2. Inter-Relationship Digraph 1 Scott Davis, QI Coordinator Tacoma Pierce County Health Department August 2012

3. Objectives By end of session participants will… – Understand purpose of Inter-relationship diagraph – When to use – How to build – How to interpret 2

4. Inter-relationship Digraph When to use this tool? – Planning … need to determine priority among high-level goals – Problem solving … need to determine which variable to focus on – Quality Improvement … need to understand complex relationship of dynamic variables 3

5. Inter-Relationship Digraph Example: What determines a good meal? 4 Good taste Experience of Cook Quality of ingredients Good recipe High nutrition Key driver

6. Inter-relationship Digraph Interpretation – Many lines OUT may indicate a driver – Many lines IN may indicate something which is dependent upon other things – An even distribution could point to a mutually determined set of variables 5

7. Inter-Relationship Digraph Steps 1.List goals/issues 2.Consolidate/prioritize to 4-7 3.Organize on large paper or whiteboard 4.Have 2-3 people (without speaking) draw lines from those goals/issues which effect others toward which they affect 5.Discuss those with the most “out” arrows and whether they are in fact “Key Drivers” within the system/organization/network that you are working on 6

8. I-D Exercise 7 Profit Absenteeism Employee Morale Compensation Customer Service Poverty Homelessness Substance Abuse Mental Illness Crime Pick a list (A or B) of systemic factors and apply the Inter-relationship Diagraph. What drives what? A.B.

9. What next? Validate the assumed relationships with data, literature search, system modeling Focus on key drivers FIRST 8

10. References The Memory Jogger Plus: Featuring the Seven Management and Planning Tools, Michael Brassard, Goal/QPC, 1989 The Team Handbook, Peter Scholtes, Joiner Press, 1988 9