Table 4

Statements about the relative importance of different reasons to evaluate any trade-offs, pleasant surprises and/or unpleasant surprises, in descending order of average strength of agreement

% rating very or extremely important*Mean rating†
Potential high harm to patients (any serious harm such as death, or common significant harm such as recoverable injury)100*4.96*
High negative workload implications for the service doing the improvement (cannot accommodate without compromising other work)98*4.80*
High negative workload implications for other health or social care services (cannot accommodate without compromising other work)95*4.71*
High negative financial implications for healthcare services95*4.70*
Potential high benefits for the service doing the improvement (significant improvement in staff morale or high financial savings)95*4.63*
Potential moderate harm to patients95*4.58*
Potential high benefits to patients (major health improvements which are not related to the initial improvement goal)90*4.53*
Moderate negative workload implications for the service doing the improvement90*4.35*
High negative financial implications for services outside healthcare88*4.31*
Increasing staff engagement with the improvement activity86*4.46*
Reducing staff resistance to the improvement activity85*4.31*
Moderate negative workload implications for other health or social care services85*4.25*
Moderate negative financial implications for healthcare services85*4.28*
Potential high benefits for other health or social care services81*4.25*
Moderate negative financial implications for services outside healthcare783.90
Potential moderate benefits for the service doing the improvement754.05
Potential moderate benefits to patients704.01
Potential moderate benefits for other health or social care services613.73
Increasing staff ownership of data and measures784.25
  • No ‘low severity’ consequences reached consensus, so these are not shown in the table.

  • *Indicates consensus among panellists meaning that ≥80% of participants rated a statement as very important and extremely important.

  • †1=not at all important, 2=slightly important, 3=somewhat important, 4=very important, 5=extremely important.