After using driver diagrams to discover what you want to change, the model for improvement is the approach, which will help you identify, carry out and evaluate the changes you make.

There are three questions every project team should ask:

1. What are we trying to accomplish?

  • Identify an area for improvement and use this to establish a specific aim – remember to be as SMART as possible (specific, measurable, achievable, realistic, and time-bound). For example; a patient falls reduction project might aim to ‘reduce patient falls on Ward A by 50% within six months.’
  • Determine what or who will be affected by this change
  • Give your project a deadline.
    NB. The aim may be the same as the aim in your Driver Diagram.

2. How will we know that a change is an improvement?

There are three types of measures:

  • Outcome measures, e.g. number of patient falls occurring
  • Process measures, e.g. reviewing the reliability of processes that may have an impact on the aim
  • Balancing measures to check unintended consequences, e.g. for a falls reduction project staffing levels may be a useful balancing measure.
    NB. The measures may be he same as those in your Driver Diagram.

3. What changes can we make that will result in improvement?

  • Get creative to develop ideas about how the improvement will be driven. Potential changes can be discovered using the driver diagram.
  • Remember, not all changes will result in an improvement. One change on its own may not achieve your aims.

Now time to PDSA

Plan, Do, Study, and Act is an effective method that helps teams plan the actions for their model, test it on a small scale, and review before deciding how to continue. It comprises four steps:

 

PDSA cycles are a fantastic way of taking ideas, trying them in practice, learning what works and what doesn’t to help you achieve success. You can broaden the scale of the test or adjust your ideas through more than one PDSA cycle – it may take a few before the idea starts to work reliably.

 

For guidance on how to use PDSA cycles effectively, see the information and video clips provided in the Resources section below.

Resources

Greenhousing

Join Chris Learoyd, as he talks through the importance of nurturing new ideas using the SUN and RAIN model. He highlights the importance of developing ideas to support the creative process at the start of a quality improvement project. These ideas can then be tested using Plan Do Study Act Cycles. The recording is taken from the West of England Academy AHSN Winter Series 2021, if you’re interested in attending similar training please visit our events page.

The Model for improvement and SMART targets

Join Vardeep Deogan, as she talks through SMART targets and how they are integral to the Model for Improvement. She introduces the Model for Improvement and why it’s a key methodology to underpin improvement projects and highlights the importance of having a SMART target. She goes on to outline what should be considered and tips for creating a SMART target with your team. At 14:20 play along with the quiz activity to test your knowledge of what is a SMART target or not. The recording is taken from the West of England Academy AHSN Winter Series 2021, if you’re interested in attending similar training please visit our events page.

PDSA

Join Teddy Baker, as he explains an activity that you can do with your teams to practice Plan Do Study Act cycles. He outlines the steps in the activity that can be completed either online or face-to-face, and identifies roles and responsibilities for your team to complete the challenge. You will need a T-Shirt and a timer! The recording is taken from the West of England Academy AHSN Winter Series 2021, if you’re interested in attending similar training please visit our events page.

Data for improvement

Join Vardeep Deogan, as she outlines the three measures used in Quality Improvement projects, outcome, process and balancing. She goes on to highlight the importance of having operational definitions for your measures and how to write one. Take part in the activity at 18:30 to create an operational definition with your team. Hopefully you’ll see how easy it can be to interpret measures differently and the need to create operational definitions with your team. The recording is taken from the West of England Academy AHSN Winter Series 2021, if you’re interested in attending similar training please visit our events page.

Video clips

Templates