Additional resources

Additional resources
Practical resources for identifying the problem
Name and source Description
Five whys approach from National Health Systems This approach involves repeatedly asking the question ‘why?’ (approximately five times) to quickly help identify the source of an issue or problem. It is a simple approach that helps to uncover root causes.
Cause and effect diagram (Fishbone) from National Health System 

This approach helps you thoroughly understand the problem and identify all the possible causes – not just the obvious. The problem is graphically displayed in the shape of a fishbone.

Practical resources for determining the knowledge gap
Name and source Description

Gap Analysis Facilitator’s Guide from Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality (AHRQ) offers a gap analysis process that includes three steps:

  1. Review of documentation of organizational practices, policies, and procedures
  2. In-person facilitated focus groups with key stakeholders
  3. Review results of the gap analysis, and define next steps in the implementation process.

Golden et al., 2017. A gap analysis needs assessment tool to drive a care delivery and research agenda for integration of care and sharing of best practices across a health system. The Joint Commission Journal on Quality and Patient Safety43(1), 18-28.

This is a systematic approach that uses data to identify needs within the system and set goals and priorities. It includes an assessment of program infrastructure, policies, protocols, order sets, health care provider education, patient education, and automated data access.
RNAO gap analysis worksheets: LTC Toolkit These worksheets help you and your team compare your organization’s current practice with evidence-based best practice recommendations from RNAO guidelines. The process identifies strengths and targets practices and processes where changes may be required.
Why does Canada need a National Quality and Patient Safety Framework for Health Services? A resource on The Canadian Quality and Patient Safety Framework for Health Services that defines five goal areas designed to drive improvement and to align Canadian legislation, regulations, standards, organizational policies, and public engagement on patient safety and quality improvement. 

Resources to develop actions or plans
Name and source Description

The “SMART” approach from National Health Systems

This guide uses SMART to set goals and action plans. The acronym SMART can be used to help you develop clear and actionable goals, objectives, or action plans. SMART stands for specific, measurable, attainable or assignable, relevant or realistic, and time-bound.


This resource uses SMART to help you clarify objectives and move those ideas into action.
Resources for prioritizing problems or knowledge gaps
Name and source Description

Prioritizing opportunities for improvement from Agency for Healthcare Research and Quality

This resource suggests three prioritization strategies: multi-voting, prioritization matrix and pick chart.
Prioritization matrix from Institute for Healthcare Improvement This video uses the analogy of a garden to explain how to use a prioritization matrix.

Nominal method (Multivoting) from American Society for Quality

This technique helps identify the priority of issues, decisions, or action plans, and can quickly and accurately reveal the group’s priorities.