement chartering. I think that's brilliant. When I think about it in relation to my personal improvement, the framework becomes a tool for rigorous thinking that results in an improvement charter for myself. I know of no organization in the U.S. that has gone as deep into personal improvement through A3 thinking and started thinking about it at an organizational level as Zuckerberg San Francisco General Hospital. They use exactly the same framework you can see in Managing to Learn. We anchor people with what they already know from John Shook's book and then we encourage them to apply it to self-improvement rather than problem solving.

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RP: Lean is a socio-technical system, so it makes sense for leaders to think about its "social" dimension as well. Yet they tend to focus more on the technical dimension. Why is that?

MH: It's unknown to them. Leaders were usually recognized in their field because of their technical achievements, because of what they learned in school, because of what they did better and better over time. It is highly unusual for anyone to have been encouraged to think about the social components of the job. They have learned to feel very confident in their technical practices and it can almost feel like a step backwards to look at the social side of things because it normally makes them feel wobbly (something they haven't experienced in a long time) and they have never been asked to focus on this. Unfamiliar content and requirements is not necessarily what an experienced person is attracted to.

William Huen: In healthcare, there is a little more balance between the social and technical side of management, because there is more focus on the relationship with patients and with the larger team. But there is still a tendency to focus on tasks and less on the organizational vision, the relationships within the organization and even with patients. Too often we turn the person into a technical system. We tend to list problems in a compartmentalized way - by "system" (such as neurological, respiratory, cardiovascular, and so on) and make it overly technical. Every now and then, we need to step back and ask what the patient is actually experiencing, what condition he is in, and how the system as a whole can work together to help him. With the specialization of the medical profession, the technical side of the work is generally more appealing - it's clearer, black and white and measurable. What I like about lean is that it draws people back to the social side.

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RP: How did you come to see A3 thinking as a tool for personal development?

MH: My formal education is College of Education, where I learned the importance of creating the conditions for learning - something that Lean Thinking and continuous improvement certainly tie into. Accessible frameworks, like A3, help people find their way forward with what's in front of them. When John Shook wrote Managing to Learn, he and I were both living in Ann Arbor. Some of his early experiments with workshops took place at the University of Michigan. He invited me to sit in to give him feedback and learn about the framework. That's how I learned more about A3 thinking and deepened my own practice. Then I gave workshops with and for LEI, where we introduced people to some lean practices. Toward the end of the workshop you told people to go back and practice.... but nothing happened. We were teaching them new ways, but asking for next steps on old ways. I kept staring at the A3 framework and wondering why it wasn't working for some of the people I was coaching. It occurred to me that if you accept the hypothesis that each of us as leaders is a workplace condition that could also benefit from improvement, there is no reason why an improvement framework like the A3 wouldn't work when applied to personal development. So I tried it out with individuals and started asking some questions that fit the different elements of the framework. It was helpful for people: when it comes to self-improvement or my own leadership development, there is often no framework to do it.

WH: For us, it was an evolution. We started by teaching a lot of tools and problem solving, until we realized that the leaders themselves had to change their behavior. Many leaders find this challenging, but once they turn the corner and begin to see their leadership role more clearly, they understand that the leadership behavior of others is dependent on their own. Many people in healthcare appreciate the A3 framework. They like the data-driven side of it, the scientific method behind it, the ability to be messy. I don't necessarily see it as a simple framework, but rather a complex framework that can be easily applied to complex problems.

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RP: How do you find that people respond to the A3 framework? Is it easy for them or not?

MH: A3 thinking is an incredibly rigorous practice. On the surface, it comes across as not overwhelming and most people can connect with the logic in the flow of the story. So initially it is not daunting. However, they are often surprised and uncomfortable about what comes to light by digging deep into it. I will say that the framework helps them discover what they need to learn, whether it is to solve problems or to explore and improve themselves.

WH: For many of our leaders, the A3 framework allows them to think deeply about challenging and complex problems, using a shared language. As they gain a deeper understanding of the organization, their teams and their units, they gain clarity and begin to see what it takes to get started. How can I contribute differently to achieving our goals? What are my strengths? How do I use them in a way that serves my followers or colleagues?

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RP: From a practical standpoint, how are people going to use the framework for self-improvement? Starting with giving their A3 a title....

MH: We present the A3 to them as an "improvement story about yourself." Each story has a title, and we ask them what might be a good name for their story right now, knowing that it will probably evolve as they think about it more deeply.

WH: In our organization, we like to think of A3s and strategic deployment as top-down and bottom-up. For example, within the context of a new strategic direction, as a leader you share ownership around the alignment and realignment of complex systems and then you operationalize solving strategic problems at the department or unit level. Personal development can also be used. A supervisor can invite a leader to begin a personal development plan A3 around specific feedback. We have invited our extended executive team to create personal development plan A3s in response to 360 surveys or trends in employee engagement. And recently, our CEO, Susan Ehrlich, challenged our executive team to include an equity goal in our personal development plans. Not an exact title, but certainly a direction we need to move in.

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RP: What parts of the A3 framework do people find most challenging?

MH: People usually struggle with the current state, just as they do when they use the A3 framework to solve problems. They tend to speak in generalities and often look at the people they are leading instead of holding up a mirror to themselves. As coaches, our role is to get our coachees to focus on themselves and get very specific about their behavior and the results they produce in the rest of the organization. We see that they are uncomfortable with this level of self-examination, but that is how self-learning and improvement happen.

WH: I agree. As with any improvement work, I think self-reflection and identifying real problems is always the hardest part. As a coach, you also have to be prepared for conversations that become very personal and often uncover organizational traumas that have existed for decades. Our job is to create a safe space where people can then go to the right side of the A3 and feel like they can find the next step.

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RP: How does the practice of A3 as personal development compare to the standard work for leaders?

WH: We use leader standard work as a follow-up tool, but also as a continuous study and adaptation tool. The goals we have are often measured through leader standard work, especially daily behaviors. We try to get people to experiment at the level of specificity of a daily behavior that is measurable. We encourage people to think about how they show up every day, about their specific daily behaviors, and then we use the standard work. It's less about which boxes I check and more about how I lead and serve others. Asking open-ended questions is a common question people put in their A3.

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RP: Who is typically the coach who challenges people in developing their personal A3? Is it a colleague? Is it their manager?

WH: From the beginning we relied on a collegial approach and over time we switched to the manager. It was the most feasible way to do it and it worked well for us. We have many experienced leaders, but they often don't have the bandwidth and capacity to do this on a regular basis. Later, we incorporated the practice into our extended executive team agendas, where we build time into our monthly meetings for people to share their improvements and standard leader work - that's how we measure its effectiveness across the organization.

MH: When we introduce this, we immediately introduce catchball and asking effective questions, which serves the A3/improvement/problem owner. Whether A3 presentations take place in a one-on-one setting or in a room full of colleagues or strangers presenting to each other, the initial interaction is universally uncomfortable. People often feel a sense of disappointment with what's on the paper (which is not the intention at all), and we often have to insist that they write down their strengths - not just their limitations. In my experience, after that first time, they realize that they survived, that they learned, that they are supported by the team, that they will leverage their strengths. Then it becomes easier.

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_{THE INTERVIEWEES}

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