PDSA-Cycles-Delon PDSA-Cycles-Delon PDSA-Cycles-Delon

PDSA

1. Managua, Nicaragua
July, 2007
Plan-Do-Study-Act (PDSA)
Cycles

2. What is a PDSA Cycle?
•A PDSA (Plan-Do-Study-Act) cycle is a way of determining if a change
leads to an improvement. It is a method for rapidly testing a change -by
planning it, trying it, observing the results, and acting on what is learned

3. Why should we test changes?
•To increase belief that the change will result in
improvement
•To decide which of several proposed changes
will lead to the desired improvement
•To evaluate how much improvement can be
expected from the change

4. •To decide whether the proposed change will
work in the actual environment
•To evaluate costs/impact/side effects from a
proposed change
•To minimize resistance upon implementation
Why should we test changes?

5. Steps in the PDSA Cycle
Step 1 -Plan
Plan the test or observation, including a plan for
collecting data.
•State the objective of the test
•Make predictions about what will happen and why
•Develop a plan to test the change (Who? What? When? Where?
What data need to be collected?)
Example
Askonepatientifhe/shewouldlikemoreinformation
onhowtomanagehis/herbloodsugar.

6. Steps in the PDSA Cycle
Step 2: Do
Tryout the test on a small scale.
•Carry out the test
•Document problems and unexpected observations
•Begin analysis of the data
Example
On Tuesday Dr J asked her first patient with diabetes

7. Steps in the PDSA Cycle
Step 3: Study
Set aside time to analyze the data and study
the results.
•Complete the analysis of the data
•Compare the data to your predictions
•Summarize and reflect on what was learned
Example
Patient was interested; Dr J. was pleased with the
positive response.

8. Steps in the PDSA Cycle
Step 4: Act
Refine the change, based on what was learned
from the test.
•Determine what modifications should be made
•Prepare a plan for the next test
Example
Dr J. will continue with the next five patients and
set up a planned visit for those who say yes.

9. PDSAs versus Traditional QI
•The PDSA philosophy is to design a smalltest
with a limited impactthat can be conducted
quickly(days if not hours!) to work out
unanticipated “bugs.”
•Traditional quality improvement:
•Laborious planning that attempts to account
for all contingencies.
•Often results in failed or partial
implementation after months or even years
of preparation.
PDSAs are the scientific method for action-oriented
learning.

10. Linking Tests of Change
•Testing changes is an iterative process.
•Team learns for each test.

11. Tips for Testing Changes
•Think a couple of cycles ahead.
•Scale down the size of the test (number of
patients or locations).
•Test with volunteers or those who want to work
with you.
•Do not try to get a consensus.
•Don’t reinvent the wheel.

12. •Be innovative to make the test feasible.
•Pick easy changes to try.
•Collect only useful data during each test.
•Avoid technical slowdowns.
•Test over a wide range of conditions.
•Try a a test quickly (e.g. what change can we
test by Friday?).
•Be prepared to end the test of change.
Tips for Testing Changes