How Do You Use a Driver Diagram?

Don Goldmann, MD, Chief Medical and Scientific Officer, Institute for Healthcare Improvement

Learning Objectives: At the end of this activity, you will be able to:

  • Define the phrase “causal pathway."
  • Explain the relationship between a driver diagram and a PDSA cycle.
  • Discuss why driver diagrams are useful to quality improvement work.
  • Differentiate between primary and secondary drivers.

Description: If you’re embarking on an improvement project, it’s common to want to start testing changes right away. You have an aim, and you want to achieve it! But how do you know the change you are making will help you achieve your aim?

Enter the driver diagram. A driver diagram, explains Don Goldmann, MD, IHI’s Chief Medical and Scientific officer, is a “simple, visual, somewhat intuitive display to help you understand where you’re going with your work.” Goldmann’s latest Open School Short explains the purpose and value of a driver diagram — a tool that can help you with anything from losing weight to protecting your patients from infection.

After you watch the video, get more improvement knowledge from Goldmann in PDSA Cycles: From CLABSIs to Cucumbers.

Discussion Questions:
  1. What is the causal pathway and how does it apply to improvement work?
  2. Why is it important to have a visual display of a system before embarking on improvement work?
  3. What’s the difference between a primary driver and a secondary driver?
  4. Have you ever created a driver diagram at the beginning of an improvement project? Did you find it helpful?
  5. Come up with your own personal improvement project — getting to work on time or losing weight, for example — and create a driver diagram with primary and secondary drivers. Did you find some changes you could test?
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