What is it?

BRAN is a framework often used by professionals to quickly make decisions with patients. Within quality improvement, it can be extended to consider the outcomes of a choice or change. It poses these questions:

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  • What are the Benefits?

  • What are the Risks?

  • What are the Alternatives?

  • What if we do Nothing?

There are additional elements sometimes added making acronyms BRAIN(S) and BRAND(S) including :

  • (I) What is your Intuition telling you?

  • (D) What is the Decision?

  • (S) What does a Second opinion tell you?

It is often used in situations requiring a fast decision. It is a tool that patients are also encouraged to use with their care providers to better understand the potential outcomes of proposed treatments.

Why use it?

A BRAN analysis can be a quick, structured way to consider the possible outcomes of a choice or change. It helps to anticipate what could happen and quickly assess the opportunities, threats and challenges of a decision.

How to use it?

Within quality improvement work, BRAN can be used when considering a change idea and when planning changes. Working with team members where possible, work through the questions in relation to your change idea. It is important to work as a team as the benefits, risks, alternatives and impact of doing nothing are likely to be different for different staff groups.

e.g. Change idea: When a prescriber declines a prescription request, an email is sent to reception team member, Chris, to make contact with the patient.

Benefits:

  • Standardised process should make it easier to track when requests are declined

  • Practice is proactive, likely to decrease occasions when patients get frustrated that request has been declined

Risks:

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  • Process may fail if Chris on annual leave

  • Chris may feel overwhelmed with amount of work, contributing to burn out

Alternatives:

  • Train more than one team member in the process

  • Have a shared way of communicating between prescribers, administrative staff and patients

Nothing:

  • Continue with current rate of declined prescriptions

  • Continue with current rate of staff and patient frustration


Want to know more about BRAN analyses? Want help completing your own?

Contact the team