Rapid-cycle brainstorming: facilitating whole-systems change in time-and scheduling-challenged health care settings

Whole-systems approaches to organizational change dominate the contemporary change literature. They focus on widespread engagement of people within organizations, -individual and collective ownership of both process and results, and encouragement of -creativity and optimism regarding the future. One potential barrier to using whole-systems methods in health care is the frequent recommendation to bring many people together at the same time, sometimes for several days. In health care, it is very difficult to find blocks of time when a group can come together, even when the target unit is relatively small. Rapid-cycle brainstorming is an alternative process for using a whole-systems change method, in this case appreciative inquiry, in a time-efficient, effective manner for change planning in health care. It was used in this case to facilitate strategic planning for a hospital-based dental service for geriatric patients and persons with disabilities. The goals of this method for applying a whole-systems approach to change planning are (1) to minimize the time required to effectively work through the whole-systems process, while at the same time (2) to maximize the engagement of participants, (3) to develop creative synergism between small groups addressing specific planning topics, and when called for (4) to be able to facilitate the involvement of large numbers of individuals across an organization.