1. Team Title
Team Members

2. Problem or Opportunity
Brief description / definition of the outcome or situation you wish to change
What do you seek to disrupt?
Can also be framed as an opportunity -- something that is missing, or a preferable alternative
Example: Puppies are whining because they are hungry. Periodically there is no food because the owners forget to buy puppy chow
[Replace all blue text; Max 50 words]

3. Customer
Who has the problem, or who will benefit most from the proposed change?
Which stakeholder will be the primary recipient of the proposed benefit/value?
Example: The 3 yellow lab puppies, currently 11 weeks old, in the household of Drs Smith
[Max 50 words]

4. Solution How do you propose to change the outcome or situation?
What is the form of your proposed solution (e.g.: product, service, process or policy)?
Example: Set up an automated purchase of puppy chow for home delivery
[Max 50 words]

5. Value
Briefly, what is the benefit of making the proposed change? What is the magnitude of the proposed benefit? Why is this compelling?
Example: The puppies will no longer whine from hunger. Drs Smith can avoid making 1 – 2 extra trips per week to buy food. The Smith family will have more time to enjoy frolicking puppies.
[Max 75 words]

6. Is the Solution “better”?
Advantages
Is the Solution “better”?
Why will the proposed change be an improvement?
AKA “competitive advantage”
What data have you collected about this assertion?
[Max 75 words]

7. Stakeholder Summary Stakeholder Feature Benefit
e.g. Patient, faculty, residents, department, etc.
What is changing for this stakeholder? (leave blank if no direct change)
Why is this change better?
Puppies
Regular supply of puppy chow
Full bellies
Owner
Home delivery of puppy chow
Simplifies shopping, saves time
Family -
Less whining and more frolicking brings joy to interaction with puppies
[Max 10 words]
[Max 15 words]

8. Feasibility
What data have you collected regarding the feasibility of the proposed change?
What challenges or obstacles might you face?
How can they be addressed?
[Max 75 words]

9. Approach
How will the proposed change be made?
Who will need to be involved?
What are the steps required?
What is the timeline to completion?
Will future or recurring actions be required?
[Max 75 words]

10. Requirements (the “Ask”)
What resources will be required, such as:
Personnel?
Funds?
Facilities?
[Max 75 words]

11. Value Proposition Summary
Recap your value proposition statement
Example: Puppies are whining because they are hungry. We are out of food because we have been too busy to shop. We propose to set up an automated purchase and delivery of puppy chow. Thus the puppies will be fed without interruption, resulting in less whining and more frolicking, and joy for our household
[Max 75 words]

12. Alternatives
Describe or list the thing(s) the current status, process, policies, or behaviors
What is done now?
How is the Problem currently addressed?
[Max 50 words]

13. Other Validation
What data have you collected that supports the testable elements of the Value Proposition?
Customer
Problem
Solution
Value
[Max 100 words]

14. Criteria for Success
How will progress be measured?
Who will measure progress?
Define the threshold for a successful outcome?
What is the best case scenario?
What is the worst case scenario?
[Max 100 words]

15. Team Title
Team Members