Alex Wakely says the Steelbacks will have to carefully assess the balance of their side ahead of Friday night's game at Birmingham Bears (start time 7pm).
Wakely's men were beaten by 31 runs by previously winless Derbyshire Falcons at the County Ground on Thursday night.
It was another hugely disappointing display that ensured the Steelbacks remain rooted to the bottom of the Vitality Blast North Group table, having lost all five of their matches so far.
And they now head to Edgbaston, the scene of their 2013 and 2016 T20 triumphs, as they bid to overcome their struggles.
Their bowling has been particularly poor and they have really missed pace ace Richard Gleeson, who is closing in on a first-team comeback following an elbow injury.
"He's a big miss for us," Wakely said. "Anyone who bowls 90mph is a big miss, especially on a ground like that (at the County Ground).
"He's had a long-term injury, he's played a few second team games and he's getting to the point where he's on the horizon for us.
"We're getting to the point now where we might have to make some changes.
"It's make or break for us now, we've got to start winning games and we're going to have to look at the balance of our side carefully."
Northants had brought Kyle Coetzer and Luke Procter into their team to face the Falcons, in place of Ricardo Vasconcelos and Graeme White.
But it was more of the same in performance terms from the Steelbacks as Derbyshire racked up 211 for two before dismissing their hosts for just 180.
"It's been the story of our season so far - we haven't managed to get anything going," Wakely said.
"We were talking about being well drilled, having plans in place, but we're in the same position where we just can't execute it.
"Going for 200 again - you're not going to win many games like that.
"We know it's a good surface, small boundaries, fast outfield and you're going to have entertaining cricket, which is what we've previously played at Northants.
"We want to entertain our fans but we can't quite string it together at the moment. I'm not quite sure why that is.
"The bowlers are doing as much practice as they can, we're talking about the game as much as possible, but T20 is a tough game.
"Calum (MacLeod, who hit 104) played a brilliant knock today, he hit the ball all around the ground and he took the game away from us."