1. Introduction to Driver Diagrams Leanne Couves May 13, 2013 Improvement Associates Ltd.

2. Objectives In this session we will; – Learn the purpose of Driver Diagrams – Review several examples – Build a draft driver diagram for your project --- apply the method to connect the Aim in your Improvement Charter to the Changes you plan to test add new changes, using change concepts Identify possible measures 12/22/2015 BC Quality Academy 2

3. Driver Diagrams Shows theory for improvement – the logic Organize theories and ideas Focuses your team - the why’s, what’s and how’s and back again Connects multiple initiatives 12/22/2015 BC Quality Academy 3

4. Reduce weight Improve Health Move More Eat Less Take yoga class Ride bike to work Drink less grape juice HOW Outcome(s) Key Drivers Change Concepts Specific Ideas to Test Join gym HOW WHY 12/22/2015 BC Quality Academy 4

5. Improve access to appointments Reduce waiting time during clinic visits Shape the demand Match supply to demand Outcomes Key drivers Change concepts Shape demand for appointments Redesign care processes Decrease demand for appointments Reduce scheduling complexity Balance supply and demand Source: The Improvement Guide 2 nd Edition - page 430 12/22/2015 BC Quality Academy 5

6. Example – Karl 12/22/2015 BC Quality Academy 6

7. Categories Vary Objectives  Change concepts  Specific ideas to test Outcomes  Key drivers  Change concepts Primary outcome  Primary sources of poor performance  Primary Changes General description  Improvement objectives  Potential PDSA cycles 12/22/2015 BC Quality Academy 7

8. Build Driver Diagram for Your Project 1.Draft a Driver Diagram – Bottom up…Affinity Diagram “on it’s side” using Post-it’s – Top Down….Strategic Priorities/Objectives 12/22/2015 BC Quality Academy 8

9. Your Project HOW Outcomes – Your AIM from Charter Key Drivers Change Concepts Specific Ideas to Test / PDSA’s HOW WHY 12/22/2015 BC Quality Academy 9

10. Build Driver Diagram for Your Project 1.Draft a Driver Diagram – Bottom up…Affinity Diagram “on it’s side” using Post-it’s – Top Down….Strategic Priorities/Objectives 2.Add Change Concepts to generate additional changes to test – P. 357 Improvement Guide 12/22/2015 BC Quality Academy 10

11. Appendix A – 72 Change Concepts Examples: 1. Eliminate things not used 12. Synchronize steps 19. Do Tasks in Parallel 49. Extend time of specialists 62. Use affordances 72. Manage uncertainty 22-Dec-1511 BC Quality Academy

12. Build Driver Diagram for Your Project 1.Draft a Driver Diagram – Bottom up…Affinity Diagram “on it’s side” using Post- it’s – Top Down….Strategic Priorities/Objectives 2.Add Change Concepts to generate additional changes to test – P. 357 Improvement Guide 3.Add measures 12/22/2015 BC Quality Academy 12

13. Your Project 12/22/2015 BC Quality Academy 13 HOW Outcomes – Your AIM from Charter Key Drivers Change Concepts Specific Ideas to Test / PDSA’s HOW WHY Specific Ideas to Test Measure ?

14. Reduce weight Improve Health Move More Eat Less Take yoga class Ride bike to work HOW Outcomes Drivers Change Concepts Specific Ideas to Test Join gym HOW WHY Measure ? 12/22/2015 BC Quality Academy 14

15. Report Out What did you learn? When / how would you use a driver diagram in your project? Any surprises? 12/22/2015 BC Quality Academy 15