QUERI – Quality Enhancement Research Initiative

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Quality Improvement Methods

28. Nominal Group Technique

a. Definition: The Nominal Group Technique (NGT) is a way to assure all the capabilities of a group are fully utilized through collaboration for problem solving or brainstorming ideas. Many QI efforts require input from multiple individuals and it is important to get the contributions from each individual. Sometimes a few individuals dominate an in-person discussion and contributions from others are missed. Organizations have found NGT useful in the early stages of research to develop new ideas and directions and to enhance the capability of a group. It can be used by groups of any size to identify problems as well as to develop solutions.

With the NGT individual members of a group submit their input confidentially and individually in writing. The results are tabulated and a summary of the inputs, such as which idea was mentioned most frequently, is reported back to the group. The individual response and summarization cycle can be repeated so as to reach a consensus. An open group discussion can follow as well. The intent is to allow all individuals to provide their opinion equally and have it received and distributed.

NGT is similar to the Delphi Method which was developed for forecasting using experts participating anonymously over multiple rounds to develop a consensus.

b. Literature:

  • Allen, Jane, Jane Dyas, and Margaret Jones. "Building consensus in health care: a guide to using the nominal group technique." British Journal of Community Nursing 9.3 (2004): 110-114.
  • Gallagher, Morris, et al. "The nominal group technique: a research tool for general practice?" Family Practice 10.1 (1993): 76-81.
  • Van de Ven, Andrew H., and Andre L. Delbecq. "The effectiveness of nominal, Delphi, and interacting group decision making processes." Academy of Management Journal 17.4 (1974): 605-621.

c. Example: A panel of experts is assembled to decide on which way to solve a particular problem. They each have a different opinion as to what approach should receive the highest priority. While all of them are familiar with the problem being addressed some are more senior and experienced. The panel leader wanted to get everyone's ideas and was concerned that a few individuals would dominate any discussion. By using the NGT the ideas were promptly gathered by e mail and summarized. The results were tabulated and a summary distributed to the full panel. A second survey was done again once the members had received a summary of the first set of responses. After that was distributed, the panel met to begin an in-person discussion of the solution.

d. Steps:

1) Identify the group membership and the issue or topic to be addressed, such as the solution to a problem

2) Survey the members for their input to the issue and the priority they would give to each of their contributions

3) Summarize the responses in terms of frequency and priority but without indentifying individuals

4) Return the summary to the members

5) Repeat the survey, response and summarizing cycle as necessary or until no further changes occur and then open to panel to group discussion, if appropriate, for additional input

Specifics of the implementation of NGT vary depending on the intent and the resources available.