Change Ideas
What is it?
Change ideas are the things that you are going to change to see if it makes an improvement. These ideas are then tested within PDSA cycles or ‘tests of change’.
Why use it?
Without introducing changes, you can’t make improvements.
How to use it?
Before coming up with change ideas, make sure you truly understand your system and that your aim is written to reflect your problem. Consider planning tools such as fishbone diagrams and process maps as well as data to diagnose the problem.
Ensure that your change ideas relate directly to your aim. A driver diagram will help you to determine which change ideas relate to your aim.
There are many ways to come up with your change ideas. Some include:
Get ‘system experts’, like patients and staff involved in thinking up change ideas. People who use the system often are most likely the people with ideas for how to improve it. You can use dot voting to help prioritise new ideas. Creating change ideas together (i.e. including your whole team) can make it easier to get people to try new processes because they were involved in the decision making
Look over your planning tools (e.g. fishbone diagram, process map) to see if there any areas where you can test a change
Use change concepts to come up with ideas
Look outwards. Other teams, health boards or organisations may have already looked at your problem and have some good ideas for tests of change. Remember to adjust these to meet your needs. Some good places to start looking can include:
our projects page
projects from the Quality Academy
When you are thinking about change ideas, you should be aware of the difference between a change idea and a task. Change ideas are often changes you are making to the process. These are things you’re going to do regularly (or not do if your change idea is to remove a step) rather than things that happen as a one off.
Change ideas should be measurable. One tip is to put “To test….” in front of everything you have identified as a change idea, to see if it is something you can test out and measure, or whether it is a thing that just needs to be done either before you start your test or as part of your QI project.
e.g. Moving all appointments for coil fittings to after 9am would be a change idea, making changes to the booking system would be a task.
Change ideas are linked intrinsically to many other QI tools and stages:
Driver diagrams: link tests of change to broader ideas and concepts
Fishbone diagrams: identifying causes to a problem will help generate best change ideas
Process maps: identifying problems in the process will help generate ideas for change
PDSA cycles: a format used to evaluate a whether a change is an improvement
Pareto charts: can be used to focus where your tests of change should begin
Dot voting: can be used to prioritise the order that you test change ideas
Prioritisation matrix: can be used to prioritise the order that you change test ideas.
Once you have prioritised your change ideas, you should test them out one at a time using a PDSA approach.
More information
Quality Improvement Zone NES - click for more information about change ideas.
IHI - click for further explanation of testing changes