Quality Improvement Zone

Model for Improvement

The Model for Improvement is a simple yet powerful tool for accelerating improvement. The model is not meant to replace change models that organizations may already be using, but rather to accelerate improvement.

Why would you use this tool?

An Improvement Team would use the tool as a framework for applying the five fundamental principles of improvement:

 

  1. Knowing why there is a need to improve
  2. Being able to interpret if improvement is happening through measurement
  3. Developing an effective change theory which will result in improvement
  4. Testing a change before moving to implementation
  5. Knowing when and how to implement a change
Where does it fit in the improvement journey?
Where the tool sits within the improvement journey
What is it?

The “Model for Improvement” is a simple powerful tool for accelerating improvement.  It is comprised of 2 key parts:

  • 3 fundamental questions that drive all improvement; and
  • The Plan-Do-Study-Act (PDSA) cycle. 

Combined, the three questions and the PDSA cycle form a framework to support continuous improvement.

Model for Improvement image example
How to use it

The first 3 questions enable the improvement team to explore what it is they want to achieve, what change ideas might make a difference and what needs to be measured to demonstrate improvement.  Some literature refers to this part of the model as the “thinking” part.

What are we trying to accomplish?

Having identified the issue that needs to be improved, it is important to outline this as an Aim Statement – The aim Statement should be Specific, Timebound, Aligned (to organisational priorities) and Numeric (realistic end point).

How will we know that a Change is an Improvement?

Improvement teams should identify a suite of Outcome, Process and Balancing measures to track progress against the improvement aim.

Outcome measures are measures of the performance of the system under study and are directly related to the aim of the project.

Process measures are measures which track the specific steps or changes in a process that are designed to influence the outcome.

Balancing measures are measures which track any unintended consequences of the improvement effort.

What changes can we make that will result in improvement?

It is crucially important that ideas are generated by the whole team.  There are a variety of tools available to improvement teams to enable them to better understand the system and identify potential change ideas (Process Mapping, Cause and Effect\Fishbone, Parerto analysis, Force-field analysis). 

We would also recommend the development of a Driver Diagram for each improvement project.  Click here for further information on Driver Diagrams.

The second part of the model is the PDSA cycle and is sometimes referred to as the “doing” part.  This part outlines the steps to be taken to test a change idea.  For further information on PDSA please click here.