A driver diagram shows the processes or systems that affect the aim of your quality improvement (QI) project and determine what you need to do to improve outcomes. Use the state Medicaid and CHIP improving timely health care for children and youth in foster care driver diagram on the next page to help plan your state foster care-related QI project. You may also want to develop your own driver diagram and change ideas. Here are some suggestions to begin:
- Develop an aim statement. A good aim statement is specific, measurable, and answers the questions, “For whom, how much, and by when?” It should be brief, easy to understand, and should not include background or side issues. An example aim statement is given on the driver diagram.
- Add primary drivers. Primary drivers are the high-level processes, structures, or norms in the system that must change in order to achieve your aim. While all the primary drivers are necessary to achieve your aim, begin your QI project by just focusing on one or two primary drivers and then expand your activities over time to address the other drivers.
- Add secondary drivers. Secondary drivers expand an understanding of the primary drivers and are action oriented, addressing the places, steps in a process, time-bound moments, or norms where changes are made to bring about improvement. Secondary drivers will help lead you to testable change ideas.
- Develop change ideas. Change ideas describe the specific, testable actions that can be taken to impact the secondary driver, the related primary driver, and achieve your aim. Change ideas are activities supported by evidence, experience, or expert opinion The change ideas on the following tables were gathered from research, case studies, expert opinions, and other resources. Where available, the resources have been referenced. Short descriptions accompany Medicaid specific experiences. Where no reference has been provided, the change idea comes from subject matter experts consulted to develop this driver diagram.