Driver Diagrams: Connecting Your Aim to Your Actions

July 2021

Olivia Morejon, MS

Improvement Specialist II

Maine Medical Center/ MaineHealth

 

Learning Objectives

  1. Describe when to use a driver diagram
  2. Differentiate between the aim, primary drivers, secondary drivers, and change ideas/interventions
  3. Construct and facilitate the use of a driver diagram with a group

Sometimes the aim of your Quality Improvement work can seem inexplicably broad and much feels out of your control. As the old adage “How do you eat an elephant?” tells us, in those times, it can be very helpful to break down a large goal into smaller, more manageable pieces. In Improvement Science, this leads us to Driver Diagrams. A driver diagram visually breaks down and summarizes the larger aim and the smaller goals and steps that will ultimately help achieve that aim.

A driver diagram consists of four interconnected parts: the aim (or the goal), the primary drivers, the secondary drivers, and change ideas (or interventions). Your aim is the overarching goal of the project, or in the healthcare setting, what is ultimately meaningful to patients. It should be measureable and achievable, and it should be summarized into one or two sentences. The primary drivers are the large areas you will need to work on in order to achieve your aim. The secondary drivers are what need to be in place to achieve your primary drivers. It can be difficult to differentiate between primary and secondary drivers. Reviewing a process map can be helpful in identifying larger areas to use as primary drivers and smaller steps that make secondary drivers. Finally, the change ideas are the ideas of what you or your team would like to test in order to move towards the aim. All of the change ideas together can also form your project plan, the actions and changes to make in order to achieve your goal. The example below illustrates all four components of a driver diagram.

Example: reproduced from Reference 1

 

A driver diagrams is most often helpful early in planning a project. It can help transform a larger, global goal into actionable goals and interventions. But putting together a driver diagram yourself can be difficult, and final product will be improved by including others involved in the process.

  1. Pull together your team. Gathering the Subject Matter Experts for your process is key to the success of your project. Choose stakeholders from all areas of the process.
  2. Develop your aim. This should be the overall goal of the project, and guided by data to focus on big quality issues and determine achievable targets for improvement.
  3. Brainstorm Drivers. Work as a team to generate drivers, or areas or items that would contribute towards achieving your aim. You can either shout out drivers for a facilitator to record or have team members record their idea on sticky notes to later share with the whole group.
  4. Group similar ideas to form Primary Drivers. Similar areas of interest can be used as primary drivers, while the more specific details will form the Secondary Drivers.
  5. Expand upon the grouped ideas to form Secondary Drivers. This can be done by both reviewing some of the specific ideas within the grouped primary drivers, as well as brainstorming interventions specific to primary driver.
  6. Ask the group to identify change ideas for each Secondary Driver. These will be your tests of change to implement within your process.
  7. Revisit the Driver Diagram as a part of the PDSA cycle. Update the document with new change ideas as they emerge.

 

References:

  1. Driver Diagram | IHI – Institute for Healthcare Improvement. (2016). IHI- Institute for Healthcare Improvement. http://www.ihi.org/resources/Pages/Tools/Driver-Diagram.aspx
  2. Understanding Driver Diagrams. (n.d.). Life QI System. https://help.lifeqisystem.com/driver-diagrams/understanding-driver-diagrams (accessed July 19, 2021)

 

 

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