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2/16/ :01 PM Driver Diagrams
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What is a Driver Diagram?
A type of logic model that describes the relationships between an aim for improvement and change ideas identified to make improvements. Most driver diagrams include: an Aim Primary Drivers: Factors believed to have a direct impact on the Aim Secondary Drivers: Actions hypothesized to impact the primary drivers Change Ideas: Actions that are more granular than secondary drivers, required if the secondary drivers are still too conceptual
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Why use a driver diagram?
Helps an improvement team generate Change Ideas that reflect a “cause and effect” relationship with the Aim; A simple visual display that helps to communicate the purpose for a project, the potential factors that could impact the aim, the set of possible change ideas to impact the aim, with an indication of which change ideas will be in scope for a particular project. While it isn’t always possible, it is ideal to include change ideas demonstrated through evidence to have an impact on the aim. Will form the foundation for process and outcome measures. Will assist staff in understanding how their improvement work contributes to/impacts the aim.
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Let’s take a closer look…
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Let’s look at a couple of concrete examples…
PRIMARY DRIVERS SECONDARY DRIVERS AIM & BIG DOT MEASURE CHANGE IDEAS & PROCESS MEASURES % of Managers Who Complete Quarterly Visits Quarterly Contact/Visit by Manager/Supervisor Access to Manage-ment Standardization of Practice Increase number of clients who are satisfied with the timeliness of a response to their concerns by 17% Open Door Session (1-4 pm) 1st Monday of Each Month # of clients that attend Scheduled Access % of Clients With Magnet on Their Fridge Fridge Magnet with Contact Information % Clients Who Respond They Are Satisfied or Very Satisfied with the Timeliness of Response to a Concern Health Literacy Review & Modify all formal information (brochures, magnets etc.) Given to Clients Re-design Client Information % of Material That Has Been Reviewed Include Visual Map of Contact Process Focus on the blue squares and note that as one moves from Left to Right - from primary drivers, to secondary drivers, and then to change ideas - the content in the squares is moving from a conceptual to a more granular & tactical level. Adapted from St Joseph’s Home Care, Hamilton
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Focus on the green, purple & peach squares and note that as one moves from Left to Right - from primary drivers, to secondary drivers, and then to change ideas - the content in the squares is moving from a conceptual to a more granular & tactical level. One more example…. Adapted from Acclaim Health
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The squares under columns 1, 2 & 3 represent primary drivers, secondary drivers & change ideas. Looking at the content in the 3 columns, which column would you identify as Primary Drivers (ie the most conceptual)? 1 2 3 AIM Streamline Pre-Screen Form By Dec 31, 2015, we will: Improve client experience with admission to Adult Day Services by 15% Reduce client wait times from Assessment to Service Initiation Identify Critical Information Needs Eliminate Duplicate Information Refresh Guidelines for Pre-Screen Process Eliminate Steps & Move Downstream Activities Up Book Assessments at Intake Regardless of RAI-HC Completion Status Decrease Number of Process Steps Streamline Client Forms Book Client Start Date for Service at Time of Assessment Would it be: Column 1? Column 2? Column 3? Adapted from ESS Support Services
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The squares under columns 1, 2 & 3 represent primary drivers, secondary drivers & change ideas. Looking at the content in the 3 columns, which column would you identify as Secondary Drivers (ie the next most conceptual): 1 2 3 AIM Streamline Pre-Screen Form By Dec 31, 2015, we will: Improve client experience with admission to Adult Day Services by 15% Reduce client wait times from Assessment to Service Initiation Identify Critical Information Needs Eliminate Duplicate Information Refresh Guidelines for Pre-Screen Process Eliminate Steps & Move Downstream Activities Up Book Assessments at Intake Regardless of RAI-HC Completion Status Decrease Number of Process Steps Book Client Start Date for Service at Time of Assessment Streamline Client Forms Next, which column would you identify as Secondary Drivers? Column 1? Column 2? Column 3? Adapted from ESS Support Services
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A Driver Diagram also serves as a foundation for identifying outcome and process measures and communicating the level at which each is relevant PRIMARY DRIVERS AIM SECONDARY DRIVERS CHANGE IDEAS Identify Critical Information Needs Streamline Pre-Screen Form By Dec 31, 2015, we will: Improve client experience with admission to Adult Day Services by 15% Reduce client wait times from Assessment to Service Initiation Eliminate Duplicate Information Streamline Client Forms Refresh Guidelines for Pre-Screen Process Book Assessments at Intake Regardless of RAI-HC Completion Status Eliminate Steps & Move Downstream Activities Up Decrease Number of Process Steps Book Client Start Date for Service at Time of Assessment Outcome Measure(s) Process Measures
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Where would you attach each of the measures in the pink circles below?
AIM PRIMARY DRIVERS CHANGE IDEAS SECONDARY DRIVERS By Dec 31, 2015, we will: Improve client experience with admission to Adult Day Services by 15% Reduce client wait times from Assessment to Service Initiation Decrease Number of Process Steps Identify Critical Information Needs Streamline Client Forms Eliminate Duplicate Information Eliminate Steps & Move Downstream Activities Up Streamline Pre-Screen Form Refresh Guidelines for Pre-Screen Process Book Assessments at Intake Regardless of RAI-HC Completion Status Book Client Start Date for Service at Time of Assessment 1 2a 2b 3a 3b 3c 4a 4b 4c 4d Write the applicable number and letter beside each of these measures to indicate where you would position each on the diagram: % Clients Who Rate Their Admission Experience as Excellent # Minutes Required to Complete An Assessment % Clients Booked for Assessment at Intake % Clients With Start Date for Service Confirmed at Assessment Average # Days from Assessment to Service Initiation
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To summarize: Driver Diagrams are a tool which assist teams in doing improvement work and help to communicate to others the Aim and the hypotheses/rationale for selecting specified change ideas to achieve improvement. More specifically, a Driver Diagram: Assists teams in generating change ideas that link to root cause and that will impact an Aim Serves as a foundation/tool for developing measures and understanding where each is relevant Communicates to others the “logic” or the design of the project Helps staff to understand how their work at the front line contributes to goals/aims
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