Brainwriting Premortem: A Novel Focus Group Method to Engage Stakeholders and Identify Preimplementation Barriers

Area of Science:

• Health Services Research
• Implementation Science
• Quality Improvement

Background:

• Healthcare interventions often face implementation challenges due to poor stakeholder engagement and barrier identification.
• The brainwriting premortem technique involves silent, written idea sharing on potential intervention failures.
• This method offers a more efficient way to engage stakeholders and identify barriers compared to traditional brainstorming or focus groups.

Purpose of the Study:

• To evaluate the brainwriting premortem technique during a transition of care intervention within the Veterans Health Administration (VA).
• To assess the method's effectiveness in engaging clinicians and identifying potential implementation barriers.

Main Methods:

• Conducted 10 brainwriting premortem sessions with clinicians from 10 VA facilities.
• Employed descriptive and content analytic methods to analyze generated ideas.
• Assessed facilitator experience and participant psychological safety.

Main Results:

• Generated 217 unique ideas, many of which were high quality.
• Written data facilitated immediate analysis, enabling rapid feedback and real-time decision-making.
• Participants reported high levels of satisfaction and psychological safety.

Conclusions:

• The brainwriting premortem approach is a novel and efficient alternative to traditional brainstorming focus groups.
• This method can rapidly inform program implementation strategies.
• The technique offers a cost-effective solution for identifying and addressing implementation barriers.