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Advisory Council January 2018 Meeting Presentation: NAPA Driver Diagram

Friday, January 26, 2018

Printer Friendly Version in PDF Format (10 PDF pages)


NAPA Driver Diagram

Bruce Finke, Laura Gitlin and Rohini Khillan

Driver Diagrams

  • A Driver Diagram...
    • Is a logic model that provides a visual display of a team's theory of action.
    • Posits the actions necessary to achieve the shared aim.
    • Shows the relationship between the overall aim of the project, the primary drivers that contribute directly to achieving the aim, the secondary drivers that are components of the primary drivers, and specific change ideas to test for each secondary driver.*
    • Is a useful tool for communicating across a range of stakeholders and a team that is working toward a shared aim. A Driver Diagram is not... A hard and fast, set in concrete, plan
  • Basic format:
    1. Start with a clearly defined aim
    2. Identify "drivers" necessary to achieve that aim.
    3. Capture drivers -- and set these out in the diagram format.
    4. Identify actions or interventions for each driver.
    5. Identify measures for drivers and actions -- that help you understand progress toward the aim.

*Institute for Healthcare Improvement's Definition

Driver Diagram Template

Organizational chart: Starts with AIM, leads to Primary drivers, which lead to Secondary drivers, and ends in Change ideas.

NAPA Driver Diagram

  • The intent was to lay out clearly how the various aspects of NAPA work and tie together
    • National Plan, Council recommendations, Summit work, federal and non-federal activities to address recommendations
  • Provides a broad overview of where things fit together and affect each other
  • Intended to be very flexible, but will hopefully allow us to see the progress made over time

First Round

  • Aim: Eliminate the Burden of Alzheimer's Disease and Related Dementias
  • Primary Drivers: 5 goals of the National Plan Given the amount of overlap, Goals 2 and 3 are together
  • Secondary Drivers: Strategies under the five goals in the National Plan
  • The subcommittee and federal workgroup chairs met to discuss and further work out the diagram


Aim Primary Driver Secondary Driver
Eliminate the burden of Alzheimer's Disease and Related Dementias Prevent and Effectively Treat Alzheimer's Disease by 2025 Identify Research Priorities and Milestones
Expand Research Aimed at Preventing and Treating
Accelerate Efforts to Identify Early and Pre-symptomatic Stages
Coordinate research with International Public and Private Entities
Facilitate Translation of Findings into Medical Practice and Public Health Programs
Enhance Care Quality and Efficacy Build Workforce
Ensure Timely and Accurate Diagnosis
Educate and Support People with Dementia and their Families
Identify High-Quality Dementia Care Guidelines and Measures Across Care Settings
Explore the Effectiveness of New Models of Care
Ensure Safe and Effective Transitions between Care Settings and Systems
Advance Coordinated and Integrated Health and Long-Term Services and Supports
Improve Care for Populations Disproportionately Affected by Alzheimer' Disease and for Populations Facing Care Challenges
Expand Supports for People with Alzheimer's Disease and Related Dementias and their Families Ensure Receipt of Culturally Sensitive Education, Training, and Support Materials
Enable Family Caregivers to Continue to Provide Care while Maintaining Their Own Health and Well-Being
Assist Families in Planning for Future Care Needs
Maintain the Dignity, Safety and Rights of Persons with ADRD
Assess and Address the Housing Needs
Enhance Public Awareness and Engagement Educate the Public
Work with State, Tribal, and Local Governments to Improve Coordination and Identify Model Initiatives to Advance Awareness and Readiness across the Government
Coordinate United States Efforts with Those of the Global Community
Track Progress and Drive Improvement Enhance the Federal Government's Ability to Track Progress
Monitor Progress on the National Plan

Expanded Version

  • Added the following columns:
    • Themes/Concepts: areas of focus for each of the subcommittees, as well as from the Care Summit
      • AD and ADRD summits can be added to this as well
    • Recommendations: Recommendations made by each subcommittee or summit related to a specific theme
    • Activities (Federal and Non-federal): Activities conducted by either the federal agencies or non-federal partners to address recommendations made


Aim Primary Driver Secondary Driver Theme/ Concept Theme/ Concept Rec Rec (2017 Rec) Activity (Fed Response)
Eliminate Burden of ADRD Prevent and Effectively Treat ADRD by 2025 Identify Research Priorities and Milestones Research Subcom Theme Robust Research Road Map for achieving Goal Research Subcom Rec The 2017 National Plan should continue to provide a robust, comprehensive, and transformative scientific Road Map for achieving the goal of preventing, effectively treating, and providing effective care and services for AD/ADRD by 2025 NIH: AD and ADRD Summits continue to provide guidance on developing a research roadmap. The annual Bypass Budget provides further assistance in developing a roadmap

Future Questions

  • Does this make sense?
  • How can we expand it to include greater details (like the bullets under each recommendation)?
  • How can we better incorporate the AD and ADRD Summits?
  • How should we continue to update this going forward?



HANDOUT: NAPA Driver Diagram - Draft

Aim Primary Drivers Secondary Drivers Actions Recommendations (2017) Activities (Federal)
Eliminate the burden of Alzheimer's Disease Prevent and Effectively Treat Alzheimer's Disease by 2025 Identify Research Priorities and Milestones Robust Research Road Map for achieving Goal The 2017 National Plan should continue to provide a robust, comprehensive, and transformative scientific Road Map for achieving the goal of preventing, effectively treating, and providing effective care and services for AD/ADRD by 2025 CMS Response
CMS has supported work led by ASPE to engage in efforts to plan research summits on ADRD, including a fall 2017 summit on care and services. Through the "Connected Care" campaign, CMS, working with HRSA, is raising awareness of the benefits of Medicare's CCM service for beneficiaries with multiple chronic conditions including ADRD, and furnishing resources for implementation across all diverse populations. CMS is driving efforts to empower beneficiaries and their providers to make decisions, take ownership of their care, and make certain they have the information they need to make informed choices
NIH Response
NIH will continue to engage a broad range of stakeholders, including academia, industry, NGOs, and individuals directly affected by AD/ADRD, in advancing the goals of the National Plan. This Plan focuses on identifying effective interventions and improving care and services, and its future updates will build upon research advances and emerging opportunities, and will be informed by additional research summits as well as feedback from the broader community. Upcoming summits that will provide guidance regarding future implementation of the Plan's goals include a summit focused on AD/ADRD care and services research in October 2017, and large AD and ADRD summits in 2018 and 2019, respectively.
NIH leadership and staff continues to update its specific research plans and cost estimates annually, as outlined in each year's Bypass Budget for Alzheimer's Disease and Related Dementias. Part of this process involves regularly updating, implementing, and tracking a broad set of specific AD/ADRD research milestones. To enable federal agencies and other organizations to track progress in reaching these milestones, NIH has made a searchable database available to the public. The Advisory Council's recommendations regarding specific research milestones will greatly contribute to these NIH planning processes.

January 26, 2018 -- Advisory Council Meeting #27

The meeting was held on Friday, January 26, 2018, in Washington, DC. The Research Subcommittee took charge of this meeting's theme, focusing on the process from targets to treatments. The Council heard speakers on the preclinical pipeline, the clinical trial pipeline, and the industry perspective. The meeting also included discussion of a driver diagram to guide the Council's future work, updates and a report from the October Care Summit, and federal workgroup updates. Material available from this meeting is listed below and at

Comments and questions, or alerts to broken links, should be sent to


General Information




Presentation Slides



  • Updates since October meeting -- [Video]

  • NAPA Driver Diagram -- [Video]

  • Federal Updates -- [Video]

  • Public Comments -- [Video]

  • Research Subcommittee Agenda -- [Video]

  • Care Summit Update -- [Video]