Visually presents a team's theory of how an improvement goal will be achieved.
What is it?
A simple visual display that outlines and logically connects:
An improvement aim that quantifies what better will look like, for who and by when
A small number of Primarydrivers that focus on the key components of the system/main areas of influence that need to change to achieve the aim. These are often associated with process, infrastructure, norms (culture) and people
Secondary drivers that break primary drivers down in to natural subsections or processes. They provide more detail on where interventions to positively influence the primary drivers are required
Change ideas – These are the specific ideas that teams can test to see if they influence the secondary drivers and ultimately the aim
What does this tool look like?
Why use this tool?
To visually present a team’s theory of change for how an improvement goal might be achieved, aiding planning and team engagement
To articulate what parts of a system, need to change in which way, ensuring everyone working on improving their system has a shared sense of why
To help teams work collaboratively and focus on changes that will impact most on their system, while avoiding spending time and resources on changes that will have little effect
To help identify outcome and process measures for improvement work so that teams can tell whether their efforts are leading to improvement
Where does this tool fit in the improvement journey?
This tool is relevant at these stages of the Quality Improvement Journey.
It is also relevant to the three themes that support your journey.
How to use it.
Driver diagram development works best as a group exercise.
Tips for Facilitation:
Bring together the subject matter experts
Ask the group to “Brainstorm” the following question and record their thoughts on post-it notes: “To achieve our aim the things we need to change are…….”
Cluster the ideas to see if common themes emerge as primary drivers
Expand these groups to identify subsections or processes that can be classed as secondary drivers
Link the groups together into the Driver Diagram format
Ask the group to suggest change ideas for each secondary driver
Prioritise these according to which is likely to have the highest and/or quickest impact
Sometimes it helps teams to develop their change theory by working backwards from their change ideas and asking, “what will this change about how the system is currently working?”
Use outputs from process mapping, cause and effect analysis and other tools that aid system understanding to help develop the change theory.
Refine the Driver diagram as changes are PDSA tested and measures tracked, using it as a focal point at improvement meetings