Plan, Do, Study, Act (PDSA) cycles and the model for improvement

Tags: Guidance

14th January 2022

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PDSA Screenshot 2022 01 14 161339

What is it?

The model for improvement provides a framework for developing, testing and implementing changes leading to improvement. It is based in scientific method and moderates the impulse to take immediate action with the wisdom of careful study.

Using PDSA cycles enables you to test out changes on a small scale, building on the learning from these test cycles in a structured way before wholesale implementation. This gives stakeholders the opportunity to see if the proposed change will succeed and is a powerful tool for learning from ideas that do and don’t work. This way, the process of change is safer and less disruptive for patients and staff.

When to use it

When planning any improvement or change to work processes, it is essential to know what you want to achieve, how you will measure improvement and to be explicit about the idea to be tested. You may not get the results you expect so it is safer and more effective to test out improvements on a small scale before implementing them across the board.

How to use it

The framework includes three key questions to answer before testing an improvement concept and a process for testing change ideas.

Key questions

1. What are we trying to accomplish? (The aims statement).

2. How will we know if the change is an improvement? What measures of success will we use?

3. What changes can we make that will result in improvement? (The change concepts to be tested)

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This approach has been unusual in a healthcare setting because traditionally, new ideas are often introduced without sufficient testing.

The four stages of the PDSA cycle are:

Plan – the change to be tested or implemented

Do – carry out the test or change

Study – based on the measurable outcomes agreed before starting out, collect data before and after the change and reflect on the impact of the change and what was learned

Act – plan the next change cycle or full implementation

For the full document please download the attached PDF