Table 1. Model for Improvement and Tools Associated with Each Stage.

Tufts CTSI Research Process Improvement Steps	Corollary in Model for Improvement	Tools and Descriptions
Establish Aim Conduct PRE-work: Prioritize a problem, Ready the team, Educate the team and develop a shared understanding of the problem Clarify area for improvement and goals in a single aim statement	Answer: “What are we trying to accomplish?”	Project Charter – Used to describe the target problem, establish project scope and goals, and delineate team members’ roles and responsibilities
		Cause and Effect or “Fishbone” Diagram - Graphically displays possible causes of a problem or opportunity for improvement
		Process Map - Illustrates existing process and future process. Helps to identify needed process changes
Identify process, outcome and balancing measures	Answer: “How will we know that a change is an improvement?”	Measurement Forms – Describe the numerator and denominator of each measure (Not used in case examples.
Identify change strategies based on PRE-work conducted above, standard change concepts, or the literature	Answer: “What changes can we make that will result in an improvement?”	Driver Diagram - Displays an improvement project in a single diagram, includes change strategies and provides a measurement framework for monitoring progress
Conduct Plan-Do-Study-Act cycles; study results; and adopt, abandon, or adapt change strategies	Conduct Plan-Do-Study- Act cycles; study results; and adopt, abandon, or adapt change strategies	Run Chart – Displays improvement measure results over time

See the Institute for Healthcare Improvement (IHI) website for additional information about tools and change concepts at: http://www.ihi.org/resources/Pages/Tools/default.aspx