Driver Diagrams

“Every system is perfectly designed to achieve the results it gets”

-Improvement Axiom

Setting Aims

• Be impossible within the current framework of how our system functions

• Specific

• Measurable

• Ambitious (notice not attainable)

• Relevant

• Time bound

Conceptual Driver DiagramOutcome 1⁰ driver 2⁰ driver Change ConceptsSpecific Change Ideas

Aim or Outcome

1⁰ driver 1

1⁰ driver 2

2⁰ driver 3

2⁰ driver 2

2⁰ driver 1

2⁰ driver 4

2⁰ driver 5

Concept 1

Concept 2

Concept 4

Concept 3

Concept 5

Concept 6

Ideas:123456789........N

Where do specific change ideas come from?

• Front line team – if you could improve your day to day work in any way what would you do differently (no new resources)?

• The literature (Medical or Improvement)

• Go to the web – what have others done– www.koawatea.co.nz– www.google.com

• Logical positive thinking methods

• Use of formal creativity techniques

Counties Manukau

Healthy & Well Days

Admissions

20,000 Days Campaign Driver Diagram

Length of stay

Readmissions

Complications

Discharges

Version 2 – 19 June 2013

Planned

Unplanned

Return to Business

GP Engagement

Experience of Care

Access to Care

Transfers of care

Delirium Care

Enhanced Recovery After Surgery (ERAS)

Better Breathing – Community Rehabilitation

Healthy Hearts - Community Rehabilitation

Well Managed Pain

Memory Team

Gout Busters

Mental Health Short Stay

Healthy Skin

Helping at Risk People

SMART (Safer Medical Admission Review Team)

CollaborativesPhase 1

Collaboratives Phase 2

Primary Drivers Secondary Drivers

AIMMeasures

Hip Fracture ManagementPatient Safety Harm/ Infections

St John Ambulance Service

Very High Intensity Users (VHIU)

Transitions of Care-Goal Discharge Date (GDD)/Weekend Discharge

SMOOTH (Safer Medication Outcomes On Transfer To Home)

Rapid Response & Supportive Discharge

Implementing Changes

Community Geriatric Service

New Collaborative

Key

Cellulitis & Skin Infections

Healthy Hearts

Inpatient Care for People with Diabetes

Enhanced Primary Mental Health

Supporting Life After Stroke

Environmental Cleaning

Franklin Co-ordination Service

ACE ( Acute Care for the Elderly)

Medical Assessment Unit

Saving Limbs, Saving Lives

Counties Manukau

Healthy & Well Days

Admissions

20,000 Days Campaign Driver Diagram

Length of stay

Readmissions

Complications

Discharges

Version 2 – 19 June 2013

Planned

Unplanned

Return to Business

GP Engagement

Experience of Care

Access to Care

Transfers of care Healthy Hearts - Community Rehabilitation

Well Managed Pain

Memory Team

Gout Busters

Mental Health Short Stay

Healthy Skin

Helping at Risk People

SMART (Safer Medical Admission Review Team)

CollaborativesPhase 1

Collaboratives Phase 2

Primary Drivers Secondary Drivers

AIMMeasures

Patient Safety Harm/ Infections

Implementing Changes

New Collaborative

Key

Inpatient Care for People with Diabetes

Enhanced Primary Mental Health

Supporting Life After Stroke

Environmental Cleaning

Franklin Co-ordination Service

ACE ( Acute Care for the Elderly)

Medical Assessment Unit

Saving Limbs, Saving Lives

Break out

• Spend time creating a driver diagram (or refining your driver diagram) that represents your teams theory about what drivers will be important to focus on to achieve the outcome you are aiming for

• Use 1 or 2 of the 2 drivers from the global driver ⁰diagram to serve as the outcome for your individual project (align these with your stated aim)

• From there, identify 1-3 primary drivers and their secondary drivers

• Begin building your theory