NHS Affinity diagram

What is it?

An affinity diagram can help you review and analyze ideas generated during brainstorming sessions.
Affinity diagrams involve grouping and analyzing ideas based on similarity or theme and their use encourages people to think inventively and make non-traditional connections of ideas.

The process promotes greater ownership of results, allowing breakthroughs to emerge naturally.
Techniques like affinity diagrams and brainstorming can help you to clarify an issue and think up new ideas so you can move on to the next steps.

Participants may be surprised that the sorting is done without speaking – this is done to prevent anyone from dominating and allows creative thinking to flourish.

When to use the Affinity Diagram

You can use affinity diagrams at any stage of an improvement project, particularly if you anticipate a large volume of ideas.

How to use the Affinity Diagram

Express the issue under discussion clearly in one sentence (top-level theme), framed as a question, for example, ‘Why are patients waiting so long for test results?’

People silently record their views on sticky notes and randomly stick these onto a flipchart or wall. As a minimum, use a noun and a verb, preferably in a four to seven-word statement.

Without discussion, the group sorts the sticky notes (single items) into 5–10 groupings (second and third-level themes). If someone disagrees with a grouping, the note can be moved, but without discussion.

Create a summary or header card for each grouping to encapsulate the main theme through a rapid team consensus. Avoid one-word headers.

Draw and record the finished diagram by connecting all the heading cards with their groupings.

Review the result with the team and other key people (stakeholders).

Affinity Diagram Tips

Aim to reach a consensus on the choice of words to express the issue. Neutral, positive or negative statements can all work well, in addition to solution-orientated questions.

A typical affinity diagram would have 40–60 items but could have 100–200 ideas depending on the complexity of the problem.

Large groups of sticky notes may need to be divided into subgroups.

You may find it helpful to move headers and groups into a logical sequence.

What next?

This will depend on why you are using an NHS Affinity Diagram, what you want to get out of it and how it went. Ensure that either you or members of your group follow up on the ideas and communicate any results to the rest of the team. If you are trying out a new idea, small tests of change (eg plan, do, study, act (PDSA) cycles) are a useful way of initiating action quickly.

If you are using the tool to identify the cause of delay in a patient journey or a safety issue, you may find it useful to capture the output in the form of a cause and effect (fishbone) diagram.

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