Lung Cancer Screening Improvement Collaborative
Mammography Positioning Improvement Collaborative
Prostate MR Image Quality Improvement Collaborative
Recommendations Follow-Up Improvement Collaborative

Glossary of Terms

A3:  The ImPower A3 template outlines the structured problem-solving process utilized to complete a project.  It is a tool for communication, coordination, and consensus building.  The template is filled in as the team progresses, documenting their project's progress as consensus is reached and telling their project story.  The left side contains the problem statement, global aim, SMART goal, measure performance, and current state analysis.  The right side contains key drivers, interventions, and sustain plans.


Cause and Effect Diagram: A tool used to capture, display, and sort causes of a specific problem.  This tool is often referred to as a fishbone diagram since the head contains the problem statement and the body contains categories for sorting observations. Your observations will populate the diagram to validate the depth and understanding of your analysis.  This organization of information can aid in the emergence of root causes. 

Control Chart: A graph used to better understand how a process is performing over time. A control chart contains a central line denoting the average of a collection of data points and upper and lower control limits acknowledging the range of variation in the process.  As changes are made to the process the control chart can validate the effectiveness of an intervention.


Current State Analysis: A series of activities that teams participate in to develop a deep, shared understanding of their current process, problems, and people.  This is best completed by the individuals who perform and oversee the work.  Tools used during the current state analysis include process maps, cause-and-effect diagram, control charts, and pareto charts.  During current state analysis, teams identify theories about what they think is happening and then observe the process, ask clarifying questions and rely on data to gain consensus on what is happening.  Teams do not disrupt the process, jump into the work, make changes or corrections to the process, or make judgements.


5 Whys: An exercise to identify the underlying root cause of a problem.  Asking "Why?" multiple times can facilitate a deeper understanding of the identified problems to aid in a nuanced approach to solutions. 


Gemba: A Japanese term meaning "the actual place", referring to the place where work is done.  Throughout the project, teams will "go to the gemba" to gain first-hand experiences of the project-related processes. 


Global Aim: The global aim is the high-level objective that the project is in service of.  This is the compelling mission that aligns with the organizational goals and energizes the project team to successfully complete the project.


Intervention:  An intervention is a specific idea being tested in a PDSA cycle.  Intervention testing can increase the understanding of the process and validate the effects of that specific intervention on the outcome.  Each intervention will address a specific key driver or will be in service of multiple key drivers. 


Key Driver: Project sub-goals that directly address the root causes that have been identified.  There are typically four to six key drivers, and they are worded as things that must happen consistently, or structures that need to be in place, for the team to reach their goal.  They are not specific interventions.


Pareto Chart: A bar chart that helps teams validate and refine their hypothesis of root causes.  It helps them identify the "vital few" from the "trivial many" causes.  


Physician Leader:  A role on the project team that helps to lead team and clinical decision making at your organization as well as across the collaborative.


PDSA: Plan Do Study Act is a systematic way to test small scale change.  It is a four-stage problem-solving method used to test and refine interventions before implementing them broadly within the process.

Problem Statement: The problem statement is the "what", not the "why" of the problem.  It is the statement that frames the project and clearly states the problem you are trying to solve. The problem statement does not include the goal or implied solution.


Process Map: A step-by-step visual representation of the process.  A high-level process map includes 5-10 process steps and is used to give context to the project and outcome measure(s). Detailed process maps can be developed to aid in the understanding of the current state.


Process Owner: Managers or supervisors who have responsibility for the process and the people working in the process.  They may not be on the project team, but need to be kept in the communication loop, because they will oversee the process when the project is complete.


Project Charter: The project charter is a document that guides the sponsor and leadership team to effectively frame the project.  The charter includes project title, problem statement, the global aim, outcome measure, project scope, and team members.  Once the charter has been completed, the project is "handed over" to the project team and the team will use this document to guide the boundaries of their project. 


QI Coach: A role on the project team to guide the application of QI concepts in the organization's local environment.  The QI coach is the most robust role on the project team.  They partner with the team leader to manage the project and team, participate in additional training to guide improvement and support change management throughout the project.


Root Cause: The root cause is the core issue, the highest-level cause, that ultimately leads to the problem.  When this cause is effectively addressed, you can expect see a positive shift in your outcome.


SMART Goal: SMART goals are Specific, Measurable, Achievable, Relevant, and Time-bound.  SMART goals are stated as what you want to achieve, from what, to what, by when.  Example: Increase the volume of lung cancer screening exams from baseline to target by September 2023.


Sponsor:  The person on the project team with organizational authority who provides resources and is highly committed to achieving the goals; typically, a manager, director, division head or chief of the people participating on the project team.  A team may have more than one sponsor depending on their organization structure.  


Sustain Plan: The sustain plan is an outline of how new processes or programs will be supported after the end of the improvement program.


Team Leader:  A role on the project team that participate as a team member and is also responsible for team and project management.  They have regular communication with the QI coach, ImPower program leaders, and project sponsor(s).


Team Member: Front-line staff that work within the process you are trying to improve.  They do the project work and are liaisons for their role in the department.  

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