Structured Brainstorming Techniques

The adoption of systems-focused risk assessment techniques has not led to measurable improvement in the rate of patient harm. Why? In part, because these tools focus solely on understanding problems, and provide no direct support for designing and managing solutions (i.e., risk control). This second installment of a 2-part series on rebalancing risk management describes a structured approach to bridging this gap: The Active Risk Control (ARC) Toolkit. A pilot study is presented to show how ARC Toolkit can improve the quality of risk management practice.

Although it is probably the best-known Prospective Hazard Analysis (PHA) tool, Failure Mode and Effects Analysis (FMEA) is far from the only option available. This paper introduces one of the alternatives: The Structured What-If Technique (SWIFT). SWIFT is a flexible, high-level risk identification technique that can be used on a standalone basis, or as part of a staged approach to make more efficient use of bottom-up methods like FMEA.

In this paper we describe the method, assess the evidence related to its use in healthcare using a systematic literature review, and suggest ways in which it could be better adapted for use in the healthcare industry. Based on the limited
evidence available, it appears that healthcare workers find it easy to learn, easy to use, and credible. Especially when used as part of a staged approach, SWIFT appears capable of playing a useful role as component of the PHA
armamentarium.

BACKGROUND: Fishbone diagrams have been widely promoted as a systems-focused hazard analysis tool for use in root cause analysis, but they suffer from a number of structural weaknesses, including a unidirectional structure that only takes into account forces that promote an accident (ignoring those that make the accident less likely or less severe) and a means of displaying these forces that does not convey any difference in strength of influence. In a separate but related issue, many healthcare organizations suffer from a lack of change management expertise.

PROPOSED SOLUTION: To address these concerns, I present a novel technique, the Lovebug diagram, which draws from both Fishbone diagrams and force-field analysis (an approach to analyzing planned change). This new technique adds value to both its progenitor methods, while retaining their key strengths and ease of use. It can be used both prospectively, to assess planned changes, and retrospectively to assess unplanned (accidental) departures from the status quo.

DISCUSSION: The Lovebug diagram is a more powerful analytical tool than its progenitor methods; however, overall adoption of systems-focused tools for root cause analysis remains suboptimal. Additional research is needed to determine how best to promote a truly systems-focused approach to healthcare root cause analysis. Beyond this retrospective use of the technique, it represents a simple tool to assist healthcare organizations with prospective change management.

Available from: http://cri.sagepub.com/content/early/2013/10/25/1356262213510855.abstract

Although it is probably the best-known prospective hazard analysis (PHA) tool, failure mode and effects analysis (FMEA) is far from the only option available. This article introduces one of the alternatives: The structured what-if technique (SWIFT). SWIFT is a flexible, high-level risk identification technique that can be used on a stand-alone basis, or as part of a staged approach to make more efficient use of bottom-up methods like FMEA. In this article we describe the method, assess the evidence related to its use in healthcare with the use of a systematic literature review, and suggest ways in which it could be better adapted for use in the healthcare industry. Based on the limited evidence available, it appears that healthcare workers find it easy to learn, easy to use, and credible. Especially when used as part of a staged approach, SWIFT appears capable of playing a useful role as component of the PHA armamentarium.

Fifteen people were randomly selected from 5 exits of the North Train Station in Bucharest on Monday 10.01.2018 to participate in a Brainstorming session organised by our international consultancy on the subject of Introducing an IT project management system in a national public company. All the people agreed to participate in the brainstorming session as they are interested in the tombola with prizes offered by the Company, amongst which a yearly theatre subscription. The people agreeing to participate are then shown the names of the participants already on the list after they accepted to participate and asked if they recognised any names and how well then know the respective participants. This is done to ensure that none of the participants knew each other. If they said no, they are told the exact date, place and hour where to present themselves to actively participate in the Brainstorming. The speech of the moderator:-Good morning, Hello and Welcome! First of all thank you all for agreeing to participate in this Brainstorming session. In the next several minutes we will together go thought the rules of this brainstorming session. Please respect the rules so as not to interfere with the results, so as to not make our efforts in vain and also so that we can finish on time. The explanations of the moderator: We are gathered here today to discuss the subject of trying to identify together the possible benefits and possible negative aspects related to the introduction of an IT /a project management system in a public national company in Romania. There are multiple models of such systems nationwide and European-wide and we would like to know from your experience and professional work some aspects related to IT/project management systems. This brainstorming is used to generate ideas for launching a project of implementing the most adequate IT/project management system in this national public company.

Background: After investing significant amounts of time and money in conducting formal risk assessments such as root cause analysis (RCA) or failure mode and effects analysis (FMEA), healthcare workers are left to their own devices in generating high quality risk control options.

In 21 st century learning, critical thinking is one of the most crucial learning skills that student-teachers have to acquire. Student's ability to think critically would promote higher level of concentration, deeper analytical abilities, problem solving skills and creativity. One approach that can be used by educators for integrating critical thinking in the curriculum is through collaborative brainstorming. Through collaborative brainstorming, students can invent an idea, find a solution to a problem, or answer a question. One particular tool that can be used for facilitating collaborative brainstorming process is by using online mind map tool. Building a mind map is an active learning strategy that engages the learner with the subject matter. This strategy can be applied in the teaching and learning process instead of traditional lectures. Through the Scholarship of Teaching and Learning (SOTL), underpinned by meaningful and experiential learning theory, this paper discusses student-teachers' participation and engagement in collaborative brainstorming for developing critical thinking by using online mind mapping tool.

Risk assessment is widely used to improve patient safety, but healthcare workers are not trained to design robust solutions to the risks they uncover. This leads to an overreliance on the weakest category of risk control recommendations: administrative controls. Increasing the proportion of non-administrative risk control options (NARCOs) generated would enable (though not ensure) the adoption of more robust solutions. Experimentally assess a method for generating stronger risk controls: The Generating Options for Active Risk Control (GO-ARC) Technique. Participants generated risk control options in response to two patient safety scenarios. Scenario 1 (baseline): All participants used current practice (unstructured brainstorming). Scenario 2: Control group used current practice; intervention group used the GO-ARC Technique. To control for individual differences between participants, analysis focused on the change in the proportion of NARCOs for each group. Proportion of NARCOs decre...

After investing significant amounts of time and money in conducting formal risk assessments, such as root cause analysis (RCA) or failure mode and effects analysis (FMEA), healthcare workers are left to their own devices in generating high-quality risk control options. They often experience difficulty in doing so, and tend toward an overreliance on administrative controls (the weakest category in the hierarchy of risk controls). This has important implications for patient safety and the cost effectiveness of risk management operations. This paper describes a before and after pilot study of the Generating Options for Active Risk Control (GO-ARC) technique, a novel tool to improve the quality of the risk control options generation process. The quantity, quality (using the three-tiered hierarchy of risk controls), variety, and novelty of risk controls generated. Use of the GO-ARC technique was associated with improvement on all measures. While this pilot study has some notable limitations, it appears that the GO-ARC technique improved the risk control options generation process. Further research is needed to confirm this finding. It is also important to note that improved risk control options are a necessary, but not sufficient, step toward the implementation of more robust risk controls.