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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