Sonja Armbruster, MA works for Wichita State University’s Center for Community Support and Research. She is a Quality Improvement Expert for the Public Health Foundation.
The definition of insanity—“doing the same thing over and over again and expecting different results”—is so common it is considered a cliché. But like most clichés, there is a nugget of truth. The questions are: why do we get stuck in our current processes and what does it take to get us out of the rut? Considering the past (how things came to be) and the present (how things are) can prepare a foundation for considering the preferred future.
Quality improvement (QI) efforts always include change. Part of the challenge is determining what needs to be changed. Often the changes that need to happen for real, measureable improvement are complicated. These complications include activities at the individual/subsystem level, the system level, and the supersystem or context level.
Nine Windows is an effective QI tool to use when an improvement team tries to develop creative solutions to a problem and the team has trouble getting out of their current state thinking, thus limiting the team’s ability to visualize other possibilities. Step-by-step instructions for using the Nine Windows, as well as a completed example, can be accessed by visiting the Nine Windows Tool webpage.