Quality Improvement Zone

A prioritisation matrix provides a structured way to consider factors such as impact, effort and helping teams make transparent and informed decisions about what to test first.

Prioritisation matrices work best in a collaborative environment where different perspectives can be considered. The discussion generated during the exercise is often as valuable as the completed matrix itself, helping teams to develop a shared understanding of their options and priorities.

Prioritisation matrices can take many forms, but one of the simplest and most commonly used is the 2 x 2 matrix. The axes can be adapted to suit the decision being made.

Improvement teams often generate many possible change ideas. A prioritisation matrix helps teams compare these ideas systematically and decide where to focus their testing and improvement efforts.

Using a prioritisation matrix can help you:

• make prioritisation more transparent and explicit
• encourage discussion and shared decision-making
• build consensus across a team
• identify which ideas may be most appropriate to test first
• make effective use of available time and resources
• support planning and sequencing of improvement work

A prioritisation matrix supports decision-making but should not replace professional judgement. Factors such as organisational priorities, stakeholder support, timing, available resources and local context may influence which ideas a team chooses to test.

A prioritisation matrix is primarily a facilitation tool to support discussion and decision-making. The goal is not to produce a perfect matrix, but to help the team agree where to focus its attention.

A prioritisation matrix template can be downloaded below. You can also start with flip chart paper and sticky notes, or an online whiteboard.

1. Agree on the criteria

Decide what factors are most important when comparing ideas. Common choices include impact, effort, feasibility, cost, risk or stakeholder support. Label the horizontal and vertical axes accordingly.

2. Gather improvement ideas

Write each improvement idea on a separate sticky note or virtual card. These ideas may come from previous improvement activities, analysis or discussions.

3. Place ideas on the matrix

As a team, discuss and place each idea on the matrix based on the agreed criteria. Focus on relative positioning rather than trying to achieve complete precision.

4. Review the overall picture

Once all ideas have been placed, step back and consider what the matrix is telling you. Look for clusters, surprises or areas where opinions differ. These discussions often generate valuable insights.

5. Explore the different quadrants

While the meaning of each quadrant will depend on the criteria chosen, a typical impact-versus-effort matrix may be interpreted as follows:

High impact, low effort: useful starting points that may offer quick learning opportunities.

High impact, high effort: potentially important changes that may require planning, resources or wider support.

Low impact, low effort: ideas that may be worth considering if resources allow.

Low impact, high effort: ideas that may not currently represent the best use of limited resources.

6. Decide what to test first

Use the matrix to support discussion about which ideas should be tested next. High-impact, low-effort ideas may provide good starting points, but high-impact ideas requiring greater effort may still be worthwhile depending on the context and goals of the project.

7. Revisit your priorities regularly

Improvement work generates learning. As the team learns more about the system and tests changes, priorities may shift. Revisit the matrix periodically and adjust decisions as needed.

• Involve a diverse group of people to bring different perspectives
• Focus on discussion rather than achieving perfect placement of ideas
• Try to assess ideas objectively rather than based on personal preference
• Avoid placing every idea in the highest-priority area of the matrix
• Remember that context matters. An idea's priority may change as circumstances change
• Review and update the matrix as learning emerges from testing