Too Many Great Ideas? Here’s How the ICE Framework Helps Us Decide What to Do First
April and May have long been a season of growth for my practice—but not just in patient starts. They’re also a time when we load up on continuing education.
This year, that tradition held strong. I attended the AAO Annual Session, spent time at a business and leadership conference in Las Vegas, and sent team members on learning expeditions—my office manager and I visited a standout practice in Utah, while two of our clinical staff members visited an innovative office in Florida.
Each of these trips gave us new insights, better systems, and fresh inspiration. But here’s the challenge: not every idea can be implemented at once. In fact, trying to do so would grind our momentum to a halt and overwhelm the very people we’re trying to empower.
That’s where the ICE framework comes in.
What Is ICE?
The ICE framework—developed by growth strategist Sean Ellis and introduced in his book Hacking Growth—stands for:
Impact: How much change will this idea create?
Confidence: How sure are we that it will work?
Ease: How easy is it to implement?
Each idea gets a score from 1 to 10 in each category. Multiply those numbers together, divide by 10, and you’ve got a quick, clear way to prioritize.
ICE Score = (Impact × Confidence × Ease) / 10
How We Use ICE in Our Practice
When our team returns from conferences or site visits, we hold structured debrief meetings where everyone shares their top takeaways. From there, we start listing potential improvements—from the big and bold to the subtle and scalable.
Then we apply the ICE system:
A minor workflow tweak that’s easy to execute with high confidence? That gets a high Ease and Confidence score—even if the impact is moderate, it’s often worth doing right away.
A bold new treatment protocol that could be game-changing but requires major retraining? We still evaluate it—but it may be scheduled for a longer-term rollout.
This method does two important things:
It removes emotion from decision-making. We all get excited after a great conference—but ICE gives us a system to slow down and think clearly.
It honors our team’s capacity. Instead of overwhelming everyone with ten changes at once, we work smarter—and everyone feels heard, included, and prepared.
Why It Works
It empowers collaborative decision-making.
It keeps innovation steady and sustainable.
It creates a culture of experimentation, not burnout.
In orthodontics—and in business—the right idea at the wrong time is still the wrong idea. ICE helps us time things just right.
Bottom Line
The best practices aren’t the ones with the most ideas—they’re the ones with the best systems for implementation.
This season, as your team comes back inspired, try using the ICE framework to move from insight to action with clarity, purpose, and sustainability.
If you’d like a template to run your own ICE scoring session or want to see how we apply it across different areas of the practice, just let me know—I’m happy to share.
