OBJECTIVES:: It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes expertsʼ opinions with different points of view, is needed for better decision making. METHODS:: The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating expertsʼ opinions. An approach for collecting data from experts and a graphical display for summarizing the obtained information are also provided. RESULTS:: The methodology is implemented for improving a hospital appointment system. The top-ranked 2 major project categories for improvements were identified to be system- and accessibility-related causes (45%) and capacity-related causes (28%), respectively. For each of the major project category, subprojects were then ranked for selecting the improvement needs. CONCLUSION:: The methodology is useful in cases where an aggregate decision based on expertsʼ opinions is expected. Some suggestions for practical implementations are provided.