Using Fishbone Diagrams To Assist In Planning Change

Organisations are always in the situation where they are having to make improvements.  The public and not for profit sectors are no exception to this.

It is not uncommon for people to be able to articulate problems at a high level.  For example talking about:

  • Long waits in A&E departments
  • Spending too much on temporary staff
  • Making too much use of management consultants
  • Wasting resources
  • Not co-ordinating procurement across departments

While it is important to identify problems, it is also vital to really understand the causes or contributors to those problems.

One technique for doing this is to make use of fishbone diagrams.  2000px-Ishikawa_Fishbone_Diagram.svg

At the right hand side you detail the problem (e.g. long A&E waits)

Then you work back to identify some of the broad categories that might be contributing to the problem.  In the case of long waits in A&E you might identify the broad categories as:

  • Capacity
  • Process
  • Management
  • Demand
  • Staffing
  • Relationship

Once you have identified the broad categories you can start to explore more detailed causes within each of the broad categories.

So within capacity you might identify that there is:

  • Insufficient space in the A&E department
  • Lack of beds in wards
  • High levels of delayed discharges for non-clinical reasons

There are a number of benefits in using something like a fishbone diagram to look at problems:

  1. You can capture the views of a range of people quickly
  2. You avoid jumping to all the obvious causes
  3. You can determine where you might get some quick wins
  4. You can make more informed choices about change initiatives
  5. It provides the basis for action planning
  6. The visual representation makes it a very powerful way of representing ideas

Often when it comes to problem solving and change planning the temptation is to dive in and start working on solutions without understanding the whole picture.

Using the fishbone approach reduces that risk and increases the likelihood of selecting the best solutions.

Goals and Achievements work in partnership with public and not for profit organisations to support and facilitate change, improvement and best use of resources.