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Learn About Quality

Impact Effort Matrix

Quality Glossary Definition: Impact effort matrix

Also called: effort matrix, impact matrix, 2x2 matrix

The impact effort matrix is an advanced tool for root cause analysis (RCA) that can help you take action once the root cause has been identified. Like force field analysis, a more basic RCA tool, the impact effort matrix was designed specifically for the purpose of deciding which of many suggested solutions to implement. It provides answers to the question of which solutions seem easiest to achieve with the most effects.

Impact Effort Matrix Procedure

Construct an impact effort matrix through the following steps:

  1. Retrieve suggested solutions from previous discussions.
  2. Construct an empty diagram with the effort required to implement the solution on the horizontal axis and the impact of the solution on the vertical axis, and divide it into four quadrants.
  3. Assess the effort and impact for each solution. Place the solutions in the diagram according to these assessments. Use a symbol, color, or label to identify each possible solution.
  4. Solutions falling into the upper left-hand quadrant will yield the best return on investments and should be considered first.


During admission to a long-term acute care hospital (LTACH), a patient destabilized and suffered cardiac arrest requiring emergency transportation to the hospital. An ambulance service was dispatched to transport the patient stat. The nursing staff photocopied portions of the chart for transport with the patient, and additional portions of the chart were faxed to the emergency toom after the patient had departed the LTACH.

Once at the emergency room, the patient was treated according to the presenting symptoms and history included in the photocopied chart pages. It was only when the faxed chart materials were received that a nurse recognized that the transported chart copies were for another LTACH patient on the same unit. This precipitated a change in treatment prior to giving the patient a medication to which they were highly allergic.

The event was investigated, and several proposed solutions surfaced:

  1. Create a policy for matching patient ID to chart ID at every point in transfer.
  2. Train every employee on patient identification policy.
  3. Bar code patient ID bands and charts and match before transport.
  4. Implant a radio frequency identification (RFID) tag under the skin of patients and attach to each medical chart for matching at each transfer point.

These four proposed solutions were assessed for effort and impact and then plotted with corresponding numbers (Figure 1), clearly showing that using bar codes on patient ID bands and charts would be the obvious first option.

Figure 1: Impact Effort Matrix Example
Impact Effort Matrix Example

Impact Effort Matrix Resources

You can also search articles, case studies, and publications for impact effort matrix resources.

Beyond the Basics (Quality Progress) This article throws the spotlight on the seven management and planning tools, to help innovate, communicate and plan, including the impact effort matrix.

Building a Consensus (Quality Progress) Certain well-known two-by-two matrices are used by quality professionals to facilitate decision making and prioritization—for example, the impact effort matrix. A new but similar tool, the consensus chart, can drive improvement activities identified during the development or operation of a quality system process.

Excerpted from Root Cause Analysis and Improvement in the Healthcare Sector: A Step-by-Step Guide, ASQ Quality Press.

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