The Nominal Group Technique: A Tool for Building Consensus in Any Setting

Submitted by: 07/15/2019 by Maureen Fitzgerald

The Nominal Group Technique (NGT) is an essential tool in the NIATx Process Improvement Toolbox.  In a NIATx change project, teams use the Nominal Group Technique to brainstorm ideas and reach consensus on which one to test first. Everyone shares their insights, and all ideas have equal weight.

Here’s a description of the NGT:

“The Nominal Group Technique is a team-based decision-making process that may be used to either identify problems in a process, or brainstorm and prioritize potential solutions to test. An NGT session starts off with a question, posed by the change leader (or executive sponsor) to the team that’s meant to explain the objective of the meeting to the participants. From there, all members of the team individually brainstorm, and then regroup to share their ideas. Then all ideas are discussed, and the team votes on which idea to run with.”—The NIATx Model: Process Improvement in Behavioral Health

A versatile tool that crosses cultures

The NGT can be used in practically any decision-making situation, and recent research publications highlight the tool’s versatility.  NIATx coach Lynn Madden and fellow authors tested use of the NGT with a group of 81 adults with opioid use disorder, asking them to rank and prioritize responses to questions about the pros and cons of specific medications.  Read the article abstract: Using nominal group technique to identify barriers, facilitators, and preferences among patients seeking treatment for opioid use disorder: A needs assessment for decision making support

In a study conducted in Ukraine, Madden and fellow authors found that the NGT works across cultures. Clinicians and administrators used the NGT to identify barriers to use of medications for treating opioid use disorder.  Read the article abstract: Using nominal group technique among clinical providers to identify barriers and prioritize solutions to scaling up opioid agonist therapies in Ukraine.  

An earlier (2013) article by Wainwright and fellow authors describes the use of the NGT to get patients involved in designing a community-based pain management program in the United Kingdom. The authors conclude that “where the research aim is to involve patients in service design, the NGT approach has advantages over other techniques, partly because it reduces the effects of power differentials between participants and also because it encourages participants to link their personal experiences to the task of designing a service and reduces the tendency to lapse into personal illness narratives.”  Read the article abstract: Using the nominal group technique to engage people with chronic pain in health service development

The backstory

The NGT emerged as the answer to a question UW-Madison researcher posed to a grad student:  Why don’t people talk in meetings? Silent idea generation was built into the tool to give everyone a voice.  For many, it’s that quiet step that inspires focused, creative thinking.  Read the full story in the  NIATx e-news item: The NIATx Files: A Brief History of the Nominal Group Technique

How to Conduct and NGT

Follow the step-by-step instructions in the NIATx Process Improvement Toolbox, and you’re bound to have a successful NGT.

Have you used the NGT recently to brainstorm creative solutions?  Share your story with the NIATx community! Email Maureen Fitzgerald:

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