Negative Branch Reservation Template

Instructions for Using NBR

We all know that when we create new processes, procedures, policies, products (almost anything),
we expect positive results – or we wouldn’t have created the new item in the first place.

However, we realize that unintended consequences may also occur as a result. While some
consequences (both positive and negative) cannot be anticipated, with a little proactive thinking and
brainstorming of different scenarios, many of them can be… and if they can be anticipated, they can be
avoided, eliminated or at least mitigated.

Negative Branch Reservation (NBR) is an extremely effective scientific method of creating “what if”
scenarios in an effort to avoid creating unintended consequences due to implementing new actions
and policies.

Here’s how it works:

1. Create an “Action Tree.” This is the diagram illustrated above, which is created by drawing one
box at the top and then drawing a vertical line representing the “trunk” of the tree below it.
2. In the top box, write the new action being considered.
3. Along with your teams, begin brainstorming all of the possible negative consequences that
could occur as a result of implementing the action in the top box; these represent your
reservations about implementing the new task.
NOTE: There is no need to put the positive consequences into the diagram, because you don’t
want to eliminate those (although you may want to create a separate list of them for later
incorporation into presentations, marketing materials, and other areas where it would be
useful to outline the benefits of implementing that action).
4. One at a time, list the potential negative consequences by drawing a line coming off one side of
the tree trunk (representing a “branch” of the tree) for each one. Write one consequence per
branch; these are your Negative Branch Reservations.
5. For each Negative Branch Reservation, brainstorm ways to eliminate, mitigate, or recover from
it. Once you’ve found a way to do so, cross it out (trim that negative branch from the tree), and
write the solution in a box below that branch.
6. Continue identifying your Negative Branch Reservations, solving them (trimming more branches
from the tree) and writing the solutions in boxes drawn down the trunk of the tree.
 7. There is no limit to the number of branches you can create and trim, nor the number of
solutions you can provide to trim those branches.
8. This diagram creates a visual representation of all proactive and critical thinking on the topic, as
well as the positive and negative consequences and solutions to any issues that can be
anticipated.

Example 1:

What if you have booked your team on a flight… should you assume that all will go perfectly? Never!
So, you can brainstorm what could possibly go
wrong using Negative Branch Reservation:
Flights
booked

1. NBR: What if they are traveling to a

X
What if bad weather?

snowy or hurricane-threatened Find alternate flights ahead

of time; track weather
climate? What if they can’t get home if
Can’t reach the team; can’t
they stay on their original flights? X
get them out quickly enough.

Research hotels and transportation

SOLUTION: Find alternate flights ahead options ahead of time
of time and keep close track of the
weather. Have the airline website up
on your computer, so you can change quickly. Have all phone numbers handy to contact team,
if necessary.

2. NBR: What if you can’t reach the team, or can’t get them out quickly enough?

SOLUTION(S): Research hotels and transportation options ahead of time, so you can quickly
book rooms, cars, etc. on a moment’s notice. This is especially important if your team is
traveling internationally and doesn’t speak the language/doesn’t know the area.

3. NBR: (other scenarios)?

Example 2:

What if you wanted to create a new policy that will help everyone do their jobs better. You anticipate
many positive results, but here are a few
Negative Branch Reservations:
New policy

1. NBR: What if people don’t read it? You

X
People don’t read it

know how everyone is so busy Highlight critical parts

nowadays that they skim over (or skip
altogether) many documents they X
People don’t understand it
receive.
Use stories, examples, case studies
to show workplace application
SOLUTION: Provide details as backup,
but create one sheet on top (in LARGE
PRINT) that highlights critical points and is entitled: “EVEN IF YOU READ NOTHING ELSE, PLEASE
READ THIS!” This trims the negative branch from the tree.

2. NBR: What if they don’t understand it (or how to use/apply it)?

SOLUTION: Give an example, tell a story, offer a case study – use a method other than words
alone to explain the purpose and usage of the new policy.

3. NBR: (other scenarios)?

Example 3:

What if you wanted to create a new policy that will help give patients test results sooner. You
anticipate many positive results, but here are
a few Negative Branch Reservations:
Pt Reports on
CD, etc.

1. NBR: What if the results of the tests

X
What if bad results?

are bad? Can we delay giving results? Delay giving results for
X days
Yes but only for a certain amount of
Can’t reach doctor/they
time, according to HIPAA. X
request report right away

Have someone sit with them until

SOLUTION: Delay giving results that fall they are OK to drive/leave
into a certain category for X days, to
give the doctor time to call the patient.

2. NBR: What if we can’t reach the doctor in X days (or they request the report right away)?

SOLUTION(S): Have them read it while someone sits with them to comfort them, answer
questions (if possible), at least ensure they are OK before getting in a car and driving away.

ALSO, even if doctor has been reached – NEVER ASSUME that the doctor has called them!
Maybe we can always ask if they’ve been contacted by the doctor before handing them the
report and letting them leave. Then if something happened and the doctor never reached
them, we are still being careful when giving them the report.

3. NBR: (other scenarios)?