Quality Improvement at MDH

Multivoting

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Also Called: Nominal Group Technique

What is Multivoting?

Multivoting allows a team to quickly come to a consensus on the relative importance of issues, problems, or solutions by accounting for individual importance rankings in a team's final priorities. This technique:

  • Builds commitment to the team's choice through equal participation in the process
  • Allows every team member to rank issues without being pressured by others
  • Puts quiet team members on an equal footing with more dominant members
  • Makes a team's consensus (or lack of it) visible; the major causes of disagreement can be discussed

How to Conduct Multivoting

1. Start a List

Generate the list of issues, problems, or solutions to be prioritized. In a new team with members who are not accustomed to team participation, it may feel safer to do written, silent brainstorming, especially when dealing with sensitive topics.

2. Record Issues (Draft)

Write statements on a flipchart or board.

3. Clarify Issues

Eliminate duplicate and/or clarify meanings of any of the statements. As a leader, always ask for the team's permission and guidance when changing statements.

4. Record Issues

Record the final list of statements on a flipchart or board. Use letters rather than numbers to identify each statement, so that team members do not get confused by the ranking process that follows.

For example: Why doesn't the public health system effectively assist local health jurisdictions with epidemiologic investigations (as described in national performance standards)?

A. Few personnel available to assist
B. No process to detect assistance needs
C. Slow response to requests
D. Sites don't know what assistance is available

5. Rank Issues

Each team member records the corresponding letters on a piece of paper, and ranks the statements in order of importance.

This example allows users to "reverse" rank choices by giving the highest number of points (4) to the most important statement, and decreasing points to less important statements. This allows team members to leave a statement blank (value = 0) without increasing its importance—important, as individual rankings will later be added.

Team Member: Sonja
Rank Statements
4 points C. Slow response to requests
3 points A. Few personnel available to assist
2 points B. No process to detect assistance needs
1 point D. Sites don't know what assistance is available


6. Combine Rankings

Combine the rankings of all team members. The issue with the highest number of votes (in this case, "A. Few personnel available to assist") is likely a good place to start work.

  Sonja Pat Rashid Total
A. Few personnel available to assist 3 4 4 11
B. No process to detect assistance needs 2 1 2 5
C. Slow response to requests 4 3 3 10
D. Sites don't know what assistance is available 1 2 1 4


Multivoting Variations

One-Half Plus One

When dealing with a large number of choices, it may be necessary to limit the amount of items ranked. The "one half plus one" approach would rank only a portion of the total.

For example, if 20 ideas were generated, then team members would rank only the top 11 choices. If needed, this process could be repeated with the remaining 9 items, ranking the top 5 or 6 items, until a manageable number are identified.

Weighted Multivoting

Each team member rates, not ranks, the relative importance of choices by distributing a value (e.g. 100 points), across the options. Each team member can distribute this value among as many or as few choices as desired.

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