A driver diagram showing primary and secondary drivers for a quality improvement project trying to improve the time taken for referrals to be made to a psychiatry liaison service.
From this, ideas for change can be generated, such as producing a short guide of how to complete the referral form, providing a short training session for staff, or ensuring referral forms are located with other referral forms in the hospital. As well as measuring the time taken for referral forms to be completed at regular intervals to assess the impact of the change, staff satisfaction scores and qualitative data could also be gathered.
Plotting results for the example quality improvement project in Fig. 3.
The time taken to complete referral forms was measured by timing eight junior doctors; each point on the graph shows the average of these measurements. A goal line (of 180 s) is shown and interventions made at each ‘plan, do, study, act’ (PDSA) cycle are labelled on the graph so the effect of each change can be clearly seen.