Health Service Co-Design


Ideas groups

Ideas groups come together to brainstorm improvement ideas and identify ways of resourcing and implementing them.

Why use it

Using ideas groups will help you to brainstorm issues and related ideas for improvements. It is an easy, fast, fun way of scoping potential improvements and innovations.

When to use it

Use this tool whenever you need to scope initial solutions to a problem or opportunity.

Note: You will need to organise a whiteboard, sheets of paper and/or Post-it pads to record people's ideas. Always emphasise the need to write down all ideas!

1. Identify the key problems and any benefits for patients if they are resolved

Write a sentence describing each problem with the benefits of resolving it (the outcomes) in plain, simple language. Avoid any descriptions that suggest a tangible solution, as this will block further ideas.

For example, "a tool to prevent miscommunication between patient and staff, so saving time, preventing errors, and helping patients feel more in control of their situation".

Make a list of the problems to focus the session.

2. Identify who needs to be in the session

Make sure you include anyone who is an (active) stakeholder in addressing the problems and opportunities.
Set up the session and invite attendees.
Consider appointing an independent facilitator.
Before you hold the session, circulate the list of problems, inviting people to think of others and contribute them during the session.

3. Begin the session

Briefly review the initial problems list and check all attendees have a clear understanding of the challenge each problem poses.

Brainstorm any additional problems if these arise.

Ask attendees to reflect on the list and note any patterns and themes they find.
Discuss these and review the list, grouping any that seem similar. Finalise the list.

4. Develop success criteria

For each problem ask: How would a patient want to experience this once the problem was resolved? What would a patient?s experience of success be?

This exercise can be done in subgroups, with each team allocated a specific problem.

Once this is complete take a brief break and prepare for a high-energy brainstorm!

5. Brainstorm ideas for resolving each problem on a separate sheet of paper

If there are many problems, split into smaller groups and allocate a set to each group.

The brainstorming question is: "How might we resolve this successfully for patients (or for its key users, if not patients)?".

Stay focused on brainstorming ideas and avoid judging ideas.

When each problem has been brainstormed, take another break.

6. Very briefly review the lists of ideas and allow 5-15 minutes of reflection and discussion

This works best if the sheets of paper are arranged around the walls of the room and group members can circulate to view them. Provide each group member with three 'sticky dots' (or a small number of other items they can stick to the brainstorming sheets).

Invite participants to vote for the three ideas they consider will make the biggest difference for patients (or whichever stakeholder group is the primary focus).

7. End the session by listing the ideas that are being put forward on a fresh sheet of paper

Review this list and reflect on the themes and priorities. Avoid making any decisions, keeping the ideas open for further assessment and development.


  • When brainstorming, the more diverse the group of people the better.
  • Be tolerant of ideas that are off the mark, even if silly - write these up as well. They are useful for stimulating more ideas!
  • Encourage fun and silly ideas as these help keep people's creative energies flowing.

Example: Gown design workshop

Patients at Waitemata DHB identified a need for better gowns when having a mammogram.

A workshop was held with staff, patients and students from Unitec's School of Design and Visual Arts. The aims were to detail problems with existing gowns, brainstorm ideas to resolve these problems and start work on new gowns.

The workshop started with a general review of known issues with the gowns. Attendees split into teams, each with a mix of students, staff and patients. The teams began their work by listing problems with the gowns in more detail. They reflected on these and some reduced them to key themes, while others chose to work on the most significant ones.

Teams brainstormed what a really good gown might be like (the success criteria for the gown). This included criteria that resolved the known problems, but also criteria that added new and different elements. The ideas were reviewed and key points identified. For example, the feeling when wearing the gown became an important criterion to consider. The teams shared all their problems and success criteria on a whiteboard.

Teams brainstormed specific solutions to problems. In this workshop they then sketched a gown that would both resolve problems and meet the success criteria. They worked on these with patients to the point where very rough examples (or prototypes) were cut, pinned together and put on a willing patient. This meant patients, staff and students could experiment in practical ways with a range of solutions to learn how these could be combined in a single gown.

Finally, each team briefly presented its prototype gown to the workshop.

What's in Robert's box?

At Waitemata DHB, the Healthcare Improvement Team had a box it takes to workshops (affectionately referred to as Robert's Toolbox in reference to the person who set it up).

You might find one useful, here's what's inside:

  • Ballpoint pens - 10 each of blue, black and red
  • Permanent markers -16 each of blue, black, red & green
  • Whiteboard markers - 3 each of blue, black, red, green & purple
  • Highlighter - 1 each of blue, pink, yellow and orange
  • Pencils and colouring pencils
  • Two rulers
  • Post-it pads - assorted colours
  • Blue Tac
  • Thumbnail tacks
  • Scissors
  • Sellotape
  • Post-it flags - 2 each of blue, red, orange yellow
  • Stress balls