Set priorities for testing potential improvements in quality, satisfaction and efficiency.
Why It's Important:
After generating dozens of ideas to improve patient safety, reduce waste, enhance patient-centered care and increase staff vitality, hospitals must determine areas of focus. Some concentrate on one theme first (e.g., reliability/safety), while others target changes across all four themes of TCAB.
How To Do It:
1. Gauge the ideas. A helpful method for identifying where to begin is to arrange the concepts from the brainstorming session on a four-quadrant plot with "low-cost to high-cost" on the vertical axis and "low-impact to high-impact" on the horizontal axis.
- Determine how easy or difficult the idea would be to implement and if it would have high or low cost implications, using the grid as a guide. Those changes that are low cost with the potential for high impact are an excellent place to begin with tests of change. When considering the cost of an idea, also keep in mind the potential cost to spread the change should it be successful.
2. Determine where to begin.
Start with tests that relate to a theme where improvement is most needed. In some cases, collecting baseline data on a set of key measures will identify areas where improvements need to be high priorities.
Alternatively, focus on an area of high staff commitment and energy. If you have an energized staff with many ideas for changing the work environment, you may want to test changes that improve efficiency or enhance vitality so that the nurses see early returns for their efforts.
Consider the democratic option. Another option for selecting which ideas to begin testing is through voting with all frontline staff on a unit. Some hospitals have found that this option creates the most buy-in among the staff to test and implement changes.