by: Ann Loraine Galvez

MSN student
 It is a model for improvement that provides
framework for

testing

implementing
developing changes

quality
improvement
 It is based in scientific method and
moderates the impulse to take immediate
action with wisdom of careful study.
 It enables you to:

Building learning
Test out changes in the test cycles General
in small scale in a structured implementation
way
 It provides opportunity for the stakeholders
to see if the proposed change will succeed
 It 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 staffs.
In planning an improvement or change in the
work process. It is essential to know:
 what do you want to achieve?
 How you will measure improvement?
 The idea to be tested

You may not get the result you expect so it is

safer to test out improvement in a small case
before implementing them across the area.
1. What are 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 concept to be
tested)
What are we trying to accomplish?

How will we know that a change is an improvement?

What changes can we make that will result in improvement

Act Plan

Study Do
Plan – the change to be tested and
implemented
Do – carry out the test or change
Study – based on the measureable outcomes
agreed before starting out, collect data
before and after change and reflect on the
impact of change and what was learned.
Act – plan the next change cycle or full
implementation
 PLAN
ACT Define the objective,
questions and
Plan the next cycle. predictions.
Decide if change can Answers(Who? What?
be implemented Where? When?. Plan data
collection.

STUDY DO
Complete the analysis
of data.
Carry out the
Compare data to plan. Collect the
predictions. Summarize data. Begin
what was learned analysis of the
data.
 As with any change, ownership is the key to
implementing the improvement successfully.
It must involve a small range of colleague in
tying something out on a small scale before it
is fully operational, thus will reduce the
barriers to change.
 WHAT ARE WE TRYING TO ACCOMPLISH?
-Clear and focused goals with measurable target
(includes the length and aim of the project)
-It requires clinical leadership and focus on
problems concern.

HOW WILL WE KNOW THAT A CHANGE IS AN

IMPROVEMENT?
-Measure the outcomes which are tools for learning
and demonstrates improvement, not for judgment.
-Collecting data to demonstrate changes resulting an
improvement.

WHAT CHANGES CAN WE MAKE THAT WILL RESULT

IN IMPROVEMENT?
-These are potential changes that the team could
make. However, an evidence based literature and
previous improvement may suggest a small number
of changes leading to an improvement.
 SEQUENTIAL PDSA CYCLE

 PDSA cycles

SIMULTANEOUS PDSA CYCLE

 Act Plan

Study Do

Act Plan

Study Do

Act Plan
This cycles are common
Study Do when the study reveals
results that suggest a
different approach is
needed.
 OUTCOMES TO BE
COORDINATED
Act Plan

Study Do

Act Plan

Study Do
Act Plan

Study Do
 This cycles may occur when the change are
more complex, possibly involving several
departments. It is important to identify any
interactions between simultaneous cycles, as
a change in method in one cycle may alter the
impact of another somewhere in the process.
 Record your PDSA’s over time to capture the
learning and demonstrate the improvement
journey, which is often lost or not recorded.
TEAM: DATE:

AIM QUESTIONS YOU WANT AN ANSWER FOR THIS TEST.

Describe your first Person responsible When to be done Where to be done
/next test of change

PLAN
List of task needed to Person responsible When to be done Where to be done
set up for this change

DO RUN THE TEST

STUDY
Describe what actually happened when you ran the test.

Describe the measured results and how they compared to the predictions and what you learned
from the cycle.

ACT
Describe the modifications for the next cycle base on what you learned.
 TIPS
•Plan multiple cycles to test ideas.
•Test on a really small scale.
•Test the proposed change with people who
believe in the improvement. Don’t try to convert
people into accepting the change while on
process.
•Only implement the idea when you’re confident
you have considered and tested all the possible
ways of achieving the change.
 Continue with the new PDSA cycles and
continuous service improvement.
 Having identified the changes with greatest
benefits , the next stage is to fully implement
the change. This will require stakeholder
analysis. You may possibly need to use the
aspect of project management and benefits
realization.
 The PDSA cycle was first started out as PLAN,
DO, CHECK, ACT (PDCA) as introduced by
Walter Shewart in 1920.