Action Period
The period of time between learning sessions. During these periods, practice teams work on improvement in their practice or office settings. These teams are supported by the collaborative leadership (project team) and collaborate with other core QI teams on webinars.

Aim
A written, measurable, and time-sensitive statement of the expected results of an improvement process.

Change Concept
A general idea for changing a process. Change concepts are usually at a high level of abstraction but evoke multiple ideas for specific processes. “Simplify,” “reduce handoffs,” and “consider all parties as part of the same system,” are all examples of change concepts.

Key Changes
The list of essential process changes that will help lead to breakthrough improvement.

Key Driver Diagram
The Key Driver Diagram organizes the theory of improvement for a specific aim. It is a way to organize and visualize the relationship between the project’s goal, the high-level changes that will get you to your goal (key drivers), and the specific activities that a practice needs to complete (interventions). The key drivers provide a focus for changes to test. The CQN Immunization key driver diagram was developed to identify pathways to improve coverage rates and overall immunization care.

Learning Session
In a project, there are potentially two types of learning sessions. Face-to-face learning sessions and/or web-based, virtual learning sessions, hosted by faculty, during which participating core QI teams will learn and practice foundational information and skills for the project.

We call these learning sessionsrather than training workshops, asthese sessions are designed to optimize learning amongst the participating core QI teams, highlight successes, and share storiesto learn from one another. Core QI teamsleave these meetings with new knowledge, skills, and materialsthat prepare them to make immediate changes.

Implementation
Testing a change and making it a permanent part of the system. A change may be tested first and then implemented throughout the organization. Key Changes: The list of essential process changes that will help lead to sustainable system improvement.

Measure
An indicator of change. Key measures should be focused, aligned with the aim, and be reportable. A measure is used to track the delivery of proven interventions to patients and to monitor progress over time.

Model for Improvement
An approach to processimprovement, developed by Associates in Process Improvement, which helps core QI teams accelerate the adoption of proven and effective changes. The model is composed of three foundational questions and PDSA cycles.

PDSA Cycle
A structured way to test a process change in the real work setting. This includes:

  • Plan: a specific planning phase;
  • Do: a time to try the change and observe what happens;
  • Study: an analysis of the results of the trial; and
  • Act: devising nextsteps based on the analysis.

This PDSA cycle will naturally lead to the “plan” component of a subsequent cycle.

Process Change
A specific change in a process in the organization. More focused and detailed than a change concept, a process change describes what specific changes should occur. “Institute a pain management protocol for patients with moderate to severe pain” is an example of a
process change.

Run Chart
A graphic representation of data over time, also known as a “time series graph” or “line graph.” This type of data display is particularly effective for process improvement activities.

Sampling Plan
A specific description of the data to be collected, the interval of data collection, and the subjects from whom the data will be collected. It emphasizes the importance of gathering samples of data and how to obtain “just enough” information.

Spread
The intentional and methodical expansion of the number and type of people, units, or organizations using the improvements. The theory and application come from the literature on Diffusion of Innovation (Everett Rogers, 1995).

Tests of Change
A small-scale trial of a new approach or a new process. A test is designed to learn if the change results in improvement and to fine tune the change to fit the practice and patients. Tests are carried out using one or more PDSA cycles.