Purpose of the tool 

This initial stage defines the clinical problem or evidence-practice gap, to ensure the project targets a meaningful issue and establishes a clear rational for change. The goal of this stage is to define the ‘why’ – clearly articulate the problem your project aims to solve. 

How to use the tool 

Work through the questions below, then create your own Problem Statement. When you have completed the questions, you can print or save the tool to guide discussion with your colleagues or mentor. 

Need more information? 

If you’re unsure where to start or want to learn about this TRIP stage, click below to go to the relevant Learning Hub page.

Learn about Identifying a Problem

1. What is the problem you are trying to solve?Describe the specific clinical or service issue in 2 sentences.

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State what is happening now (sentence 1) and why this is a problem (sentence 2).

2. Why does this problem exist?Base your response on data, observed practice, or stakeholder input. Clearly label assumptions where evidence is limited. Consider contributing factors such as processes, resources, behaviours, or policies.

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Identify the primary contributors to the problem (list only factors that plausibly contribute to the problem). Consider:

  • Evidence: What data or information suggests this is a problem?
  • People: Who is involved or influencing the situation?
  • Context: What internal (local or organisational) and external factors contribute?

Understanding why the problem exists helps you design targeted and effective strategies.

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Consider whether you need additional information or perspectives to fully understand the problem.

3. Who is affected by this problem?Identify who is impacted by the problem, and how significantly they are affected.

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Recognising all affected parties helps ensure your approach reflects diverse perspectives and promotes engagement in the change process.
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Engage key stakeholders early to capture a full picture of the issue.
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Use the TRIP Stakeholder Matrix to explore stakeholder influence and interest.

4. How significant is the impact?Consider the impact of the problem on the factors below. Rate significance based on available data or consistent stakeholder feedback.

0 – Unknown1 – Not significant3 – Moderate5 – Very significant
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By assessing the significance of the problem across key areas such as patient outcomes, cost, efficiency and safety, this helps prioritise issues that have the greatest effect on quality of care or resource use.
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Consider how you will measure the problem to confirm the problem is genuine and meaningful.

5. What are the consequences of inaction?What will happen if nothing changes?

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Is your understanding of the consequences based on your current knowledge of the problem, or drawn from engagement with those affected by the problem?

Understanding these consequences strengthens the case for change and motivates engagement.

Consider potential effects at different levels:

  • Individual – impact on patient, carer or staff wellbeing (e.g. staff stress, patient dissatisfaction)
  • Service or setting – operational or workflow implications (e.g. access, timeliness of care, inefficiencies, ongoing risk)
  • System – service delivery, funding or policy effects (e.g. waste, duplication, inequity, cost)
  • Society – broader public health or equity outcomes (e.g. poor population outcomes, increased costs)

Anticipating the cost of inaction can help generate urgency for improvement.

6. What data exists to confirm the problem?

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Use existing data – such as audit results, patient feedback, or incident reports – to validate and quantify the problem. Reliable data provides evidence to support the need for improvement and helps track progress over time.

Use existing data where possible before commissioning new data collection.

Output: Problem Statement

A problem statement is a concise summary of the identified health issue and its underlying causes. Drawing on relevant data, it presents a compelling case that engages stakeholders and lays the foundation for exploring solutions.

Example: Currently, median sternotomies affect acute care patients following cardiac surgery and results in potential sternal wound complications, pain, and reduced independence that impacts discharge to home. Existing practice of restrictive sternal precautions following cardiac surgery focuses on protecting the healing sternum through activity and movement limitations but does not effectively support functional independence or optimise discharge to home.

Developed from Gach et al. (2021). “Keep Your Move in the Tube” safely increases discharge home following cardiac surgery. Physical Medicine & Rehabilitation, 13, 1321–30. doi:10.1002/pmrj.12562

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A strong problem statement typically describes:

  • Current state – what is happening now.
  • Who is affected – who experiences the problem and the local impact.
  • Underlying causes – contributing factors or conditions.
  • Current approach – how the issue is currently managed or addressed.
  • Consequences of inaction – what will occur if the situation remains unchanged.
  • Practice gap – the difference between current practice and the desired state.