by June Kaminski, RN MSN PhD (c)
CJNI Editor in Chief
This feature is the newest entry of our column – Theory in Nursing Informatics written by our Editor in Chief, June Kaminski. Theory is an important aspect of nursing informatics – one that is often neglected due to time and context. In each column, a relevant theory will be presented and applied to various aspects of informatics in nursing practice, education, research and/or leadership.
Appreciative Inquiry (AI) is a capacity building approach that selectively seeks to locate, highlight, and illuminate the life-giving forces within an organization or community. AI seeks out the best of “what is” to help ignite the collective imagination of “what might be”. The aim is to generate new knowledge that expands the “realm of the possible” and helps people envision a collectively desired future and to carry forth that vision in ways which successfully translates images of possibility into reality, and belief into practice. AI is not a methodology. It is a philosophy, an orientation to change, and a way of seeing and being in the world!
The AI 4-D Theory entails four stages of change activity:
- DISCOVERS – what gives life to an organization; what is happening when the organization is at its best;
- DREAMS – about what might be; what the world is calling the organization to be;
- DESIGNS – ways to create the ideal as articulated by the whole organization; and,
- DELIVERS – through an on-going and iterative processes. This is not a static solution but rather a dynamic process of continuous change.
This theory, first introduced by David Cooperrider, supersedes the usual problem-solving approach to finding solutions to organizational problems. Instead, the theory directs organizations to identify their strengths, to cultivate what works, and together make decisions through brainstorming and capitalizing on the enthusiasm and energy of the organizational members. This is a generative process that leads to organizational transformation in whatever area it is applied, including technologically-related issues.
The principles of AI can be effectively applied by informatics leaders in a variety of situations. By raising the energy of stakeholders of an initiative, change agents and project managers reap the benefits of accessing the best in people.
Positive approaches often elicit positive attitudes, thinking, valuing, and participating. A central activity of AI is to involve EVERYONE affected by a decision. This is the essence of opitmal change management and helps the end users ‘own’ the decision and choices made. Taking the time to visualize the final outcome of a project together, where every person involved is given the opportunity to be heard and acknowledged (and appreciated) is a critical strategy that can make all the difference in end-user preparedness and buy-in.
The Positive Core of an organization is the central heart of AI – it includes the best of the organization: the successes, best practices, peak experiences, key learnings, social capital, innovations, loyalty, retention strategies, and so on. In the first stage of the AI cycle, the Discover stage, time is taken to focus on this positive core, to appreciate what is already done well in the organization. This includes what is done well and who the key players or champions are in the technology sphere of the organization. Tapping this positive core elevates the mood and creative thinking abilities of organizational members, and supports resilience and collaborative abilities within the group.
The five principles serve as theoretical foundations for the positive core and the four dimensions or 4-D stage cycle of AI. These five principles can be summarized as:
Although this process may seem very time-consuming, in reality it takes about the same amount of time as any other change and project management approach. The difference is that all involved feel connected and engaged, like they are a central part of the decision or choice. It is a method that has been proven again and again by many organizations to work to unify and inspire organizational members to pull together and create a better organization. Thus, the process not only catalyzes a solution to a perceived problem, e.g. choosing the right hospital information system, but it also energizes the people involved to embrace the initiative, and work to implement it in a seamless and collaborative manner. It can, in effect, remove the nightmare from technology implementation, and instead, create the best environment for organizational change.
Cooperrider, D. L., Whitney, D. (1999). Collaborating for Change: Appreciative Inquiry, Berrett-Koehler Communications, Inc., CA,
Cooperrider, D. L. & Godwin, L. N. (2010). Positive Organizational Development: Innovation-inspired change in an economy and ecology of strengths. Current Commentary on AI and Positive Change. Appreciative Inquiry Commons. Retrieved from http://appreciativeinquiry.case.edu/intro/comment.cfm
Appreciative Inquiry: A Conversation with David Cooperrider
What is Appreciative Inquiry? presented by Jackie Kelm