Identifying stakeholders

It is important to identify the main stakeholders to help ensure that everyone's perspectives are considered and that potential sources of error in the system are identified. For example, a consultant in a cataract clinic might prescribe an eye drop dispenser to their post-operative patients with limited vision. However, a patient perspective may show that the dispenser can easily be misassembled without the patient realising, making it impossible to use.

Stakeholders can be identified by examining the types of people represented in each stakeholder group. This can be assisted by looking at organisational diagrams. For example, Human Resources diagrams of organisational hierarchy can help to identify groups and types of people involved in the system. However, these diagrams may not be complete and typically only show internal stakeholders.

It may also be useful to refer back to the brief system description from Outline goals, as this may refer to key groups of stakeholders. Alternatively, it may describe some of the main processes and by reference the stakeholders involved in these processes.

Once key stakeholders have been identified, it can be helpful to describe them using personas, as in the example below. Personas are fictitious people that represent the key stakeholders. They are often described using a brief summary of their key characteristics as well as a photo or image. This can help participants in the SSA to engage with the stakeholders and consider their needs throughout the SSA.

Personas of key stakeholders from a study on stopping smoking in a unit (Images posed by models)

 

Personas may be particularly useful when it is not possible for all stakeholders to attend the SSA meetings, or when a wide range of characteristics needs to be considered carefully. SSAs have taken place where NHS staff developed a range of personas. By developing a list of high-risk scenarios, the staff considered how, given their diverse characteristics, each persona would fare in each scenario.

Putting ‘Identifying stakeholders’ into practice

Space to record this information is provided in the SSA Assessment Form. To do this: Select the ‘Identify stakeholders’ page in the Assessment Form. Enter the main people who will be involved in or affected by the system in the boxes headed Internal stakeholders, External stakeholders and Patients and representatives. People can be described using names and/or job titles. (Optional) Include simple pictures or photos to represent the stakeholders. This can help them come to life, but it is not necessary.   Case Study The completed ‘Identify stakeholders’ page from the Section 136 case study is shown opposite. Further explanation of this stage in the case study can be found on the Section 136 page about Identifying stakeholders. Click to enlarge Click to download PDF for full case study

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Selecting stakeholders

For various reasons, not all stakeholders identified may actually take part in the SSA. When selecting the stakeholders who actually will be involved, it is worth taking some time to consider their different characteristics. This is important because stakeholders vary a great deal in terms of what they can contribute, their readiness for change and their power to make a difference. For example, a consultant may not only have a lot of influence to enable changes to a system, but also may be opposed to them. In this case it is particularly important to involve them in discussions about the SSA.

A stakeholder's influence may not be directly related to their seniority. Less senior members of staff often have an important role through peer-to-peer communication. For example, a junior nurse who is popular might well exert significant influence over other junior colleagues on their unit, and can thus play an important part in encouraging or discouraging the uptake of changes. Other stakeholders may already be in favour of the project or have little power to obstruct it.

All stakeholders potentially have a lot to contribute in terms of information on how the system operates and where the risks are located. Taking the time to consider how they can help in the different SSA activities is important.

Putting ‘Selecting stakeholders’ into practice

Space to record this information is provided in the SSA Assessment Form. To do this: Select the ‘Identify stakeholders’ page in the Assessment Form. Highlight the stakeholders who will be involved in the SSA in the boxes headed Internal stakeholders, External stakeholders and Patients and representatives. This may include stakeholders who will be present in SSA meetings as well as people who will be consulted in other ways. Case Study The completed ‘Identify stakeholders’ page from the Section 136 case study is shown opposite. Further explanation of this stage in the case study can be found on the Section 136 page about Selecting stakeholders. Click to enlarge Click to download PDF for full case study

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Involving stakeholders

Once the stakeholders have been identified and selected, it is important to involve them in the SSA. This is an ongoing activity which should take place throughout all the phases of the SSA, not just in a single activity. As such, it is described in more detail in the Engage stakeholders section in the Manage phase of the SSA.

In fact, some thought may already have been given to the people required to take part in the assessment, even before the current ‘Identify Stakeholders’ activity. These people might already be present in the room. However, it is common for the ‘Identify stakeholders’ activity to highlight additional stakeholders who should be involved, and it might be necessary to schedule additional meetings to engage with them separately, as individuals or in groups.

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