Creating communicating an improvement strategy Introducing driver diagrams

Creating & communicating an improvement strategy Introducing driver diagrams

What is your aim ?

Driver Diagrams AIM PRIMARY DRIVERS SECONDARY DRIVERS CHANGE PROJECTS Secondary driver 1 CP 1 Primary driver 1 CP 2 Secondary driver 2 AIM – an improved system CP 3 Secondary driver 3 Primary driver 2 CP 4 CP 5 Secondary driver 4 Secondary driver 5 CP 6 CP 7

Avoid silver bullet thinking

Avoid blindspots

innovation AND improvement

Generate Change Ideas Gym work out 3 days Buy only 1 sandwich Take stairs 2 stone weight loss in 6/12 No pub weekdays Low fat meals Cycling kit out night before Put cycling days in diary Water bottle for work bag Take packed lunch Squash weekends Put away large wine glasses Fruit for dessert Get rid of Oyster card Pedometer

Look for patterns Buy only 1 sandwich Take stairs Low fat meals Cycling kit out night before Put cycling days in diary Water bottle for work bag 2 stone weight loss in 6/12 Take packed lunch Gym work out 3 days No pub weekdays Squash weekends Put away large wine glasses Fruit for dessert Get rid of Oyster card Pedometer

Marshall the mass of ideas Take packed lunch Low fat meals Substitute lower calorie foods Eat less Buy only 1 Water sandwich bottle for Fruit forwork bag dessert Put cycling days in diary Cycling kit out night Do sport before Gym work out 3 days Squash weekends Drink less alcohol No pub weekdays Put away large wine glasses 2 stone weight loss in 6/12 Be more active during the day Pedometer Take stairs Get rid of Oyster card

Driver Diagrams Weight loss example Reduce calories in 2 stone weight loss in 6/12 Substitute lower calorie foods Low fat meals Eat less Take packed lunch Buy only 1 sandwich Fruit for dessert Water bottle for work bag Put away the Drink less alcohol large glasses No pub weekdays Gym work out 3 days Increase calories out Do sport Squash weekends Put cycling days in diary Cycling kit out night before Be more active during the day Get rid of Oyster card Pedometer Take stairs

Example AIM PRIMARY DRIVERS SECONDARY DRIVERS CHANGE PROJECTS Choice of insulin CP 1 Prescribing How much? By when? Reduce hypos in insulin treated patients How much? By when? CP 2 Adjust for hot weather CP 3 Adjust for time zone Self adjustment How much? By when? CP 5 Adjust for exercise Adjust for food Monitoring How much? By when? CP 4 CP 6 CP 7 CP 8 At every appointment CP 9 CP 10 By family / friends CP 11 Dealing with early hypo How much? By when? Recognition Taking action CP 12

2. Help marshal change ideas AIM Improve access Waiting room info, list clinician interests/languages, web info, Rx access (Feel Better Faster), signpost more (WIC/HV/minor inj/Secs/DNs/A&E), Chronic disease training, care planning, review periods, get it right first time, test results processing, teamworking/multiskilling, results line hours, protocols for test results, widen skill mix, BP machine in watiting room, update rpt Rx, pharmacist planning, streamline processes, streamline recalls, education & reflection, up-to-date pt contact details, know what appt is for, pt registration management, Triage, Care planning / pathways, more Tel. C, email. C, clinical buddies/teams, test results, repeat Rx, forwarding tasks + results, check + update usual GP, results actioned by right person, advance appt booking, reserve list, ask pt who they want, rota in advance, notekeeping w plan + pt info, Consult skills, comp skills, speed reading/typing, forms + equipment, multi-skilling, longer appts, No emerg appts, Test results, Care planning, High risk processes, Referral chase-up, results continuity, streamline processes, streamline recalls, clear up alerts, handling of normal results, self-checkin, fast-track queue

AIM Improve access PRIMARY DRIVERS SECONDARY DRIVERS CHANGE PROJECTS

AIM PRIMARY DRIVERS SECONDARY DRIVERS Supply of GP time Doctors (capacity) CHANGE PROJECTS GP rota change project Community education Waiting room TV Organisation of GP time PILS & CDs & DVDs Feel better faster Improve access Pt help-seeking Demand Student sick notes Reception signposting Deflecting demand Test results Consulting skills Creating our own workload Dealing (efficiency) Longer appts Guaranteed interpreters Planning care Continuity Dealing w failed referrals Chronic disease pathways Review periods Appt system More Tel. C’s Appt system project Email appts

Software for driver diagrams – Power. Point – Dia – Freemind – VUE – Mind. Meister – Mind. Jet