How To Achieve Financial Sustainability Without Sacrificing Impact
Explore practical approaches to achieve lasting financial sustainability for your social innovation
TABLE OF CONTENTS
How To Eliminate Chaos With Backlog Prioritization
Eliminate chaos and streamline workflows with effective backlog prioritization.
This is part of a series on problem solving for innovations that scale
1. Goals and Metrics
Tech-Enabled Services Versus SaaS Business Model: Key Metrics
How To Achieve Financial Sustainability Without Sacrificing Impact
2. Problems
Strategic Prioritization: Why Your First Move Might Be Your Biggest Mistake
How To Get Results With Business Process Optimization
How to Find Your Ideal Client
3. Solutions
How To Eliminate Chaos With Backlog Prioritization
How to Prevent Scope Creep in Your Innovation Strategy
Strategic Decision Making Framework: Don’t Miss This Essential Tool
Process Improvement for 20 Extra Hours a Week
4. Team & Execution
How to Build Accountability in a Team: Your Essential Guide
Successful Innovation Strategy Requires Internal Alignment
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The Promise of Strategic Backlog Prioritization
Imagine yourself as the executive director of a community-based healthcare organization. For years, your team has delivered essential services—from chronic disease management to maternal health education—even as patient demand continues to surge.
After a deep-dive analysis using strategic prioritization, you’ve identified that an inefficient patient scheduling system is the single largest barrier to expanding your services.
To address this challenge, you'll need a system for backlog prioritization.
With a clear goal—to increase patient capacity by 40% within the next two years while maintaining high-quality care—you now face the challenge of transforming your scheduling process.
The question is: how do you develop and prioritize solutions that are both impactful and practical?
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Laying the Groundwork for Backlog Prioritization
Before delving into solution development, it’s essential to build on a strong foundation and apply backlog prioritization principles.
As we’ve seen in the prior post on strategic prioritization, we’ve set a specific, measurable goal and conducted a comprehensive problem audit.
Data from multiple sources and extensive stakeholder input confirm that your current scheduling process—with manual workflows, double-bookings, and unfilled appointment slots—is critically undermining your capacity.
With this clear challenge defined, your focus sharpens: resolving your scheduling issues is a prerequisite for scalable growth, and effective backlog prioritization is the key to identifying your best steps forward.
1) Brainstorming Solutions for Backlog Prioritization
With the scheduling problem pinpointed, it’s time to generate potential solutions and utilize backlog prioritization to assess them.
These solutions might include the following categories:
- Automating repetitive tasks using technology, leveraging key tools for digital transformation.
- Restructuring workflows by strategically modifying steps (eliminating, reordering, adding, or refining), grouping tasks (e.g., reworking, batching, combining, or clustering), or redefining process boundaries or steps (e.g., narrowing the scope)
- Delegating tasks or processes to staff or external providers whose strengths align better with the required outcomes.
- Providing targeted training to close skill gaps and improve effectiveness.
- Optimizing resource allocation to ensure time, budget, and personnel are used cost-effectively to solve the problem.
For more ideas to rework processes, check out the below:
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Example
Drawing from ideas in brainstorming sessions and industry best practices, you surface three promising solutions for prioritization:
- Cloud-Based Scheduling Platform: Research shows that many leading healthcare organizations have adopted cloud-based systems offering real-time updates, automated reminders, and seamless integration with existing electronic health records. This approach promises to automate scheduling, reduce manual errors, and optimize appointment slots.
- Staff Training & Process Standardization: By refining current processes and training staff to use existing systems more effectively, you can quickly enhance scheduling efficiency without needing to vet or adopt new technology. This approach leverages in-house expertise and has a rapid time-to-impact.
- Lean Pilot for Scheduling Redesign: Testing targeted improvements through a lean pilot allows for quick iteration. By focusing on specific bottlenecks and measuring outcomes on a small scale, you can refine solutions before scaling up organization-wide.
These ideas form the basis of your strategic brainstorming, and each will be evaluated using clear criteria in the next section, focusing on backlog prioritization.
2) Primary Criteria for Backlog Prioritization
To evaluate these solutions systematically, we use three primary criteria with the consistent running example—the Cloud-Based Scheduling Platform—compared against the other two solutions.
I recommend three primary criteria to prioritize your backlog of solutions (effectiveness, viability, and evidence quality, each of which will be reviewed in more detail below). After identifying your solution “finalists” using these primary criteria, you can use secondary criteria to distinguish between your top finalists for investment.
The three primary criteria are:
- Effectiveness and depth of impact:Â Consider the predicted impact based on similar problems, relation to root causes, and buy-in or perception of those affected.
- Viability:Â Evaluate the simplicity, cost, and speed to impact of each solution.
- Evidence quality:Â Assess the reliability and strength of the data supporting your scores for the above criteria.
Effectiveness/Depth of Impact to Prioritize Your Backlog
This criterion measures how significantly a solution will make an impact on your goal we discussed in the prior post, which is improving patient capacity by 40%.
More effective solutions are likely to have a high predicted impact, based on similar successful cases or situations, a strong connection to root causes, and approval from or alignment with those who will be affected.
How to Estimate Predicted Reductions or Increases: These figures typically come from a combination of sources, including:
- Industry Benchmarks:Â Researching performance improvements achieved by similar organizations that implemented similar solutions.
- Internal Data:Â Analyzing historical scheduling data to identify patterns, inefficiencies, and potential areas for improvement.
- Expert Opinions:Â Consulting with scheduling experts or IT professionals who have experience with similar systems or process improvements.
It is helpful to brainstorm which root causes the below would address to then address potential bottlenecks. Backlog prioritization requires understanding these connections. The root causes identified for your scheduling issues are:
- Difficulty coordinating schedules between patients and staff.
- Lack of clear communication or reminders about the session.
- Limited availability of demo slots or intake sessions.
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Example
Solution | Estimated Increase in Goal (Patient Capacity) | Effectiveness Score (1-4) | Workflow Improvement and Root Causes Addressed |
Cloud-Based Scheduling Platform | 20% increase | 4 | Automates processes; minimizes manual tasks |
Staff Training & Process Standardization | 10% increase | 3 | Enhances and streamlines existing processes |
Lean Pilot for Scheduling Redesign | 15% increase | 4 | Targets key inefficiencies directly |
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The Cloud-Based Scheduling Platform and Lean Pilot for Scheduling Redesign are projected to have the highest impact on improving effectiveness.
The cloud platform largely relies on automation to minimize error, while the lean pilot relies on a data-driven methodology to address a wide range of bottlenecks. This is a key consideration for backlog prioritization.
Viability to Prioritize Your Backlog
Viability evaluates how quickly and easily a solution can be implemented with minimal disruption, considering ease of integration, staff training requirements, and time to achieve benefits.
Even the best idea must be executable. A solution that is simple and quick to create impact on your goal is crucial, especially when resources are limited.
Notably, Staff Training & Process Standardization scores higher here as it leverages current systems and avoids the complications of new technology adoption.
Example
Solution | Ease of Implementation | Required Training Level | Time to Impact | Viability Score (1-4) |
Cloud-Based Scheduling Platform | Moderate – Requires vetting, integration, and testing | Moderate – Involves learning a new system | Approximately 3 months | 3 |
Staff Training & Process Standardization | High – Leverages current systems with immediate deployment | Minimal – Focuses on refining existing workflows | Approximately 1 month | 4 |
Lean Pilot for Scheduling Redesign | Moderate – Requires careful pilot planning and resource allocation | Moderate – Involves iterative adjustments to workflows | Approximately 2 months | 3 |
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Staff Training & Process Standardization has the highest viability because it leverages existing processes, knowledge, and expertise that are already familiar to your team.
The Lean Pilot offers a moderately viable option, but carries the risk of requiring more internal labor to conduct iterations.
The Cloud-Based Scheduling Platform has the least viability, requiring integration and testing that will take more time, personnel, and potentially external resources.
Brainstorm alternatives to get viability as low as possible for quick impact:
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Evidence Quality to Prioritize Your Backlog
Evidence Quality assesses the robustness of the data supporting a solution, including case studies, pilot test outcomes, and stakeholder feedback. Backlog prioritization benefits from strong evidence, increasing the likelihood effective execution.
Reliable evidence minimizes risk and increases confidence in the solution’s benefits. Strong evidence confirms that improvements are based on proven outcomes rather than mere assumptions.
My primer on how to use evidence quality effectively below:
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Example
Solution | Case Studies Availability | Pilot Test Success | Stakeholder Feedback | Evidence Quality Score (1-4) |
Cloud-Based Scheduling Platform | Numerous case studies in similar organizations | High success rates reported | Overwhelmingly positive | 4 |
Staff Training & Process Standardization | Several documented examples | Moderate improvements observed | Generally positive | 3 |
Lean Pilot for Scheduling Redesign | Emerging data from recent pilots | High success in limited scope | Positive feedback from test groups | 3 |
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All three solutions enjoy a strong level of evidence quality.
The Cloud-Based Solution has an edge, as there are numerous available case studies in similar organizations. The Staff Training solution will similarly enjoy a strong baseline of data, while the pilot test success data is still emerging.Â
Backlog prioritization is strengthened by this diverse evidence base.
Holistic Comparison and Recommendation
By consolidating the primary criteria scores, we compare the three solutions holistically to inform backlog prioritization:
Solution | Effectiveness (1-4) | Viability (1-4) | Evidence Quality (1-4) | Overall Average Score |
Cloud-Based Scheduling Platform | 4 | 3 | 4 | 3.67 |
Staff Training & Process Standardization | 3 | 4 | 3 | 3.33 |
Lean Pilot for Scheduling Redesign | 4 | 3 | 3 | 3.33 |
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The Cloud-Based Scheduling Platform scores highest overall in effectiveness and evidence quality, making it a strong candidate despite its moderate viability. While Staff Training offers the best viability with rapid implementation and minimal disruption, its lower effectiveness and evidence scores suggest it might not fully resolve the scheduling challenges.
Based solely on primary criteria, the Cloud-Based Scheduling Platform appears to be the frontrunner, delivering significant improvements with robust supporting data.
3) Secondary Criteria for Backlog Prioritization
To refine the decision further, consider these additional dimensions for your top ranked solutions.
Not all of these have to be used. You are free to stop your analysis at your top three criteria, but the below can help distinguish between similar solutions in your backlog.
Breadth of Impact to Prioritize Your Backlog
This filter evaluates the solution’s ability to be applied beyond the immediate scheduling challenge, benefiting other departments or service lines.
This is useful because a single solution that addresses multiple needs can provide greater overall value and return on investment for the organization, enabling you to tackle new opportunities in the future.
Example
Solution | Breadth of Impact / Transferability | Score (1-4) |
Cloud-Based Scheduling Platform | High – Applicable across departments and adaptable to various service lines | 4 |
Staff Training & Process Standardization | Moderate – Benefits primarily the scheduling team; limited transferability | 3 |
Lean Pilot for Scheduling Redesign | Moderate – Focused on current scheduling issues; limited broader application | 3 |
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The Cloud-Based Scheduling Platform’s effectiveness can apply to various service lines beyond just scheduling. Staff Training has less transferability since it focuses primarily on scheduling alone.
Scalability to Prioritize Your Backlog
Scalability assesses whether the solution can grow with the organization, managing increased volumes or multiple locations with minimal incremental costs.
This is crucial because a solution that works well initially but fails to scale will ultimately hinder long-term growth and require costly future replacements.
Example
Solution | Scalability | Score (1-4) |
Cloud-Based Scheduling Platform | High – Easily scalable across multiple locations with minimal additional cost | 4 |
Staff Training & Process Standardization | Moderate – Scalable but may require ongoing training as the organization expands | 3 |
Lean Pilot for Scheduling Redesign | Moderate – Scalable after validation, but may need iterative adjustments as volume increases | 3 |
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Similar to the previous point, the Cloud-Based Scheduling platform is highly scalable for multiple locations at minimal extra cost, while the other two options require more effort to scale with potential adjustments and personnel.
Unique Advantages and Expertise
This filter considers any unique organizational advantages or expertise that could make one solution contribute to your organization’s distinctiveness, especially for customer-facing solutions.
Focusing on unique advantages helps ensure chosen solutions integrate with existing strengths, increasing their likelihood of success and long-term sustainability.
Example
Solution | Unique Advantages/Expertise | Score (1-4) |
Cloud-Based Scheduling Platform | Moderate – Leverages modern technology; may require external expertise | 3 |
Staff Training & Process Standardization | High – Leverages in-house expertise and deep operational knowledge | 4 |
Lean Pilot for Scheduling Redesign | Moderate – Offers targeted improvements but relies on standard process adjustments | 3 |
Leveraging a Cloud-Based Scheduling Platform would require more external resources, while Staff Training leverages the expertise and existing processes of your team. With a Lean Pilot, the team might lean on processes that are unique to the existing team.
Example: Holistic Comparison for Backlog Prioritization
Now we combine both primary and secondary criteria into one final holistic table. For simplicity, we average the scores from the primary criteria (Effectiveness, Viability, Evidence Quality) and the secondary filters (Breadth of Impact, Scalability, Unique Advantages) to obtain an overall recommendation.
Solution | Primary Average (Effectiveness, Viability, Evidence Quality) | Secondary Average (Breadth, Scalability, Unique Advantages) | Overall Average Score |
Cloud-Based Scheduling Platform | 3.67 | (4 + 4 + 3) / 3 = 3.67 | (3.67 + 3.67) / 2 = 3.67 |
Staff Training & Process Standardization | 3.33 | (3 + 3 + 4) / 3 = 3.33 | (3.33 + 3.33) / 2 = 3.33 |
Lean Pilot for Scheduling Redesign | 3.33 | (3 + 3 + 3) / 3 = 3 | (3.33 + 3) / 2 = 3.17 |
The Cloud-Based Scheduling Platform consistently outperforms the alternatives with the highest overall average score (3.67).
It excels in effectiveness, has strong evidence backing, and offers high transferability and scalability. Although Staff Training & Process Standardization is highly viable and leverages unique in-house strengths, its overall impact remains slightly lower.
Based on both primary and secondary filters, the Cloud-Based Scheduling Platform is the recommended solution. Its superior effectiveness, robust supporting data, broad impact across departments, and scalability make it the best option for addressing your scheduling challenges and meeting your goal of increasing patient capacity by 40% within the next two years.
Experimentation is Key to Effective Backlog Prioritization
However, before fully committing to a Cloud-Based Scheduling Platform, try a pilot program.
In keeping with the principles of strategic decision-making, build evidence quality incrementally for unproven solutions, particularly those that demand significant resources or carry other risks. The quality of evidence should be proportionate to the level of cost or risk involved.
A pilot allows you to gather empirical data on its effectiveness, viability, and potential impact, ensuring that your investment is well-informed and strategically aligned with your organization's goals.
For more on these concepts, refer to:
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By prioritizing backlogs, tackling key bottlenecks, and driving incremental improvements, we can boost impact, fuel growth, and better serve the community.
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