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Case Study Sections


		Getting Started
		Developing a Strategic Plan
		Identifying the Problem
		Describing the Problem
		Analyzing the Problem
		Planning the Solution
		Implementing the Solution
		Monitoring/Evaluating the Solution

Related Topics


		Identify the Problem Concepts: Identify the Problem
		Identify the Problem Tools: Brainstorming

Determine Users' Needs

Mrs. Alvarez decides to analyze why health services are not being utilized, despite the fact that other health centers are located farther away from the community than this one. She discusses her idea with the team, and they realize that there are two ways of identifying the problems according to the users: a consensual process, such as brainstorming or a prioritization matrix, or a data-gathering process, such as a user survey. The team decides to use both processes by utilizing three different tools to understand why people have not been using the health center's services. These three tools are:

Each team member agrees to participate in exercises using these tools after thinking through how these tools help to understand the users' needs and how the users' needs define quality.

Brainstorming To Identify Problems

As a first step in identifying the problems that are affecting the quality of the services offered through the health center, the team conducts brainstorming with users chosen randomly in the health center. Mr. Diaz is in charge of the brainstorming session.

After grouping about 10 users in a room together with the team, Mr. Diaz asks them the following question: "In your opinion, what are the problems of quality that the health center is facing?" He asks them to take a few minutes to think to themselves about this issue, and assures them that there are no right or wrong answers.

Next, each participant states his or her ideas, one at a time, and Mr. Diaz writes the ideas on a large pad of newsprint so everyone can see the ideas. The participants add to the list when new ideas come to mind during the discussion. Mr. Diaz groups all the ideas together, and asks the group to clarify ones that are not clear. After the list of ideas is finished, the group discusses the ideas together. Mr. Diaz leads them to consensus on which ideas to keep and which to eliminate.

The result of the brainstorming session is a final list of the problems that are reducing the quality of the health center services. The problems identified by the users are

no appointments in the afternoon
delays in registration
incomplete laboratory
insufficient care in dentistry
not enough doctors
not enough material for labs
broken-down ambulance
segregation of patients
long waiting time
patients feel that they are not treated with respect

This list is circulated to all staff to educate them on the work of the team members and the challenges facing the clinic to improve the quality of services.

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