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  1. Gilmartin, Heather PhD, NP
  2. Lawrence, Emily MPH
  3. Leonard, Chelsea PhD
  4. McCreight, Marina MPH
  5. Kelley, Lynette RN, NP
  6. Lippmann, Brandi MA
  7. Coy, Andrew BS
  8. Burke, Robert E. MD, MS


Background: Many health care interventions encounter implementation challenges because of inadequate stakeholder engagement and identification of barriers. The brainwriting premortem technique is the silent sharing of written ideas about why an intervention failed. The method can engage stakeholders and identify barriers more efficiently than traditional brainstorming focus groups.


Purpose: We evaluated the method during a transition of care intervention in the Veterans Health Administration (VA). Clinicians from 10 VA facilities participated in 10 brainwriting premortem sessions.


Methods: Using descriptive and content analytic methods, we assessed the quantity and quality of ideas generated, facilitator experience, and participant psychological safety.


Results: In total, 217 unique ideas were generated. Many were deemed high quality. The written data were immediately available for analysis, allowing rapid feedback and real-time decision making. Participants reported high satisfaction and psychological safety.


Conclusion: The brainwriting premortem approach is a novel, efficient alternative to brainstorming focus groups that can rapidly inform program implementation at minimal cost.