Refining aim and change theory

The service development team should use the learning from understanding the current system to refine their aim. When refining the aim, you should consider what "better" looks like and what parts of the current job planning processes may be a higher priority to change first.

Ideally the aim will become more specific. Any changes should be updated in the project charter.

Driver diagram

The driver diagram below outlines the change theory that will help the service development team achieve their aim. 

The service development team can customise the driver diagram to a service by adding a specific aim and adding additional secondary drivers that are specific to that service.  More information on driver diagrams can be found on the QI zone.

Measurement plan

Measurement will help you determine if the changes you have made to your system are having the desired impact outlined in the driver diagram.  The Team Service Planning measurement plan specifies the measures to use whilst implementing changes.  The data collection template will help you collect and present data as run charts. 

The measurement plan has three types of measures:

• Process measures relate to the primary drivers of the driver diagram and can demonstrate if the changes you make are starting to change how your system works.
• Outcome measures relate to the aim to demonstrate the impact of your changes. 
• Balancing measures are used to determine if your changes are having an impact elsewhere in your system.

More information about run charts and using measurement for improvement can be found in the QI Zone.

Your theory of change

Please get in touch if you have customised the driver diagram or measurement plan to better meet your local situation.  You can contact us through the feedback form or by emailing us at his.accessqi@nhs.scot.