The PMI (Plus/Minus/Interesting) tool is a useful way of weighing up the pros and cons of each option for solving a problem. It also helps to consider what is interesting about the options that may not have been thought of before.

Plus: assign a score of 1 to 5 (mildly favourable to strongly favourable)
Minus: assign a score of -1 to -5 (mildly unfavourable to strongly unfavourable)
Interesting: assign a score of 1 to 5 (mildly interesting to strongly interesting)

Consider the following example:

A community pharmacy has high dispensing volumes, but has limited floor space for expansion to enhance workflow efficiency. What can the team do?

Option 1: Install a dispensing robot

Positives (total +9)

Reduced dispensing errors and enhanced patient safety (+5)
Makes good use of limited floor space (+4)

Minuses (total -7)

Investment cost (-3)
Upheaval to the workflow during implementation (-4)

Interesting (total +5)

Able to reduce inventory stockholding by 25 per cent (+5)

Total score for Option 1:

9 (Plus) €“ 7 (Minus) + 5 (Interesting) = 7

This process is repeated for each option and the option with the highest score selected so they can be compared.

It is good practice to document any agreed option(s). This focuses the mind on the
solution and ensures that everyone remembers what has been agreed.