Improvement Method Olympics Day 8

Posted by: NHS Horizons - Posted on:

  1. Driver diagram (tool)

Driver diagrams are structured charts of three or more levels. They translate a high level improvement goal/aim into a logical set of high level factors (primary drivers) that you need to influence in order to achieve your goal. They also show the specific projects/activities that would act on these high level factors.

Driver diagram from the Welsh Ambulance Service

Graphic showing an example of a driver diagram

Read more about driver diagrams

2. Kotter’s Eight Steps (method)

The 8-Step Process for Leading Change was developed by John Kotter based on over four decades of observations of countless leaders and organisations as they were trying to transform or implement their strategies. He identified and extracted the success factors and combined them into a methodology — 8-Step Process for Leading Change. He revised it in 2014 following further research. The 2014 version is made up of the following eight steps:

  1. Create a sense of urgency – Help others see the need for change through a bold, aspirational opportunity statement that communicates the importance of acting immediately
  2. Build a guiding coalition – A volunteer army needs a coalition of effective people – born of its own ranks – to guide it, coordinate it, and communicate its activities
  3. Form a strategic vision and initiatives – Clarify how the future will be different from the past and how you can make that future a reality through initiatives linked directly to the vision
  4. Enlist a volunteer army – Large-scale change can only occur when massive numbers of people rally around a common opportunity. They must be bought-in and urgent to drive change – moving in the same direction
  5. Enable action by removing barriers – Removing barriers such as inefficient processes and hierarchies provides the freedom necessary to work across silos and generate real impact
  6. Generate short-term wins – Wins are the molecules of results. They must be recognized, collected and communicated – early and often – to track progress and energise volunteers to persist
  7. Sustain acceleration – Press harder after the first successes. Your increasing credibility can improve systems, structures and policies. Be relentless with initiating change after change until the vision is a reality
  8. Institute change – Articulate the connections between the new behaviours and organisational success, making sure they continue until they become strong enough to replace old habits.

Kotter’s eight step model

Circles describing Kotter's eight steps

Source: Kotter Inc website  

3. SWOT (tool)

SWOT stands for Strengths, Weaknesses, Opportunities, and Threats, so a SWOT Analysis is a technique for assessing these four aspects of our team or organisation.

We can use SWOT Analysis to make the most of what we’ve got, to our team or organisation’s best advantage. We can reduce the chances of failure, by understanding what we’re lacking, and eliminating risks or barriers that might otherwise catch us unawares.

People usually ideas storm their SWOT as a team. Multiple views are better than single views. To clarify which section an idea belongs to, it is useful to think of Strengths and Weaknesses as internal factors – that is, to do with the organisation, its assets, processes, and people. Think of Opportunities and Threats as external factors, arising from what is happening in your wider environment, other players and potential partners, trends, and the bigger economy.

Adapted from MindTools

Four coloured squares. Green square has text strengths, orange square weaknesses, blue square opportunities, purple square threats

Source of graphic: Wikipedia

4. Juran Trilogy (methodology)

The Juran Trilogy is a universal way of thinking about quality—it fits all functions, all levels, and all kinds of services and products. The underlying concept is that managing for quality consists of three universal processes:

  • Quality Planning – setting goals based on the needs of our end user and planning action to achieve these
  • Quality Control – monitoring performance within existing process designs
  • Quality Improvement – redesigning processes to continuously improve and achieve our goals

Juran stressed the inter-relatedness of these functions and the importance of achieving an appropriate balance between them to develop an effective approach to improving quality. Often in health and care, we over-focus on quality control and under-focus on quality improvement.

Diagram with three interconnected circles. The text in each circle says planning, improvement, control

Source of image: Royal College of Physicians

Content adapted from the Juran Institute

See the Juran Trilogy adapted for a practical health and care context in this paper by Amar Shah