What You Might Do


a. Generating Alternatives

All along the way you will find yourselves generating and noting potential leverage points and potential options for improvement you might want to test, sometimes thoughtfully, sometimes by chance. But at a certain point, after some additional brainstorming, you will want to pull those notes together and boil them down into a small set of highly promising change options. Your task then is to consider the odds of success with each and how well each meets the criteria you establish for an optimal solution.

b. What Others Are Doing That Works and What Can You Learn From Them

Before or immediately following your brainstorming, it is important to seek fresh ideas, not to mention the latest information concerning relevant evidence based practice, by setting out to learn how others are handling similar situations. Done with care this is called “benchmarking.”

It can be a matter of asking around, contacting colleagues near and far, searching the internet or searching a medical library. These phone calls, emails and literature searches don’t necessarily need to be extensive, but taking good notes as you go can avoid unpleasant do-overs.

When several members of your team are dividing this up, set times to meet and share what you come up with. The need for additional, more focused searching may surface at any time. Once you identify some good ideas and which ones might work particularly well in your own setting, think about how to reinvent them (how you can make them your own).

c.  Selecting One Change to Test

When you’ve analyzed the situation, benchmarked and brainstormed well enough to generate a solid list of possible interventions, you need to select one item to test (the one likely to make the biggest difference over time). If more than one seem important to try, remember to test them one at a time.

Some teams use a set of criteria such as those in the worksheet below to numerically rate alternative interventions. The matrix is first used by individuals to rate each of the change options from their particular perspective, then each column is summed to get the total for that option. The totals for each option from all improvement team or practice members are averaged.

                      CHOOSING A CHANGE WORKSHEET


Change 1

Change 2

Change 3

  • Ease of Implementation
  • Low Cost
  • Chance of Success
  • Effect on Patient Satisfaction
  • Effect on Healthcare Team Satisfaction
                        Individual Totals:
                               Team Totals:


0 = poor

5 = excellent

[Click here for a “Choosing a Change Worksheet” W-3.]