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The investigation team may need to generate ideas about the patient
safety incident, or a particular aspect of the incident, at some point
during their work. Where anonymity may be important for the group
generating ideas, or where complex issues are involved, Brainwriting
may be a helpful tool to use. This document discusses its nature and


What is Brainwriting?
Brainwriting is essentially the same as Brainstorming, but it allows the group
to generate ideas anonymously and in a short time-frame. These can then be
mapped onto a flip chart and considered by the group.

When to use Brainwriting?

Brainwriting is best used when:

• the anonymity of participants needs to be protected

• there is a mixture of senior and junior personnel in the group
• complex ideas are expected
• it is feared that some people might dominate the brainstorming if it were to
be conducted orally.

How to Brainwrite
1. Clearly define the topic and problem area to be explored or addressed.
2. Allow participants a few minutes to familiarise themselves with the topic
and problem areas.
3. Have participants write down their ideas on their brainwriting cards (see
Figure 1), one idea per card.
4. The facilitator collects each card and writes the contents on the flip-chart.
5. The duplicates are then removed and the ideas grouped where applicable.

Positive Attributes of Brainwriting

• allows people to provide their views anonymously and safely
• is useful for enabling junior or less confident persons to contribute
• is useful for exploring sensitive issues
• uses a quick and simple methodology
• will limit group think

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• is structured and time efficient.

Negative Attributes of Brainwriting

poor facilitation may threaten the anonymity of participants and thus the safety
aspects of this technique
• can be unnecessarily ‘secretive’ for staff groups with open and healthy
working relationships
• can generate an unmanageable list of ideas, or a list that is difficult to
prioritise (See Nominal Group Technique).

Brainwriting Card and Example


Topic: How to admit a mental health patient from A&E in an

emergency to a psychiatric bed, rather than a medical or surgical

1. Bed manager is to be made aware of the current condition,

diagnosis and possible future state of patient at the time of request
of a psychiatric bed.
Brainwriting - Figure 1

Please note that there is a template for Brainwriting available for you to
use in the Template section of the Resource Centre.


Adams, S. et al, Long Version of the CRU/ALARM Protocol: Successful

Systems Event Analysis (In print, 2002

Ammerman, M.,The Root Cause Analysis Handbook: A Simplified Approach

to Identifying, Correcting and Reporting Workplace Errors (Quality Resources,
New York, 1998)

Dineen, M., Six Steps to Root Cause Analysis 18 September Consequence

(Oxford, 2002, ISBN 0-9544328-0-0)

Joint Commission on Accreditation of Healthcare Organisations, Root cause

analysis in healthcare: Tools and techniques. (2000).

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Warren, I,. Events and Causal Factor Charting for Healthcare. Conference
(Presentation at The St Paul Conference on Root Cause Analysis, :London, 3
October 2001)

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