Elements of a quality improvement project

Focus on frailty

There are four elements to a quality improvement project: project aim, driver diagram, change ideas, and measurement. Click on the sections below to find out more about each of them.

Project aim

Setting a project aim

All quality improvement projects should have an aim that is:

  • Specific
  • Time bound
  • Aligned to the organisation’s objectives, and
  • Numeric (STAN)

The national aim for the Frailty Improvement and Implementation programme:

People living with or at risk of frailty have improved experience of and access to person centred, co-ordinated health and social care.

By [Insert Locally Agreed Date]:

  • More people over 65 are identified earlier as living with frailty
  • People living with frailty, carers and family members report positive experiences of health and social care services
  • Health and social care teams report improved integrated working

 

Driver diagram and change ideas

What is a driver diagram?

A driver diagram visually presents an organisation or teams’ theory of how an improvement goal will be achieved. It articulates which parts of the system need to change, in which way and includes ideas of how to make this happen. It is used to help plan improvement projects and ensure team engagement.

The primary drivers are the key components of the system that need to change to deliver the aim. The secondary drivers are the processes that influence the primary drivers. Changing the processes outlined in the secondary drivers should change the primary drivers and deliver the aim.

Change ideas

Change ideas are specific practical changes the project team can make to alter the processes in the secondary drivers. The following pages provide a list of change ideas. They are grouped by the primary driver that they influence. Teams should select change ideas to test and implement based on their understanding of the local system.

Teams can generate their own change ideas that will help drive change in the secondary drivers. One way of generating ideas is to use the question “How might we?” For example, “How might we engage with people and their families to improve the experience of care?”

Measurement

Measurement is an essential part of improvement as it helps the project team understand if the changes they are making are leading to improved care. Below you will see an outline of three types of measures used in improvement and a link to the measurement framework.

Outcome measures

Outcome measures are used to understand if the changes are resulting in improvements towards the aim.

Process measures

Process measures demonstrate that change ideas are improving the underlying processes that contribute towards falls prevention.

Balancing measures

Balancing measures are used to determine if the changes are affecting things elsewhere in the system (unintended consequences).

The suggested measures for this toolkit are for teams to use in their local context and area of focus for frailty improvement. You may identify other concepts and changes that require measurement to further understand your progress towards improved care. Our team’s contact details are available in the introduction should you wish to discuss measurement for improvement.