2. Learning Objectives
By the end of this session, participants will be able to:
• Write a clear and concise problem statement
3. Outline
• Define Problem Statement
• Purpose of Problem Statement
• When to Use Problem Statement
• Examples
• Group Work
4. Problem Statement Definition
• A clear and concise statement that describes the
symptoms of a problem to be addressed
• Describes the scope and impact of a problem
• Generally includes a brief description of the
problem as well as supporting data on:
Where the problem is occurring
Time frame
Size of the problem
5. Outline
• Define Problem Statement
• Purpose of Problem Statement
• When to Use Problem Statement
• Examples
• Group Work
6. Problem Statement Purpose
• Creates a sense of ownership for teams
• Serves as both an internal and
external communication tool for QI
teams
• Describes the “symptoms” in measurable
terms
• Drives the Root Cause Analysis (RCA) process
7. Problem Statement
Does NOT include the causes
Does NOT include the actions or
corrections required
Does NOT assign blame
Does NOT address more than one
problem
8. Outline
• Define Problem Statement
• Purpose of Problem Statement
• When to Use Problem Statement
• Examples
• Group Work
9. When to Use Problem Statement
• Due to the complexity in health care, it is
important for multidisciplinary teams to have a
consensus on the definition of a problem
• Can be very helpful for teams to define the
problem operationally for improved
communication with other stakeholders
• Agreement is crucial among stakeholders in all
parts of the QI process to ensure success of
initiatives
10. Outline
• Define Problem Statement
• Purpose of Problem Statement
• When to Use Problem Statement
• Examples
• Group Work
11. Examples
• Partner X does not meet their targets
• Wait times are too long
• There are many errors in our data
• Partner X’s reports are always late and
incomplete because there is a lot of
turnover in their staff
Does these include the key elements of a
strong problem statement?
12. Example 1: Long Wait for Test
Results
• “In the last 6 months, wait times for HIV test results
at the district hospital have risen to more than 4
hours on average. This is leading to crowded waiting
rooms and an increase in the number of clients who
leave without their HIV test results. As a result, the
program is missing opportunities to provide
effective prevention, care and treatment services.”
Does this include the key elements of a strong
problem statement?
13. Example 2: Low CTX Coverage
• “Over the past 2 years, only 50% of HIV-
exposed infants at the 22 health facilities
supported by implementing partner X were
prescribed CTX by the time they were 6-week-
old, leading to avoidable morbidity and
mortality.”
Does this include the key elements of a strong
problem statement?
14. Tanzania USG and MOH Team
Problem Statement
PEPFAR Tanzania IP Program Data report for the
past six months indicates low rates of HIV testing
services among PWID with 586 tested, 34 positive
identified and 23 linked to care by March 2016.
National population estimates of PWID stands at
30,000 with HIV prevalence of 35% (NACP; Consensus
estimates on key population in size and HIV prevalence in Tanzania, July
2014)
Where?
Magnitude?
15. South Africa CDC and MOH
Team Problem Statement
In South Africa, the rate of viral load (VL) tests done is
low. According to the NDOH HIV/AIDS/STI
Dashboard Indicators from the DHIS on February 24,
2016, only 54% of VLs are documented on TierNet.
Time Frame?
Where?
Magnitude?
16. Outline
• Define Problem Statement
• Purpose of Problem Statement
• When to Use a Problem Statement
• Examples
• Group Work
17. Group Work
• Each team will agree upon a focus area and draft
a problem statement using the information
obtained from the Rich Picture exercise
• Think about the definitions of quality to help
clarify focus on the quality problem statement
from the Rich Picture exercise
• By the end of the exercise, turn in the problem
statement to ICAP training team. Make sure
team name is on the problem statement
18. Discussion
• Why would having a clear problem statement
help while solving quality challenges with
different tools?
• Why would it be helpful to not have identified
causes and solutions at the problem statement
stage?
The boundaries of the problem- where the problem begins and where it ends.
Effective problem solving begins with a good problem statement
Einstein is quoted as having said that if he had one hour to save the world he would spend fifty-five minutes defining the problem and only five minutes finding the solution
The truth of the matter is that the more specific the statement, the better the chance the team has of solving the problem. An inadequate problem statement can lead the team down a dead-end path. When defining the problem statement try to avoid these four common pitfalls: The problem statement should not address more than one problem. The problem statement should not assign a cause. The problem statement should not assign blame. The problem statement should not offer a solution.
- Helps teams with problem selection as well.
Important to remove any confusion and ambiguity about the issue you face by describing with detail exactly what occurred.
Keeps your team focused precisely on your issue. It will also help your teams consistently stay focused on the agreed upon challenge and keep the dreaded "scope creep" at bay.
Help prevent blaming
Each team will present their problem statement for group appraisal.
