Driver diagrams

A driver diagram is a conceptual model that helps teams to identify an aim they want to achieve and then to align the relevant system components in order to support its achievement.

A driver diagram is a visual model that highlights all the factors that influence the patient’s experience, to enable you to structure your thinking about how to affect the experience. It helps you to identify existing improvement initiatives that could influence the experience, and to select current and future priorities for action.

For example, in a given area, you might identify the main ‘drivers’ of quality as:

  • good care processes that determine how clinics are organised, appointments are made and diagnostic tests carried out
  • interested, competent staff
  • patients having an understanding of what is going on and who is involved in decisions about their care
  • a physical environment that is appropriate for this group of patients 
  • a communication style that enables patients to feel they are treated with kindness and respect and involved appropriately in their care.

A driver diagram also provides a structure for discussion, to help team members identify the priorities for high-quality care. It is a useful way of communicating this discussion more widely and, ultimately, of clarifying goals as you get ready to implement your project. It can be used as a tool throughout the PFCC process, but particularly in Step 3 (Evaluate the current state), as it will help you to focus your shadowing activities. It will also help you with Step 5 (Develop a shared vision for the ideal patient experience) and Step 6 (Identify individual projects and improvement teams).

Key points

  • If you are feeling overwhelmed by the scale of what you want to achieve, driver diagrams can help you cut your aims down to a manageable size to enable you to identify elements to concentrate on now, and what can go on the ‘to do’ list for later
  • To complete the driver diagram, gather a group of people in different roles who work in the care experience in question. Set out a clear goal such as ‘95 per cent of patients feel that care met their expectations’. Brainstorm areas for improvement. Pull them together into groups to see if they point to a category that ‘drives’ positive experience. 
  • The act of producing the diagram is a very important way of getting the team working together and committing to some common agreed goals and priorities.
  • Any health care improvement driver diagram is likely to include some universal categories, such as care, clinical processes, environment and communication. But your diagram will focus on some details specific to the particular care experience you are looking at. 
  • You can identify further categories by reading around the area, working with what your organisation already knows and then building on this.
  • You can refine your driver diagram over time as you receive further data from other processes such as shadowing and process mapping.
  • It is helpful to look at real examples of driver diagrams in the document list accompanying this section. The  PFCC driver diagram for patient experience template is a template produced by the Institute of Healthcare Improvement, which you can use as a basis for your own diagram. The  PFCC sample driver diagram is a real driver diagram developed by Alder Hey Children’s NHS Foundation Trust to identify what works when responding to children’s abdominal pain.

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