Quality Improvement at MDH
|Print a Handout: Multivoting (PDF: 177KB / 2 pages)|
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|
|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.
|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|
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.
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.
- Gaining Consensus among Stakeholders through the Nominal Group Technique (PDF: 205KB / 2 pages)
Centers for Disease Control and Prevention
- Nominal Group Technique
American Society for Quality
- Public Health Memory Jogger
Public Health Foundation, GOAL/QPC