5.9 References

Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. (2009). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd ed.).

Key Driver Diagrams as a tool connecting AIM to change ideas within the Model for Improvement

The KDD is a core planning tool in the IHI Model for Improvement ecosystem, used to organize the third question ('What change can we make?') after the AIM is set. Langley et al. (2009) is the foundational source for KDD methodology and its role in structuring PDSA work.

Institute for Healthcare Improvement (IHI). (2024). Driver Diagram.

KDD structure, tool template, and application guidance. Also supports Section 5.4's "What Do We Mean by 'Impact' and 'Effort'?" definitions (the criteria used to judge high/low on each axis) and the blank fillable Effort/Impact Matrix template that follows it, giving teams a tool to apply the same prioritization approach to their own change ideas.

Section 3 describes the step-by-step process for building a KDD (AIM → Key Drivers → Change Ideas) and the Effort/Impact Matrix for prioritization. The IHI Driver Diagram resource provides an accessible template and how-to guidance that learners are directed to use.

Provost LP, Murray SK. (2011). The Health Care Data Guide: Learning from Data for Improvement.

Connecting measurement to key drivers; using data to prioritize which drivers to address first

Module 5 builds on Module 4's measurement framework by using data to prioritize key drivers. Provost & Murray's data guide bridges the measurement and driver diagram work, supporting the module's guidance on using the Effort/Impact Matrix informed by data.

Institute for Healthcare Improvement (IHI). (2024). Cause and Effect (Fishbone) Diagram.

Fishbone diagrams as a tool for identifying root causes that become key drivers

Section 2 of Module 5 references tools from Module 1 — including fishbone diagrams — as inputs to KDD development. The IHI Fishbone resource is cited here because the module explicitly positions root cause analysis as the foundation for identifying meaningful key drivers.

Institute for Healthcare Improvement (IHI). (2024). Process Mapping.

Process mapping as a tool to identify workflow gaps that surface as key drivers

Module 5 explicitly lists process maps as a tool supporting KDD development. The school clinician example in Module 1 (3 undocumented handoffs) directly generates key drivers for Module 5's referral tracking KDD example. The IHI Process Mapping resource supports this connection.

Institute for Healthcare Improvement (IHI). (2024). How to Improve: The Model for Improvement.

KDD as the bridge between the AIM (Module 3) and PDSA cycles (Module 6) in the Model for Improvement

Module 5 is explicitly positioned as the bridge between writing a SMART AIM and launching PDSA cycles. The IHI Model for Improvement resource establishes the structural role of the KDD in the overall improvement framework.