Chartering a project for
improvement
Improvement Science Consulting
Model for Improvement
What are we trying to
accomplish?
What change can we make that
will result in improvement?
How will we know that a change
is an improvement?
Act
Plan
Study
Do
Improvement Science Consulting
Langley, et al.
Background information
• This section represents a place to provide
some essential information to the audience
which sets the stage for improvement.
• It should be limited to 7 or less bullets
• It should cover issues like geography, history,
context, environment, political sensitivities,
etc.
Improvement Science Consulting
Define the need for improvement
• This slide should succinctly make the case for
improvement
• In just a couple of bullets lay out, what the
problem is, which requires the application of
QI methods to create better quality
Improvement Science Consulting
What are we trying to accomplish?
• This is place to define the Aim of your
improvement project
• Some teams like to answer the above question
“what are we trying to accomplish” using these
two questions “by how much do you want to
change” and “by when do you want to change”
• Implicit is answering those questions is an
understanding of current performance, this too
should be reflected in the aim (i.e. mortality is
currently at X% and we aim to reduce this to Y%
is Z amount time)
Improvement Science Consulting
How will we know that a change is an
improvement?
• On this slide you should list the measures you suspect will
help you to know if and how much progress you are making
during the course of the next 6-12 months
• Include an outcome measure, process measures and any
balancing measures you think are relevant
• Remember measures are defined through a statistic you will
be reporting on
• lets brainstorm 3 possible measures
• All measures should be reported with the statistic you will be
collecting each week, or month
Improvement Science Consulting
System of Feedback
O1
B
O2
B
Measure Types
O = Outcome Measure
P = Process Measure
P1
P2
P1
P2
B = Balance Measure
S = Process Step Measure
S1
S2
S3
S1
S2
PDSA4
PDSA4
PDSA3
PDSA2
PDSA1
Improvement Science Consulting
PDSA3
PDSA2
PDSA1
S3
= Learning Cycle
Measure
PDSA
What changes can we make which will
result in an improvement?
• This slide represents a good place to display a
driver diagram which you have created to
supplement your charter
• It is a place to display concepts you think
articulate why things are the way they are and as
a result where the leverage points exist for
change which will result in improvement
• If you have a change package or preliminary
change ideas for testing, these can be presented
here as well
Improvement Science Consulting
Conceptual Driver Diagram
Outcome
1⁰ driver
2⁰ driver
2⁰ driver
1
1⁰ driver
1
Change Concepts
Concept 1
Concept 2
2⁰ driver
2
Concept 3
Aim or
Outcome
2⁰ driver
3
1⁰ driver
2
2⁰ driver
4
2⁰ driver
5
Improvement Science Consulting
Concept 4
Concept 5
Concept 6
Specific Change Ideas
Ideas:
1
2
3
4
5
6
7
8
9
.
.
.
.
.
.
N
Who will lead and participate in
improvement?
• Critical to any improvement process is the
participation of people whom the improvement work
with effect
• On this slide it will be good to:
– Lay out who will be leading the change effort
– Who will support the change effort as part of a QI team? –
position and name if possible
– Who is sponsoring the change effort (to whom does the
change effort matter, which senior leader)?
– Who is accountable for the improvement initiative?
Improvement Science Consulting
Break out
• Spend some time formulating a real project,
whether you are ready to move on it now or not,
this will be a useful exercise
• Start with
–
–
–
–
Background info
Define the need
What are you trying to accomplish
How will you know a change is an improvement
(measures)
– What changes can you make (theory for change)
– Who will be involved in the effort
Improvement Science Consulting