Sonja Orff RN, MS, CNL, CSCT

Maine Medical Center, Department of Surgery, Operative and Perioperative Services


Learning Objectives:

  1. Describe the purpose of a storyboard
  2. Summarize the utilization of a storyboard as a quality improvement tool
  3. Synthetize the key elements of a storyboard

What is a Storyboard?  

A storyboard is a visual collage of a particular subject or subject matter. It is a page-limited document that tells a story. The board can be merely illustrations, or the illustrations can be combined with text. Storyboards are an alternate way to communicate, disseminate, and share knowledge and information to a variety of audiences. The condensed platform portrays and organizes the author(s) thought processes and the assimilation of ideas as they integrate and converge in some ways and radiate and branch off in others.1

History of the Storyboard

Leonardo da Vinci was thought to be the first person in history to utilize storyboards. His talents as an illustrator are perfect examples of one-page documents telling a clear and concise story. Many of his sketches and works have been used as blueprints to replicate different types of working models2 (Figure 1).

Figure 1. Leonardo da Vinci, Machine Gears Engineer Sketch

In the 1930s Walt Disney Studios was known to utilize storyboards in the pre-production phase as a tool to plan and develop engaging and coherent stories3 (Figure 2).

Figure 2. Walt Disney and storyboard.

In the early 1960s, Hughes Aircraft Company adopted storyboards from the film industry as a business communication tool. The aircraft engineers used the storyboard as a way to organize subject matter in a page-limited document.1

Today, the use of storyboard varies depending on the audience and the innovation of the creators. Examples are the use by industries for ad campaigns, commercials, movies, proposals, and project management.

Storyboards and Quality Improvement

As a quality improvement tool, storyboards can be used as a way to communicate and/or showcase a team’s decisions and steps undertaken to solve a particular problem. The storyboard pulls in compelling information to educate its audience on how the team came to work on a particular concern and how the team achieved their outcome(s).  It is a document that provides information on the whole project. Storyboard is a tool that keeps all team members on the same page and can be a team building process that generates enthusiasm for the project. Quality efforts can be complex and the storyboard provides a format to showcase difficult to understand work while bringing it to life. This visual method to display work provides a context for discussion and feedback in which there is opportunity to acquire important insight. For quality improvement, the storyboard serves as a consistent document that highlights a team’s efforts in an organized high-level fashion, from the beginning to end of a project, with the intent to convince or persuade an action.4

“When you help people understand what you do, you’ll be more successful in attracting support for your work.” 5

Key Elements of a Quality Improvement Storyboard: Format, Attract, & Share

When you create a storyboard considering the following essentials6,7:

  • Choose a formatg. : Plan Do Study Act (PDSA), DMAIC (Define, Measure, Analyze, Improve, Control), or other
  • Define the concern
  • State a clear purpose and problem statement
  • Provide clear example(s) of why the topic is relevant
  • Provide background information and metrics when necessary
  • Showcase the team and the steps taken to reach a goal
  • Show connectivity of work process
  • Ensure it is a page-limited document
  • Attract readers with use of picture aides
  • Visually exhibit the analysis: fishbone diagrams, control charts, histograms, Pareto charts, surveys
  • Share relevant information
  • Use data to back up recommendations
  • Share barriers and new ideas
  • Share best practice
  • Highlight progress
  • Show innovation


Below an example of a quality improvement storyboard8 (Figure 3).


Figure 3. Safe Surgery Debriefing.


  1. Barkman, P. (1985), The Storyboard Method: A Neglected Aspect of Organizational Communication. The Bulletin, September 1985, P 21-23.
  2. StudyMode, 2020, retrieved, August 2020,,became%20the%20planning%20process%20for%20Disney%27s%20entire%20organization.
  3. Carnahan, A. (2013), retrieved, August 2020,
  4. Fraser, S. (2003) Project storyboards: catalysts for collaborative improvement. International Journal of Health Care Quality Assurance, 16, 6/7 p. 300-305.
  5. Harvard Business Review, 2014, retrieved, August 2020,
  6. Institute for Health Care Improvement (IHI), 2020, retrieved, August 2020,
  7. Lean Six Sigma, 2005, retrieved, August 2020,
  8. Orff, S. 2019, Safe Surgery Debriefing. Greenbelt Walk, Portland, Maine.
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