Planning for action


Decisions chart

We have arrived at the point whereby we have developed an understanding of the problem, set a goal for improvement and have measures that will tell us if we are achieving it

You and your team are probably having ideas about the changes that will help to reach that goal. People have ideas all the time and their arrival (and departure) can be unexpected and fleeting. We cannot remember everything, so we need to write things down.

The project template has a section for capturing change ideas. Use this as well as any other useful capture methods, making the ideas as clear as possible and capturing who the idea ‘author’ is, so you can check back with them if further clarity is needed.

It is tempting to rush off and start making lots of changes, but unless we do this in a controlled and structured way, we cannot be sure that we will have understood what is working / not working or helping / not helping.

This is the point whereby we need to bring in some additional structure to help with controlling and directing the work.

Our objective at this stage is to create a project ‘driver diagram’. This is a tool that helps us to:

  • understand the factors that will impact on our aim
  • group our change ideas around these factors
  • use as a catalyst for generating more ideas
  • prioritise the change ideas that we will test

Before we construct the driver diagram it is helpful to identify the key factors / themes that impact on the aim. These are the ‘drivers’ that we will build our driver diagram on and are likely to have started to emerge in your thinking and discussions with the project team.

Imagine your aim is to lose weight. The main factors that impact on this would be calories in and calories out. These are the ‘primary drivers’ that will have an effect on achieving your aim.

You will find a full explanation of this technique in the following section of this guide (here), but for now capture your thoughts and those of the project team on the template.

A final thought at this stage is that it is helpful to check that you have a good understanding of the problem / current situation. Again, it is tempting to start making changes, but if you do this from a position of poor understanding of the current state, your solutions will not have the impact you anticipate.

Quality Improvement is a non-linear process and if you are using the curious mind-set you may have already carried out some in depth analysis. If you haven’t then your next actions are to get that understanding.

You don’t want things to slow down trying to ‘know’ everything – we would suggest that it wouldn’t be possible to do that. You just need to be confident you have understood the problem sufficiently to have a good chance of generating ideas that will improve it.

We suggest using one or many of the four techniques outlined in this guide; root cause identification, process mapping, data analysis and ‘go see’.

The reality is that understanding the problem is a highly iterative process and as you start working to make improvements, further insights into the situation will be gained which will inform your next actions.