Driver Diagrams: Improvement Theory · 2016-05-02 · Purpose • To become familiar with driver diagrams. • To recognize the input required for the development of improvement theory.

Driver Diagrams: Improvement Theory

Jim Handyside

Improvision Healthcare Inc

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Purpose

• To become familiar with driver diagrams.

• To recognize the input required for the development of improvement theory.

• Differentiate the driver diagram from other similar planning and improvement tools.

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Why Theory? Effective change is not a “black box”.

Improvement

Aim

A new

process,

system,

culture… ?

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A “simple” personal improvement

Improve my health and well being

Better mental health

Better physical health

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A “simple” personal improvement

Better mental health

Better physical health

Burn more

Reduce Weight

Consume less

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A “simple” personal improvement theory

Burn more

Reduce Weight

Consume less

Change Daily routine

Standing Desk

Walk to work

Start Exercise

Return to sport

Lunch time walks

Measure (app)

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My improvement project

Burn more

Reduce Weight

Consume less

Change Daily routine

Start Exercise

Standing Desk

Walk to work

Return to sport

Lunch time walks

Measure (app)

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A simplified quality improvement

Reduce falls resulting in

harm by 50%

Risk Identification

Multifactorial risk assessment

Multifactorial interventions

Communication of fall risk status

Education of staff, patient, and family/carer

10 secondary drivers

45 change ideas and concepts

Ref: Falls Prevention Driver Diagram and Change Package NHS

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“Experience by itself teaches nothing… Without theory,

experience has no meaning.”

W. Edwards Deming(from: The New Economics)

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Theory Definition

(Oxford English Dictionary)

A supposition or a system of ideas in intended to explain something…

An idea used to account for a situation or justify a course of action.

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Two kinds of causal theory diagrams:

Fishbone:Team theories about what IS causing an effect.

Driver Diagram:Team theories about what changes WILL result in improvement.

Account forpresent situation

Justifyaction (change)

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Anatomy of Driver Diagram

See article: What’s Your Theory

ImprovementAim

PrimaryDrivers

SecondaryDrivers

Direction of cause or influenceChange

Ideas

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Change is an expression of theory

Thinking

Change ideas:

ProcessEliminate wasteKnowledge, skill

Behavior Technology

Etc.

(bundle)

Action

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AIM

HOWHOW

HOW

HOW

HOW

HOW

build theory

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AIM

WHYWHY

WHY

WHY

WHY

WHY

Rationale for change15

Careful with your logic…Is education a secondary driver?

Reduce falls resulting in

harm by 50%

Risk Identification

Multifactorial risk assessment

Multifactorial interventions

Communication of fall risk status

Education of staff, patient, and family/carer

Ref: Falls Prevention Driver Diagram and Change Package NHS

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Work Breakdown Structure (type of tree diagram)Project Management

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Work Breakdown Structure

Project Name

A: Planning Deliverables

A1: Charter & Other Planning Docs

A2: Driver Diagram

A3:Implementa-tion Plan*

B: PDSA Implementation

B1: Information Package

B2: Recruited Sites

B3: Prepared Sites

B4: Designed & Test PDSAs

B5: Implement PDSA(s)

B6: Analyzed Outcomes

C: New/Improved Process

C1: Lessons Learned

C2: New Standard Process

C3: Plan for Spread

C4: Implemented & Spread Process

QI Project schematicRef: Alison Paprica, PhD, PMP18

Your theory, driver diagram and PDSA

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PDSA to develop/test change AND confirm or adjust theory

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You need measurement to test theory

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Improvement theory inputs

1. Evidence

2. Experience

3. Other’s improvement

4. Analysis of your current state

……

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1. Compile inputs:• Evidence• Experience• Other’s improvement • Analysis of current situation

2. Sort, organize build primary and secondary drivers

Sticky note exercise

Or use a template document

DRAFT!

(it’s a draft until you know what worked or didn’t and why.)

Getting started:

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@CFHI_FCASScfhi-fcass.ca |

Thank You!

Two articles:What’s Your Theory?

Demystifying Theory and Its Use In Improvement