Step 3: When and Where? Prioritization and Preparation

Changes succeed when they’re manageable. This section helps you identify which practice changes to prioritize based on impact and effort, how to connect with team members, prepare for your first interaction, and establish a shared mental model.

*Corresponds to Quick Implementation Guide Sheet 4: Stp 3 – How (priorities)*


Changes succeed when they’re manageable. New policies and practices are most likely to be successful when they’re actionable, low to moderate burden, and aligned with stakeholder goals or priorities.

One way to identify how to prioritize changes is to evaluate them according to high/low impact and high/low effort, which helps you identify whether they are: quick wins, fill ins, thankless tasks, or major projects.

Quick Implementation Guide

Sheet 4: Stp 3 – When and Where (priorities)

  • How to prioritize changes/new policies/practices
    • May be completed by lead/co-lead of implementation team, or as a group
    • Impact may be assessed according to safety, stakeholder satisfaction, or other measure
    • Effort may be assessed according to effort by those implementing or doing the activity
  • Column B pre-populates from ‘Stp 1 – What (SBAR)’ (Sheet 3), column D (‘Recommendation/Likely Approach’ entered by user)
  • User assesses the draft recommendation/approach for impact (high/low) and effort (high/low):
    • A filled cell counts as a “yes” under columns C-F. Any letter/number works.
    • Leave empty cells that don’t apply.
    • Columns G-J calculate whether the recommendation/approach is a “quick win,” “fill in,” “thankless task,” or “major project” based on responses in columns C-F
  • Use the results to fill in the Prioritization Quadrant (pdf)


Acknowledging the constraints of COVID-19, in-person team interactions may be conducted by video-conferencing, conference calls, or email. Face-to-face options encourage better participation.

Beforehand, utilize this team preparation checklist table (doc), or jot down:

  • Background and expectations (may not be shared, but should be able to be communicated):
    • Goals and aims
    • Roles and responsibilities
    • Situational assessment
    • Expectations and norms
  • Confirmation of team members:
  • Identification of resources/infrastructure/needs
  • Request for relevant materials (members may have professional societies’ guidelines/statements (list of COVID-19 guidelines), research articles, or other items that inform their perspectives)

Shared Mental Model[i]

A shared mental model provides overall cohesion and common purpose among team members. It should establish that common purpose while being flexible and adaptive to new information and other points of view. TeamSTEPPS advises team members to:

  1. Scan the situation to gain and maintain an understanding of what’s going on (“individual situational awareness”)
  2. Discuss team members’ situational assessments, identifying commonalities and alternate interpretations (“team huddle”)
  3. Establish a “shared mental model”, wherein the team’s common goal emerges out of members’ situational assessments, and team members commit to the common goal