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NHS Project Management Fresh Eye’s 

 April 6, 2022

By  Dave Litten

What is Fresh Eye’s?

We naturally view situations using our own personal perspectives and experience, but to get radical new ideas and ways of working, it is important to look at things from perspectives that are different from our own

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A ‘fresh pair of eyes’ brings a new perspective to a situation when you may feel that all the options being suggested are just variations on what happens already

The fresh eyes tool is based on these principles, and it helps to generate new ideas by getting you to view a situation from very different perspectives

When to use it

If you feel you have tried to make something work better but there has been little real improvement, you could try the fresh eyes approach


A different perspective or a fresh attitude will generate a range of ideas for solving long term problems over which you and your team may have been thwarted

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How to use it

  1. Define the problem or issue
  2. Randomly select alternative viewpoints and view the new problem from that new perspective

Ask the following questions:
What would be important to them here?
What aspect of the topic would they focus on?
What ideas and approaches might they have?

Viewpoints could include people from all walks of life: politicians, parents, comedians, children, retired people, teachers, etc.

Reflect on what has been generated and think about how these ideas could be adapted for use in your situation

If there is a particularly useful concept, you might want to carry out a brainstorming session focusing on that concept to explore it further

Five Why’s

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It can be helpful to ask ‘why?’ five times (see Root cause analysis using five whys)
Why do we have to come to this place?
Why do we need to see lots of different people?
Why do we have to have this done?
Why do we have to wait?
Why do we have to see this person again?

Example

John is once again waiting for 3–4 hours in the orthopedic follow-up clinic – he thinks he should have an x-ray, but no one has given him a form
Last time he waited to see the doctor, who then wrote the form for the x-ray, after which he had to queue again to see the doctor
John can now book his outpatient appointment, but no matter what is done, waiting times always seem to be the same

Look at this issue through the eyes of a child, who might ask:
Why do we have to come to this place?
Why do we have to have the test?
Why do we have to wait?
Why do we have to see the doctor again?

Fresh Eye’s Tips

The whole process may only take an hour of your time: 30–40 minutes to gather all the ideas and 20 minutes to decide what to do next

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You should aim to use at least four or five different perspectives and record the combined results so that you can review the ideas later.

If you are really struggling to see how a particular viewpoint would link to your issue after giving everyone a chance, just move on to a different perspective

It will help if you are able to give some examples of how different perspectives can be applied to common healthcare issues so that people can see how the tool works – these can be used as warm-up exercises. For example, ask the group to look at the issue of increasing the takeup of flu vaccinations and consider it from the perspective of a fast-food chain

How would a fast-food chain run a flu vaccination service?

The idea of a ‘drive through’ will come up and although people may laugh, this is now a common approach today!

The list of different fresh eye perspectives can be added to, changed, or modified – you could set the group a warm-up task of identifying a list of different job roles and then use these in the session.

Even if you can’t see an immediate connection, others probably will

Try not to censor the choice of perspectives, some will work better than others, but all are valid. When you have identified some of the challenges, you can also use the simple rules tool to help make the changes.

By looking at this issue through fresh eyes, we might ask ‘How would a supermarket manager reduce waiting at checkouts during peak times?’

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We might think of the following:

  • Encourage internet shopping with home delivery
  • Have flexible opening times
  • Open smaller stores close to where people work so that people can stop by on their way home from work
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This encourages us to make lateral connections we might not otherwise have made – in the healthcare context we could consider:

  • Do all follow-ups have to be face-to-face or could we telephone patients?
  • Can we run follow-up clinics at different times to reduce demand?
  • Can we form partnerships or agree on protocols with our local GP practices to assess the viability of patients being followed up elsewhere?
  • Can we plan the process so that it runs more smoothly?

What next?

  • Review all the ideas – try using Six Thinking Hats® as a refining tool
  • Run several small-scale tests to learn more and see what works in practice (PDSA)
  • Share the findings
  • Implement the best ideas
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Other useful tools and techniques that can help you:

  • Brainstorming
  • Simple rules
  • Thinking creatively to solve problems

Alternatives

There are two alternatives to the description of fresh eyes: Invite others to discuss your challenges from outside your usual contacts, e.g. invite a local factory manager and others to see how they would solve the problems, perhaps run a workshop with members of the local community.

  • Use the ‘fresh eyes’ of new members of staff – ask them: does anything strike as processes that can be improved?
  • What would you do differently?
  • What have you learned from other organizations that could help us here?

Dave Litten


David spent 25 years as a senior project manager for USA multinationals, and has deep experience in project management. He now develops a wide range of Project Management Masterclasses, under the Projex Academy brand name. In addition, David runs project management training seminars across the world, and is a prolific writer on the many topics of project management.

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