Improvement Science Driver Diagram Starter Kit with templates

Improvement Science (Driver Diagram) Starter Kit with templates Developed by The CEC Academy, NSW Clinical Excellence Commission www. cec. health. nsw. gov. au

Primary Drivers Driver Diagram Template Secondary Drivers Change Ideas Priority Change Ideas Impact: High Low Implementation: Easy Hard The Problem: xxxx Process Measure: • How much: • By when: Impact: High Low Implementation: Easy Hard SMART Aim: Process Measure: • How much: • By when: Balancing Measure: • How much: • By when: Process Measure: • How much: • By when: Outcome Measure: • How much: • By when: Team Members: • • • Project Sponsor/s Team Leader Consumer QI Advisor Xx Xx xx NB: Can Hyperlink Xx measures to Graphs in xx Spread sheets Impact: High Low Implementation: Easy Hard Impact: High Low Implementation: Easy Hard Process Measure: • How much: • By when: Impact: High Low Implementation: Easy Hard

Flow Chart Template Start Yes Example only: Delete the arrows and boxes that you don’t use No Decision point Yes End Decision point NO

Adapted from material sourced from the www. ihi. org Measurement Strategy Aim Statement: Type Outcome. Process & Balancing Measures OUTCOME PROCESS BALANCING Name of Measure Operational Definition Numerator / Denominator Data Collection Methods / Sampling / Schedule Reporting: Format & Frequency (Who report to: Sponsor / Project Team / Others)

Use the CEC Improvement Science Step by Step Cheat Sheet to guide you through your project More information at CEC Website: http: //www. cec. health. nsw. gov. au/quality-improvement/improvement-academy/quality-improvement-tools Reference: The Improvement Guide (2 nd Edition) by G. Langley, R. Moen, K. Nolan, T. Nolan, C. Norman & L. Provost. The Health Care Data Guide - Learning from Data for Improvement by Lloyd Provost & Sandra Murray

Use the CEC Improvement Science Step by Step Cheat Sheet to guide you through your project

Use the CEC Improvement Science Step by Step Cheat Sheet to guide you through your project

Use the CEC Improvement Science Step by Step Cheat Sheet to guide you through your project

Use the CEC Improvement Science Step by Step Cheat Sheet to guide you through your project

Use the CEC Improvement Science Step by Step Cheat Sheet to guide you through your project

Use the CEC Improvement Science Step by Step Cheat Sheet to guide you through your project

Charts to consider for Outcome, Process, Balancing and Diagnostic Measures

Charts to consider for Outcome, Process, Balancing and Diagnostic Measures

PDSA Cycle Plan & Progress – Also in Excel ‘Quality Tools’ s-sheet Priority 1 Priority 2 Priority 3 Priority 4 Priority 5 Priority 6 Priority 7 Priority 8 Priority 9 Priority 10 Change Ideas to Staff to cotest ordinate PDSA Measures How will you know that a change is an improvement? Team meeting 1 date: Team meeting 2 date: Team meeting 3 date: Team meeting 4 date: Team meeting 5 date: Team meeting 6 date: Team meeting 7 date: Team meeting 8 date: Team meeting 9 meeting 10 meeting 11 meeting 12 date:

Graph your results using the Quality Tools: Run Chart, Pareto Chart etc Run chart: http: //www. cec. health. nsw. gov. au/qualityimprovement/improvement-academy/quality-improvement-tools/runcharts Pareto Chart: http: //www. cec. health. nsw. gov. au/qualityimprovement/improvement-academy/quality-improvement-tools/paretocharts

Your Deliverables by the end of the CEC CLP Program Complete a Quality Improvement Project 1. Conduct a 15 minute Power Point presentation at Graduation – see template slides 2. A 1 size poster for Graduation – see template poster 3. Complete ACI Innovation Exchange summary and email to aciie@health. nsw. gov. au – see template form and more information at http: //www. aci. health. nsw. gov. au/ie/submit-your-project

Example of a Gantt chart (copy & past this into Excel) Gantt Chart Project Plan Confirm problem worth solving Appoint Project Team & Team Leader Appoint Sponsor/s Appoint Quality Advisor SMART Aim statement Literature review Flow chart current process Collect diagnostic / baseline data Brainstorm Causes of Problem Affinity Diagram Driver diagram - Primary & Secondary Drivers Devise Change Ideas: Brainstorm & literature Devise measures: Outcome, Process & Balancing PDSA Ramp 1 PDSA Ramp 2 PDSA Ramp 3 PDSA Ramp 4 PDSA Ramp 5 Run charts /SPCCs of data to Measure Impact Plan to sustain gains Plan to spread Reports to Sponsor/s (Guidance team) Develop Poster for graduation Develop Power Point Presentation for Graduation Send summary to ACI Innovation Exchange Colour code Planned In progress Completed Late Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Additional short videos to watch 1. Tuckman - The 4 Stages Of Team Formation by Eric Sutherland, Dynamic Business Teams, Scotland (7 minute video) https: //www. youtube. com/watch? v=P_HZd 5 r. AF 6 g 2. How to draw a Flow Chart in Power Point by i. Yogi Tech Support (2. 30 minute video) https: //www. youtube. com/watch_popup? v=XRpl. Zx. P 6 RFg 3. A Family of Measures: Outcome, Process & Balancing Measures by Robert Lloyd Ph. D from the IHI (8 minute video) https: //www. youtube. com/watch? v=uow 7 mzr. Fif 4&feature=yo utu. be 4. Plan Do Study Act (PDSA) Cycle – Part 1 by Robert Lloyd Ph. D from the IHI (5 minute video) https: //www. youtube. com/watch? v=_-ce. S 9 Ta 820 5. Plan Do Study Act (PDSA) Cycle – Part 2 by Robert Lloyd Ph. D from the IHI (4 minute video) https: //www. youtube. com/watch? v=e. Yo. Jxjmv_QI 6. Run charts by Robert Lloyd Ph. D from the IHI (8 minute video) http: //www. ihi. org/education/IHIOpen. School/resources/Pages/Audio 18 and. Video/Whiteboard 7. aspx

Tuckman Article & Survey i. Please read the Article: Tuckman Forming Storming Norming Performing Model at http: //www. businessballs. com/tuckmanformingstorming normingperforming. htm ii. Please complete the Teamwork Survey & tally up the scores – survey on following slides/pages. iii. What stage was your team at? Were you at: q forming q storming q norming q performing stage

Tuckman Team Survey - please complete and tally up your score

Tuckman Team Survey - please complete and tally up your score

Tuckman Team Survey - please complete and tally up your score

Tuckman Team Survey ACTION PLAN Do you need to address any issues found in the Tuckman Survey? Action required Who to co-ordinate Planned date for completion

Sustaining the Gains - How sustainable is your project? • Complete the British NHS Sustainability Survey and score your project? See survey on next few slides / pages • The closer the score to 100, the better chance of successful sustainability Ø Score of 55 or higher offers reason for optimism Ø Score of 45 or lower suggests reason for concern

Complete the British NHS Sustainability Survey and score your project

Complete the British NHS Sustainability Survey and score your project

British NHS Sustainability Survey ACTION PLAN Do you need to address any issues found in the Sustainability Survey? Action required Who to co-ordinate Planned date for completion

More information on Driver Diagrams & PDSA • You Tube videos from NHS: Ø Driver Diagrams Lesson 1 of 3 Introduction https: //www. youtube. com/watch? v=2 m. Bp. JIzz. YI 8 Ø Driver Diagrams- Lesson 2 of 3 - Reasons to use driver diagrams https: //www. youtube. com/watch? v=x. XRym 4 a. FLa 4 Ø Driver diagrams Lesson 3 of 3 How to develop a driver diagram https: //www. youtube. com/watch? v=Bh. Y-rw 9 ej. Dk • Driver Diagram References: Ø The Kings Fund – UK - http: //www. kingsfund. org. uk/projects/pfcc/driver-diagrams Ø IHI – USA - http: //www. ihi. org/education/ihiopenschool/resources/Pages/Activities/Goldmann. Driver. aspx Ø Health care Scotland – UK - http: //www. healthscotland. com/OFHI/Resources/resources_driverdiagrams. html Ø NHS Scotland QI Hub -UK - http: //www. qihub. scot. nhs. uk/knowledge-centre/quality-improvement-tools/driver-diagram. aspx Ø What’s your theory - Driver diagram serves as tool for building and testing theories for improvement by Brandon Bennett & Lloyd Provost: http: //www. apiweb. org/QP_whats-your-theory_201507. pdf - July 2015. Ø Carnegie Foundation Summit – Slides - http: //www. slideshare. net/Next. Gen. LC/carnegie-foundation-summit-on-improvementin-education-driver-diagrams 2 nd March, 2015. Ø IHI - The Model for Improvement - http: //www. ihi. org/resources/Pages/Howto. Improve/default. aspx Ø IHI - PDSA - http: //www. ihi. org/resources/Pages/Howto. Improve/Scienceof. Improvement. Testing. Changes. aspx - • PDSA References: Ø http: //www. ihi. org/resources/Pages/Howto. Improve/Scienceof. Improvement. Testing. Changes. aspx

Links to other Clinical Quality & Safety Websites: State: • Clinical Excellence Commission: www. cec. health. nsw. gov. au • Agency for Clinical Innovation: www. aci. health. nsw. gov. au • Bureau of Health Information: www. bhi. nsw. gov. au National: • Australian Commission on Safety & Quality in Health Care (ACSQHC): http: //www. safetyandquality. gov. au/ • Australian Association for Quality in Health Care (AAQHC): https: //www. aaqhc. org. au/ • Authoritative information and statistics to promote better health and wellbeing http: //www. aihw. gov. au/data/ International: • Institute for Healthcare Improvement resources www. ihi. org • Intermountain healthcare (transforming healthcare) https: //intermountainhealthcare. org/about/transforming -healthcare/ • Agency for Healthcare Research and Quality: www. ahrq. gov • National Patient Safety Agency: www. npsa. nhs. uk • Institute for Innovation and improvement: www. institute. nhs. uk • Scottish Patient Safety Programme: www. patientsafetyalliance. scot. nhs. uk • Healthcare Improvement Scotland www. healthcareimprovementscotland. org • Ko Awatea Health System Innovation and Improvement: http: //koawatea. co. nz • International Society for Quality in Healthcare: http: //www. isqua. org/home 29

Driver Diagram Primary Drivers Secondary Drivers Change Ideas Priority Change Ideas Impact: High Low Implementation: Easy Hard The Problem: Process Measure: • How much: • By when: Impact: High Low Implementation: Easy Hard SMART Aim: Process Measure: • How much: • By when: Balancing Measure: • How much: • By when: Process Measure: • How much: • By when: Outcome Measure: • How much: • By when: Team Members: • • Project Sponsor/s Team Leader Consumer QI Advisor - NB: Can Hyperlink measures to Graphs in Spread sheets Impact: High Low Implementation: Easy Hard Impact: High Low Implementation: Easy Hard Process Measure: • How much: • By when: Impact: High Low Implementation: Easy Hard