3P: The Mindset Behind the Tool

“We did a 3P for our last project, and it was HORRIBLE.  I will never do another one again!”  I heard this at a networking event not long ago, and I felt the need to know more.  What went wrong?  How was it approached?  What did the process really look like?  It made me wonder how many more people might feel this way and shy away from this kind of event after hearing about other experiences like this one. How many organizations replicate this “less than ideal” version of 3P – the one without true transformation, quality results, and champions - without even realizing what they missed?

Saying 3P's aren't valuable is like saying "I hate shovels!"

When you don’t get the result you want you have to ask yourself several things. First: was this the right tool for the job? If you try to build a house with a shovel, you probably won’t get the results you want. And that shouldn’t be an indictment on shovels - or houses for that matter - it’s just the wrong tool for the job. The next question should be: were you using the right tool incorrectly? Answering “no” to either of these questions represents a call to action. While the 3P can be leveraged as a powerful tool, the tool is only as good as the method and the mindset behind it.

In the last 10 years, many progressive healthcare organizations have joined the Lean mission to eliminate waste and enhance customer value utilizing the 3P as part of the process, but with varying degrees of success. In order for this collaborative event to really function properly, there are a few insights that can yield better outcomes:

Timing is Everything!

When a 3P event is deployed early in the design process, participants have many more levers to pull to influence operations, space program, and design at the same time. If deployed late in the design process after many design decisions have been made, there will be far fewer opportunities to generate transformative ideas that could actually influence the project scope. Furthermore, our experience has taught us that rather than the traditional 3-day event held on consecutive days, a more spread out process allows time between each session to more fully investigate operational ideas that may emerge, before having to commit to a spatial response the very next day. We have found that a few 4-hour meetings on a 3-week cadence over several weeks is most effective.

One Size Does NOT Fit All

Every time we lead a 3P, we replicate 75-85% as standard work, and leave ourselves 15-25% for experimentation and improvement. Identify your needs early on to adjust the approach, and craft your 3P agenda to be specific to those needs, focusing energy on the areas with the most opportunity to achieve transformation.

Don’t apply tools and techniques just because they are familiar; they may not be very effective for the specific problem you are trying to solve (even if they worked really well in your last event). For example, if you are planning a 3P event around your future clinic module but already have a standard exam room you must use, then you probably shouldn’t spend any time mocking up an exam room. Make sure you know your constraints and objectives, and plan your event accordingly.

And remember: controversial topics – when planned for and discussed in a high-respect environment – can lead to innovation – embrace them as lightning rods for targeted, intentional change!

Transformation is both a Marathon and a Sprint

Lastly, the 3P is just a tool; true transformation often requires a change in systems, behaviors, or even philosophy to get the results you want. Don’t assume that simply conducting a single 3P event, even if many people are involved, will sustain change over time. Rather, use the 3P as a catalyst for change and as a way to build champions invested in the outcome, who can recruit and lead others.

With the right culture that allows for and fosters an appropriate mix of standardization and innovation, teams can more easily adapt their 3P to the needs in front of them.  Gift your teams with empowerment and information, and a successful 3P can transform your project. And after the 3P is complete, be careful not to resort to old models of design and delivery in the remaining design phases; the entire project team (design, operations and facilities management) must hold each other accountable to follow through on the promises made in the 3P.

Looking Forward

The 3P is constantly evolving, and the future is bright.  With new advances in Virtual Reality, the proliferation of design standards, and the demand for modular, universal design for future flexibility, we continuously re-invent the 3P to improve how we use them in our own practice.

For more information and to learn more about where we think the 3P is headed next, please consider attending one of our upcoming educational workshops:

May 2 in Milwaukee, Wisconsin

June 11 in Washington, DC

Andrew Zimmer and Kiki Werkheiser
HGA

About the authors:

Andrew Zimmer is a Vice President and Principal in the healthcare practice at HGA Architects and Engineers. Andrew has led more than fifty 3P workshops and events at all scales around the country and has conducted seminars on their effective use for Catalysis Healthcare Value Network and internationally for the Lean Healthcare Association of Finland in Helsinki.

Kiki Werkheiser is a Work Process Specialist at HGA Architects and Engineers. Her insight into the priorities of clinical workflows, human needs, and change management make her an exceptional facilitator who turns skeptics into champions. She is trained in Evidence-based Design and is a Certified Lean Six Sigma Green Belt; she presents on topics related to process improvement and change management in healthcare at national and regional conferences.

About HGA

HGA  is an integrated design firm with eleven offices nationwide. Our goal with every healthcare project is to deliver creative, elegant solutions to complex challenges that increase operational efficiency, improve clinical outcomes, and elevate human experience.

We merge research, ethnography, lean process improvement, data analytics, and design thinking with architecture, engineering, and planning, and work collaboratively to deliver value-driven solutions for the organizations we serve.