Ask an Expert: Help! How do I start my change project?

Submitted by: 06/02/2017 by Maureen Fitzgerald

NIATx Coach Scott Gatzke has heard this question from many change leaders.  

“It’s easy for change leaders to feel uncertain about where to begin, especially if they are new to NIATx or if they feel that they need to improve everything in their organization at once,” says Scott.

His advice?

“Go back to five fundamental questions[1] on the NIATx Smart Chart. Asking these questions provides the foundation for your change project and helps clarify who you will need on your change team.”

The NIATx Smart Chart is one of many tools available in the NIATx Process Improvement Toolbox.

The five questions
1. What is it like to be our customer? 

Conduct a walk-through to find out what customers experience.  Decide when to do the walk-through and who should participate. Be sure to inform staff ahead of time and let them know that the purpose of the walk-through is to evaluate processes, not people.

2.What are we trying to accomplish?

“The key here is to focus on one change at a time, says Scott.  “Use the flow-charting exercise to pinpoint the problem you want to address.  Then, make sure your  aim statement states a baseline and a target measure.”  

3.How will we know if a change is an improvement?

“Here’s where your data collection will come into play,” says Scott. “Decide how you will collect and record the data, and who will review it and how often.” 

4.What changes can we test that may result in an improvement?

“Here’s where you will use a series of PDSA Cycles to test a change,” explains Scott.  “Use the Nominal Group Technique to get ideas for changes to test. You can also review the Promising Practices section of the NIATx Resource Center for change project ideas.

5.How can we sustain the improvement?

“Once you’ve tested a change, proved its effectiveness, and decided to adopt it as standard procedure, you’ll need to make sure you have a plan for sustaining the change,” says Scott. “To do that, assign a member of your change team to act as the Sustain Leader who will monitor the change and make sure staff members don’t slide back to the old way of doing things.”

By concentrating on these five questions and using the fundamental NIATx tools (walk-through, flow charting, Nominal Group Technique, and PDSA Cycles), change teams can stay on course to achieve their improvement goals.


[1] The five questions are derived from Langley, Nolan, Nolan, Norman, & Provost. The Improvement Guide, San Francisco, Jossey-Bass Publishers, 1996

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