10.7 Tools: Impact-Effort Matrix

Once you have generated change concepts and ideas for each critical X that may optimize the stability, shape, variability, and mean of all the CTQs, you need to select the change concepts and ideas that you and the team will implement in the pilot test. It would be best to involve the people who work closely on the process to leverage their knowledge and expertise and facilitate buy-in to the process change you selected.

Suppose determining the best idea is not straightforward, and there is debate among team members regarding the best set of change concepts. In that case, you can use a more objective method of selecting the optimal configuration of the process. One useful tool in this context is the impact-effort matrix.

An impact-effort matrix acts as a decision-making tool to prioritize ideas and manage time more efficiently. In short, you can use the tool to assess the impact of potential configurations of the process based on the effort the team will require to execute them.

The matrix is set up as a 2 × 2 grid with the effort needed to implement the solution on the horizontal axis and the solution’s impact on the vertical axis. Here are the specific steps:

1. Assemble the potential solutions the team identified.

2. Construct an empty diagram with the effort required to implement the solution on the horizontal axis and its impact on the vertical axis, and divide it into four quadrants.

3. Assess the effort and impact of each solution.

4. Place the solutions in the diagram according to these assessments.

The solutions falling into the upper left-hand quadrant will yield the best return on investments, and you should consider those solutions first.

As an example, let’s suppose that a local health unit admitted a patient that suffered a cardiac arrest shortly after admittance. Such an episode required the patient to move to the main hospital. While waiting for the ambulance to arrive, a staff member photocopied portions of the patient chart to follow with the patient in the ambulance. Then, the staff sent the remaining parts of the chart via fax to the emergency room at the main hospital after the patient left in the ambulance.

Using the symptoms and the history included in the copy of the chart that arrived in the ambulance, the healthcare team treated the patient. However, when the remaining information came via fax, the team noticed that the copies of the ambulance were actually to a different patient in the same unit. This error led the healthcare team to administer mistakenly a medication to which the patient was highly allergic.

The team investigated the episode and proposed various solutions:

1. Create a policy for matching patient ID to chart ID at every transfer point.

2. Train every employee on the patient identification policy.

3. Barcode patient ID bands and charts and match before transport.

4. Implant a radio frequency identification (RFID) tag under patients’ skin and attach it to each medical chart for matching at each transfer point.

Under these circumstances, you could assess the four potential solutions determining the effort and impact of each and then plotting them with corresponding numbers. Assuming the assessment led to the result below, we can see that barcodes on patient ID bands and charts would be the first option.