Describe the gap before proposing a fix
A useful aim names the workflow, the observable gap, and the intended direction of change.
Problem: what is happening, where it happens, and what observable evidence shows a gap. Aim: what the team intends to improve within a defined scope and period. Keep the two separate so a preferred solution does not get mistaken for the problem.
A practical pattern is: “In [defined workflow and setting], improve [observable process measure] from [starting point] toward [intended direction] by [review date], without worsening [relevant balancing consideration].” Use local, approved sources for any operational baseline or deadline.
Worked example: make the handoff note easier to use
Problem statement
In the fictional Harborview Care Network, a sample of notes from one weekly service-coordination meeting showed that the next owner was not clearly named in some handoff entries. The example focuses on documentation of ownership, not on whether a clinical decision was correct.
- Workflow: notes produced after one weekly service-coordination meeting.
- Observable gap: next owner is not explicitly recorded in some sampled entries.
- Scope: one meeting workflow, not every unit or care setting.
Aim statement
For the next four weekly reviews, increase the share of sampled handoff entries that name a next owner from 12 of 20 (60%) toward at least 16 of 20 (80%), while checking that note completion does not add avoidable work for the meeting team.
- The values are fictional sample figures, not a live baseline or target.
- The denominator is 20 reviewed entries per sample in this example.
- The four-week period is an illustrative cycle window, not a service commitment.
Prompts for a clear problem and aim
Use these prompts to make the scope and evidence visible before choosing a change.
| Prompt | Harborview example |
|---|---|
| Which workflow is in scope? | Notes after one weekly service-coordination meeting |
| What gap can the team observe? | Some sampled entries do not name a next owner |
| What is the intended direction? | Increase entries with an explicitly recorded next owner |
| What boundary matters? | One meeting workflow; no claim about other settings |
| What else should be watched? | Whether note completion adds avoidable work |