Key Driver Diagrams

A driver diagram is a visual display of a team’s theory about what is needed to make improvements, and often serves as a roadmap.  This tool is used for analysis, organization, and communication to help direct the improvement work. By using a key driver diagram, change teams focus on the influences in cause and effect relationships in complex systems. Driver diagrams are structured logic charts, which help teams to “see” these relationships and to organize their work. The Key driver diagram provides a “theory of change” and is used as a planning and analysis tool at the initiation of a project, and throughout the project to stay focused. Drivers need to be updated throughout the life of a project, to acknowledge continuing improvement and extend the life of the improvement work.

For current TIPQC Key Driver Diagrams:

TN Antibiotic Stewardship

On March 6th, 2018, TIPQC launched IPP LARC as a Maternal Quality Improvement Project.  The goal is to increase access to IPP LARC for all women in Tennessee by working with providers, hospitals, pharmacies, nurses, lactation consultants, and insurance providers to decrease barriers and extend IPP LARC access across the state of Tennessee.  Ultimately, this goal will help women have control over their reproductive choice while improving the health of infants through the lowering of unintended and short-interval pregnancy rates and hopefully the rates of neonatal abstinence syndrome across the state.  The immediate aim of TIPQC is to increase IPP LARC access to 50% of the participating delivering institutions in Tennessee and 70% of eligible women by March 2019.

Click to read the full article or to apply, contact:  Brenda.Barker@tipqc.org.

Dr. Stevens and colleagues recently reported in the Journal of Pediatrics from the New York State Perinatal Quality Collaborative (NYSPQC) on their efforts to reduce postnatal growth restriction, defined as discharge weight <10th percentile for postmenstrual age.  Infants less than 31 weeks gestational age admitted to a New York State Regional Perinatal Center within 48 hours of birth during the years 2010 through 2013 and survived to discharge were included in the cohort. Cohort demographics (gestational age, birth weight, survival, male gender) were similar during the four year study period.  The incidence of small for gestational age infants at birth ranged from 7.8% to 9.3%.  The teams adopted better nutritional practices identified through literature review and collaborative learning. The incidence of postnatal growth restriction decreased by 19% from 32.6% in 2010 to 26.3% in 2013 (p<0.01).  The delta weight z-score from birth to discharge decreased from -0.78 to -0.68, also a significant improvement.  There was no difference in the incidence of sepsis and necrotizing enterocolitis, duration of hospital stay and postmenstrual age at discharge. Targeted changes in initiation of feedings, earlier breast milk fortification and having a protocol for gastric residual management appear to have played a role in the improvements seen. J Pediatr Apr 2018