Table 1

Overview of improvement identification method

StepActivity; toolsDescriptionMain purposeNo. Participants
1Identify themes; Affinity diagram, Interrelationship diagramResearchers, together with a group of practitioners, identified four themes. Broad problem areas were identified through a workshop to scope the issues of the sick leave insurance systemProbe the problem11
2Collect data; BrainstormingData were collected through a conference with practitioners who worked with the system daily. The data were in the form of 717 sticky notesGenerate data220
3Analyse data; JMP Pro®The gathered data from the conference, which were in form of sticky notes, were transcribed, analyzed, and grouped into 10 groups using latent semantic analysis and topic analysis in the Text Mining platform in JMP Pro® to conceptualize structural meta-themesConcentrate and distil data2
4Clarify improvement areas and root causes; Affinity diagramClarifying issues and root cause was done in a group consisting of practitioners that represented different hierarchical actors in the system plus the researchers. The groupings were discussed, elaborated, and titled with a why/what/how-label representing the deeper meaning of the clusterMake sense and find root causes of problems and data8 + 2
5Clarify interrelationships; Interrelationship diagramThe practitioner team identified the cause-and-effect relationships between the clustersDeepen understanding and interrelationships. Find potential cause-and-effect8 + 2
6Generate potential benefits; Brain-writing, BrainstormingThe practitioner team generated potential benefits tied to resolving each issueIncrease understanding of potential effects8 + 2
7Verify results; SurveyThe results were validated and confirmed by gathering feedback from the smaller practitioner team in the previous step, but also to the participants of the conference through a survey, presenting the results from Steps 1–5Verification8 + 220 (48)
8Grade benefits; SurveyIn a second part of the survey, the participants were asked to grade the most important benefits, generated in step 6, followed by a motivation concerning why it was importantSupport prioritization220 (48)
9Create improvement suggestions; SurveyThe last step aimed to identify what could be done to realize the benefits. This was done through an open question to conference participants in the surveyFind tacit ways for how to start to improve220 (48)

Note(s): The number of participants that responded to the survey was 48 out of a total of 220

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