5.5 Example Key Driver Diagram

Seeing a Key Driver Diagram in action can make the process easier to understand and apply. The examples below illustrate how teams in different settings can translate an improvement goal into key drivers and actionable change ideas, creating a clear pathway from planning to implementation.

Example KDD — Depression Screening

AIM Statement Key Drivers Change Ideas

Increase depression screening for youth (12–17) from 45% to 80% by December 2025 in our pediatric clinic

Reliable workflow
  • PHQ-A added to standard intake forms
  • EMR auto-prompt at check-in
  • Medical assistant completes screening before provider enters room

Staff training and buy-in
  • Weekly huddles on workflow
  • Peer champions in each clinic pod
  • Brief training on responding to positive screens
  • Celebration of screening milestones

EMR integration
  • Screening prompt and auto-documentation
  • Alert for positive screens routed to provider
  • Auto-referral trigger for scores above threshold

Family engagement
  • Patient/family handout explaining purpose of screening
  • Warm introduction by medical assistant
  • Screening framed as routine care, not interrogation

Audience-Specific KDD Examples

The table below summarizes each audience’s scenario, key drivers, and change ideas, alongside the takeaway that makes the example worth remembering.

Audience Scenario / Application Key Takeaway

Emergency Physician

AIM: Increase the percentage of adolescents receiving suicide risk screening within 60 minutes of ED arrival from 45% to 85%. Key Drivers: EMR integration, triage workflow redesign, staff training on C-SSRS, disposition protocols, charge nurse accountability. Change ideas include auto-populated screening in triage, a mandatory field before disposition, and a monthly compliance report by provider.

The KDD reveals that triage workflow and EMR placement are higher-priority drivers than additional training alone.

EMS Team / EMS Medical Director

AIM: Reduce inappropriate transport destinations for youth in behavioral health crisis from 60% to 20%. Key Drivers: Crew training, protocol availability, dispatch decision support, destination agreements. Change ideas include a laminated decision card in every unit, a dispatch script for behavioral health calls, quarterly scenario-based training, and signed destination agreements with 3 receiving facilities.

Each driver has 2–3 testable change ideas. The laminated card (low effort, high impact) is the natural first PDSA.

PECC

AIM: Achieve 95% suicide screening at triage across all shifts. Key Drivers: Consistent triage protocol, EMR prompt visibility, charge nurse verification, shift handoff communication. Effort/impact matrix sequencing: EMR prompt for screening is the high-impact, low-effort first step; charge nurse verification is the high-impact, moderate-effort second step.

The KDD organizes the PECC’s multiple improvement levers into a logical, sequenced plan.

School Clinician

AIM: Increase the percentage of referred students attending their first appointment within 30 days from 35% to 70%. Key Drivers: Timely referral submission, family engagement, appointment availability, follow-up tracking.

The KDD surfaces family engagement as an under-addressed driver — most interventions to date have focused on referral logistics, not family connection.

Primary Care Team

AIM: Reduce referral-to-appointment wait time from 45 to 20 days. Key Drivers: Referral process clarity, care manager role, warm handoff, appointment access, insurance navigation. Change ideas include care manager warm handoffs, a same-day brief behavioral health visit, and an insurance pre-authorization checklist.

Change ideas span process redesign and resource activation. The care manager warm handoff is the highest-impact, moderate-effort starting point.

Behavioral Health Staff

AIM: Increase the percentage of families receiving a documented safety plan at ED discharge from 55% to 95% by June 2026. Key Drivers: Standardized documentation workflow, staff training on safety plan delivery, family engagement during discharge, EMR integration. Change ideas include a safety plan template embedded in the discharge documentation screen (high-impact, low-effort first step), a mandatory completion field before disposition, brief staff training on teach-back technique, and a “safety plan station” with printed materials in the behavioral health area.

Documentation workflow and family engagement are co-equal drivers — improving one without the other will not reach the 95% target.

Hospital Leadership / CMO

AIM: Reduce average ED boarding time for pediatric behavioral health patients from 14 hours to under 8 hours by December 2026. Key Drivers: Psychiatric coverage availability, inpatient bed access, disposition decision support, care coordination, leadership accountability structures. Change ideas include telepsychiatry during off-hours and a daily boarding brief at operations huddle (both high-impact, low-effort starting points), a dedicated behavioral health inpatient unit, a standardized disposition criteria checklist, and a behavioral health navigator role.

A leadership KDD spans multiple departments and requires executive authority to act on. The most impactful early changes are those that increase visibility and coordination — not just add capacity.

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