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Do you know the impact your decisions have?

Big decisions are regularly made in primary care, often without knowing the full impact they will have. A positive impact may be intended but there may also be unintended negative consequences away from the focus of the decision.

It’s important to identify the full impact to be sure a decision is a good one, or one that should be ditched, or needing action to mitigate negative impact.

A way to do this is to map out each potential impact, good and bad.


The INTENDED IMPACT, at the centre, is the focus of the decision.

Next consider who, or what, is immediately connected and what UNINTENDED DIRECT IMPACT the decision might have at these points.


As the impact of the initial action ripples out consider all consequences to identify each UNINTENDED INDIRECT IMPACT.

For each decide if its affect will be low, medium or high, and positive or negative. The latter needs to be managed.


Low impact is usually managed with little or no change in plan.


For Medium impact you may need to consider changes to mitigate the negative affect.


If High impact then consider whether to proceed with the decision, or what changes are needed to protect against the damage of the negative impacts.


It’s best to know the impact of the decisions you make.


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