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Managua, Nicaragua July, 2007

Plan-Do-Study-Act (PDSA) Cycles. Managua, Nicaragua July, 2007. What is a PDSA Cycle?.

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Managua, Nicaragua July, 2007

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

  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. Why should we test changes? • 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

  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 Ask one patient if he/she would like more information on how to manage his/her blood sugar.

  6. Steps in the PDSA Cycle • Step 2: Do • Try out 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 small test with a limited impact that 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. Tips for Testing Changes • 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.

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