So what changes are we actually going to make? You will probably have a few ideas of your own already and some of these could have a high chance of success. However, we want to draw out all the potential ideas we can, because there might be ideas we hadn’t thought of ourselves or ideas from other people that may be just as good. Once we have many ideas, we can decide which ones we want to try first.
A tool which is very useful in exploring different ideas is a driver diagram. We work in very complex systems, with many factors influencing all parts of clinical practice. Identifying the main factors that influence your aim allows us to come up with different ideas to address them. Unfortunately, there is very rarely a ‘silver bullet’ idea that on its own solves everything and so using the driver diagram exercise to explore different change ideas is crucial to eventual success.
To construct a driver diagram you place your SMART aim, word for word, at the left hand side. You then branch factors that influence the aim to the right. Driver diagrams have 2 levels of branches:
Primary Drivers, which are the main general topics of influence
Secondary Drivers, which are the specifics within each general topic and themselves influence the primary drivers