By Karen Morrell, CLIC Programme Manager


As the name suggests the A3 is linked to its size – an ideal size to visually capture information about your improvement initiative. The A3 is a thinking and planning tool, helping you to focus and visualise your ideas for improvement. 

The A3 has recently been refreshed to include the 4Ss (Staff, System working, Service quality and Sustainable finance), which link to the joint business objectives/priorities for the system. By using the 4S approach, Process Owners / Sponsors for improvement can consider what are they hoping to achieve by delivering this improvement, and how is it going to benefit our staff and patients. Here are some examples of how the 4S approach has been used:

  • Staff – Standardised processes and clearly defined roles and responsibilities
  • System Working – Improve flow and working with our partners across health and social care e.g. ICC colleagues
  • Service Quality – Reduce waiting times, reduction in length of stay, improved key performance indicators for example 4 hour A&E target
  • Sustainable Finance – Reduction in agency use, reduction in travel expenses

The A3 is a ‘living’ document and should be updated for the life of the improvement initiative, revisiting the 4S’s on a regular basis to review whether any further benefits have been achieved / or will be achieved through implementation of the improvement.

For more information on A3s and to download a template, please visit the Cumbria Production System Toolkit.