Practice Tip of the Week: Building on what works with Appreciative Inquiry
Tuesday, September 12, 2017
Posted by: Nadia Tamez-Robledo
By Ellen Martin, PhD, RN, CPHQ
Director of Practice
Texas Nurses Association
What is Appreciative Inquiry?
Appreciation: Recognition of the best in people and the world around us; a full understanding of past and present strengths, successes, assets, and potential.
Inquiry: To ask questions, to study, to search, explore, delve, or investigate with curiosity and an openness to change.
The Scope and Standards of Practice for Nursing Administration describes Appreciative Inquiry (AI) as a framework for nursing leadership. AI is the study of human systems when they function at their best by asking questions in a positive way to identify what is at the core of success. The principles of appreciative inquiry can be used with individuals or with groups in several ways including as a quality improvement method, a form of engagement, and in participatory action research. Nurses in any role can benefit from learning and implementing an appreciative inquiry approach.
Contrast AI with Traditional Problem Solving
The core principles of AI are rooted in positive psychology, providing an effective alternative to traditional problem-solving. The basic assumption of problem-solving methodologies is that people and organizations are “broken” and need to be fixed. The process usually involves: (1) identifying the key problems; (2) analyzing the root causes; (3) searching for possible solutions; and (4) developing an action plan. Deficit-based analysis, while powerful in diagnosis, can undermine motivation when it results in pointing fingers and assigning blame. This often leads to a conclusion that some group in the organization needs more education, which is not an effective long term improvement strategy.
In contrast, the underlying assumption of appreciative inquiry is strengths-based. Consider the external factors review conducted by nursing peer review committees and systems analysis in patient safety. High reliability organizations often have experts who are adept at using quality tools such as root cause analysis, process mapping, and Failure Modes Effects Analysis. Adding an AI approach can take this important work one level deeper by asking: When this process is functioning optimally, what does that look like? Who is involved? What conditions are present?
AI in Everyday Practice
Stories are at the heart of appreciative inquiry. The magic happens when appreciative questions are crafted in a way that elicits stories of peak experiences. For example, organizations often use exit interviews to determine why staff leave yet often get minimal information. Most employees leave organizations because they feel underappreciated but will rarely say so to avoid negativity and so they don’t “burn any bridges.” What if departing employees were asked “Tell me about a time when you felt fully appreciated for the work you do here?” or “Tell me about a time when you were most satisfied with your job?” What kind of information might you get then? And what if you didn’t wait and instead started doing “stay interviews” with current employees?
Many organizations around Texas will be reviewing their emergency plans and response. There are always lessons to be learned after a natural disaster and it’s important to identify opportunities for improvement. At the same time, leaders can also inquire about peak experiences around teamwork, communication and coordination, to name a few. Eliciting and sharing positive stories can help all staff learn and grow, building trust and capacity across the organization.
Resources for More Information
The Center for Appreciative Inquiry
Cooperrider, D., Whitney, D., & Stavros, J. (2008).The Appreciative Inquiry Handbook: For Leaders of Change, 2nd Ed.
Gardner, D. (January 31, 2005). "Ten Lessons in Collaboration". OJIN: The Online Journal of Issues in Nursing. Vol. 10 No.1, Manuscript 1. DOI: 10.3912/OJIN.Vol10No01Man01
Whitney, D., Trosten-Bloom, A, & Cooperrider, D. (2003).The Power of Appreciative Inquiry: A Practical Guide to Positive Change