Frequently Asked Questions

Is this guide only appropriate for the healthcare context?

The approach and process can be equally useful in a variety of situations – really anywhere that system-level decisions are made.

What healthcare context is this intended for?

The tool can be used in any healthcare context, from public health and home care to residential and acute care settings.

In what contexts has this approach been used?

This process has been used in healthcare and non-healthcare contexts. Within healthcare, it has been used in a variety of programs from mental health & addictions and public health & primary care, to nephrology and maternal & child health. Outside healthcare it has been used in private enterprise and civil society arenas to guide questions concerning organizational structure, organization core values, facility use guidelines, and resource allocation criteria.

How quickly can we do this? How much time will this take?

It will likely take two meetings of between two and three hours each to get to a preliminary decision. Three more meetings, with engagement and communication along the way, will probably be required before the team will be ready for implementing the decision. (See the suggested schedule for a sense of what is involved.)

Must we use the entire process?

This depends on how good a decision you want. Using the process up to Step 7 will likely still offer a team improvement from most existing methods of decision-making. The Engagement piece is necessary to maximally achieve the benefits of legitimacy and compliance. The follow- up steps are necessary to achieve the benefits of effectiveness, especially in the middle and long term.

When should teams use this tool?

A team might be well-advised to use the tool first on a very important policy decision that must be made but for which a time-horizon of a few months is available. This will allow the group to go through the process carefully and learn without feeling rushed. This first iteration will help teams decide whether and how the process might become part of standard procedure.

What specific types of decisions have past teams made using this process?

The approach has been used to assist teams to determine criteria and processes for allocating resources, to determine practice guidelines for responding to challenging clinical issues, and to assist newly formed programs to determine how they can best work together.

Is this a linear process?

Although the process looks linear, there is much interplay between the steps. For example, it may not be until part way through the process that the key question becomes confirmed. And conversation about values may lead to the identification of new facts or missing information. While it is important that the process be complete, each step need not be completely finished before moving on to the next. (Indeed on some occasions it has made more sense to switch certain steps around.)

Who should be involved in the process and at what point? (i.e. whose values should determine the answer to the question?)

Will using this process guarantee a good outcome?

Why should we use this process? What are the benefits?