Planning and preparation
Explore existing solutions, map out current processes, and gather necessary data to prepare for effective changes.
Step 5: Explore existing solutions
Learn from what others have already done. Investigating how similar challenges have been addressed both locally and internationally can provide valuable insights. This exploration helps you identify best practices and measures that can be adapted to your context.
To help search for what others have published on your topic, access support and training through HNE Health Libraries.
Tip for success
Avoid reinventing the wheel: by looking at how others have tackled similar problems, you can build on the successful aspects of their approaches rather than starting from scratch.
Step 6: Map the current process
Visualise how things are done now. Draw a flow chart to clearly show each step and decision in the process you're reviewing. This helps everyone see the current workflow and identify where improvements can be made.
| Capture each step | Start at the beginning and chart the process all the way to the end. Include every action and decision point. |
|---|---|
| Look for problems | As you map out the process, watch for any gaps, inconsistencies, or bottlenecks that could be causing issues. |
For more information on creating flow charts: Flow Charts - Clinical Excellence Commission (nsw.gov.au)
Step 7: Collect baseline data about the problem
Use your flowchart to pinpoint where to collect initial data. This baseline data provides a snapshot of current operations, helping to identify areas for improvement.
Examples of baseline data:
- Time metrics: Measure how long it takes to complete specific tasks, such as dispensing medication or processing patient admissions.
- Staff confidence: Assess staff confidence levels in performing certain procedures through surveys or interviews.
- Resource usage: Track the use of resources, like the number of supplies used per procedure or the frequency of equipment use.
Step 8: Brainstorm the causes of the problem
Identify what's causing the problem or issue with a focused brainstorming session. Gather your team and use the tools you've collected—flowchart, baseline data, and any relevant literature - to guide your thinking.
| The process | Tips | |
|---|---|---|
| Silent brainstorming | Each team member writes their ideas on sticky notes, one idea per note. This allows everyone to contribute without interruption. | Concentrate on identifying the underlying causes of the problem, not jumping to solutions. Aim for specific descriptions (e.g., "lack of patient education materials" instead of just "education"). |
| Organise ideas into themes | Place all of the sticky notes on a flat surface where everyone can see them. Go through each sticky note and begin to group similar ideas together to identify common themes. Remove any duplicate ideas and merge similar ideas. Group the sticky notes into logical categories based on common themes. | Common themes might be education, communication, environment, staff skills, resources, policies, and more. You might find anywhere from two to eight distinct categories, each representing a different aspect of the problem. |
| Assign category headings | Once the notes are organised, assign a clear heading to each category. | This process of organising and linking causes is referred to as creating an 'affinity diagram', which helps to form the basis a driver diagram. |
| Create a driver diagram | Transform your organised sticky notes into a driver diagram by rearranging the categories to show relationships between causes and effects. The sticky notes are the ‘secondary drivers’ and the category headings are your ‘primary drivers’. Use arrows to connect secondary drivers to their respective primary drivers. | Click here for more information on driver diagrams. |
Tip for success
For key issues identified during brainstorming, apply the Five Whys technique to drill down to the root causes. Start with a problem statement, ask "Why?" and record the answer. For each answer, ask "Why?" again (up to five times) until you feel you've uncovered the fundamental reason behind the problem. This method helps ensure that you are addressing the real issues at the heart of the problem.
Step 9: Brainstorm and prioritise change ideas
Once you've identified the drivers of your problem, it's time to brainstorm specific interventions that can address these issues.
Use your driver diagram to guide the creation of these change ideas:
| The process | Tips | |
|---|---|---|
| Identify change ideas | For each secondary driver, come up with change ideas that could potentially solve the issues identified. | Consider both your team's ideas and insights gathered from relevant literature. |
| Add changes to your driver diagram | Add the change ideas to your driver diagram in a new column to the right of the secondary drivers. Use arrows to connect each change idea to the corresponding driver, illustrating their relationships. | Some ideas may impact more than one driver. It's ok to have multiple arrows. |
| Determine feasibility and impact | Assess each potential change to determine its feasibility and potential impact. | For each change idea, ask:
|
Tip for success
Select ideas to test first that are easier to implement and likely to have a significant impact on the problem, considering the size, scope, and resources of your project.