The case describes the set of facts or arguments in support of improving a system and delivering a particular solution(s) to a problem within the system.
Contents
Introduction
The need to Make the Case is the fifth of the seven strands in the improvement model. It underlines the importance of making the case for change for the system to be improved, following understanding the system, defining the problem, developing the solution and collecting the evidence. As a result, it is expected that such a case will be developed in the early stages of the improvement process and revised, as appropriate, as the process develops.
Purpose
Making the Case is critical to systems improvement: predicting the benefits to stakeholders of the proposed change; estimating the resources required and cost associated with the proposed change; and making a credible and ultimately successful care for changing and improving the system.
Activities
The process of making the case may include a wide range of activities including, but not limited to: Demonstrate Future Improvement, Predict Stakeholder Benefits, Calculate Resources Required, Estimate Time Required and Present Case for Change.
Tools
The practice of making the case may draw on a wide range of tools including, but not limited to: PEST(LE) Analysis, SWOT Analysis, Stakeholder Analysis, The Five Ws and two Hs and Wardley Map.
Getting Started
Making the case is critical to the successful delivery of an improvement project. It is particularly important to make the care at the beginning of the improvement process and to refine the description as necessary during the remainder of the process.
The Understand, Design, Deliver and Sustain stages of an improvement process were previously described within the Introduction section, where each stage will likely comprise a preliminary activity, followed by a number of stage activities.
For the Make the Case strand of the Understand phase, the preliminary activity is entitled Draft the Pitch. For the Design, Delivery and Sustain stages, the initial case should be further developed into a full case for the benefits to be delivered by the proposed solution(s).
Draft the Pitch
This preliminary activity encourages people to create a simple description of the problem, the process that will solve it, and the benefits that might be achieved and compile the most compelling case to deliver the proposed solution(s) for improving the system.
Worksheets: Improvement Questions, Improvement Stakeholders, Improvement Strands Canvas, Improvement Plan
Top tips:
- Describe and quantify the scale of the challenge
- Outline the plan for improving the system
- Quantify the likely benefits for patients and stakeholders
Following on from this preliminary activity, the remaining stage activities are: Demonstrate Future Improvement, Predict Stakeholder Benefits, Calculate Resources Required, Estimate Time Required and Present Case For Change. Each of these are now described in turn, together with the tools that may be used to support them.
Activities
Demonstrate Future Improvement
The demonstration of most likely behaviour and corresponding improvement to be delivered by the modified system
Purpose: to demonstrate the feasibility of improvement to be delivered by the proposed solutions
Inputs: Define Requirements, Synthesise Evidence, Predict Stakeholder Benefits, Calculate Resources Required, Estimate Time Required
Tools: tbd
Outputs: a demonstration of the future improvement of the modified system
Top tips:
- Describe the likely future behaviour of the system
- Estimate the level of future behaviour of the system
- Compare the predicted performance against the desired performance
Predict Stakeholder Benefits
The prediction of most likely behaviour and corresponding benefits to be delivered by the modified system
Purpose: to predict the stakeholder benefits expected by delivering the proposed improvement
Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Demonstrate Future Improvement, Calculate Resources Required, Estimate Time Required
Tools: tbd
Cards: Service Stakeholders
Outputs: a prediction of the stakeholder benefits of the modified system
Top tips:
- Estimate the value of meeting the individual stakeholder needs
- Estimate the value of meeting the system requirements
- Predict the benefit of delivering improvement
Calculate Resources Required
The calculation of the resources most likely to be required to develop and deliver the modified system
Purpose: to calculate the resources required to develop and deliver the proposed improvement
Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Demonstrate Future Improvement, Predict Stakeholder Benefits, Estimate Time Required
Tools: tbd
Outputs: a calculation of the resources required to deliver the modified system
Top tips:
- Estimate the effort required to meet the system requirements
- Estimate the cost required to meet the system requirements
- Calculate the resources required to deliver improvement
Estimate Time Required
The estimation of the time most likely to be required to develop and deliver the modified system
Purpose: to estimate the time required to develop and deliver the proposed improvement
Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Demonstrate Future Improvement, Predict Stakeholder Benefits, Calculate Resources Required
Tools: tbd
Outputs: a calculation of the time required to deliver the modified system
Top tips:
- Estimate the effort required to meet the system requirements
- Estimate the time required to meet the system requirements
- Calculate the time required to deliver improvement
Present Case for Change
The drafting of a case for change, reflecting the system requirements, predicted system performance and likely benefits
Purpose: to present a comprehensive case for change, balancing stakeholder benefits against costs of delivery
Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Demonstrate Future Improvement, Predict Stakeholder Benefits, Calculate Resources Required, Estimate Time Required, Agree Aim Statement
Tools: PEST(LE) Analysis, SWOT Analysis, Stakeholder Analysis, The Five Ws and Two Hs, Wardley Diagram
Outputs: a comprehensive case for change and delivery of the modified system
Top tips:
- Describe the routes to and priorities for enabling improvement
- Identify the support required to deliver demonstrable improvement
- Build a compelling case for the benefits and timeliness of the work
Tools
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