Module 5
For PMHCA programs, problems such as inconsistent screening or poor follow-up with the teams they work with rarely have a single cause. They’re usually the result of overlapping system issues such as staffing, workflow, training, EMR design, family factors, and more. Without a structured way to organize these factors, teams often default to the most visible or familiar solution rather than the most impactful one.
A Key Driver Diagram helps you:
- Focus improvement efforts on the factors most likely to influence outcomes
- Ensure improvement strategies are grounded in system-level thinking rather than individual behavior alone
- Align team members around a shared understanding of what drives success
- Communicate the rationale for improvement efforts to leadership, funders, and frontline staff
💡 Real-World Application
Consider a team working to improve depression screening rates in a pediatric clinic. Their first instinct might be to provide additional staff training, which is a reasonable and familiar response. But when the team builds a Key Driver Diagram like the one you saw in 5.1, a different picture emerges.
Working from their aim — increase depression screening rates — the team identifies two primary drivers: consistent screening workflow and provider prompts at the point of care. Underneath those, the secondary drivers tell the real story: an intake process that varies by provider and time of day, and no EMR reminder to prompt screening before the visit begins. Staff training doesn't appear as a driver at all, because it wouldn't move either of these levers. Instead, the change ideas that map to these drivers are things like standardizing the intake script across shifts and building an EMR prompt tied to the visit type.
This is what a Key Driver Diagram does: it forces the aim, the drivers, and the change ideas onto one page, in one line of sight, so the team can see whether their planned change actually connects to something that drives the outcome — rather than just being the most familiar fix. It surfaces the system, not just the symptoms, and gives leadership, funders, and frontline staff the same shared picture of why a change idea was chosen.
This is what a Key Driver Diagram does: it surfaces the system, not just the symptoms. It helps teams focus improvement efforts on the most impactful drivers, ground their change ideas in evidence rather than assumptions, and communicate a clear rationale to leadership, funders, and frontline staff.