PDSA – Plan – Do – Study – Act

PDSA, or Plan-Do-Study-Act, is an iterative, four-stage problem-solving model used for improving a process or carrying out change.
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  • Guide
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REFERENCES

 

Associates in Process Improvement. PDSA Cycle.  Retrieved from web: http://www.apiweb.org/     31 May 2017

Bassard, M., Ritter, D.(2010). The Memory Jogger 2. Tools for Continuous Improvement and Effective Planning.Second Edition.Salem, NH: GOAL/QPC

Gillam, S., Siriwardena, A.N.,  (2013). “Frameworks for improvement: clinical audit, the plan-d-study-act cycle and significant event audit.”  Quality in Primary Care 2013;21:123-30

Handbook for Basic Process Improvement http://www.au.af.mil/au/awc/awcgate/navy/bpi_manual/handbook.htm,  retrieved 30 May 2017

Institute for Healthcare Improvement.  How to Improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx   Retrieved from web: 30 May 2017

Sollecito, W. A., Johnson, J. K. (2013). Continuous Quality Improvement in Health Care Fourth Edition.Burlington, MA: Jones & Bartlett Learning.

Spath, P. L. (2013). Introduction to Healthcare Quality Management, Second Edition.Chicago, IL: Health Administration Press.

White, S. V. (2012). Q Solutions: Essential Resources for the Healthcare Quality Professional.  Quality and Performance Improvement. Third Edition.Glenview, IL; National Association for Healthcare Quality

REFERENCES

How to PDSA

The Plan-Do-Study-Act (PDSA)

Brief video explaining how to conduct a PDSA cycle.

Materials Needed:

  • A team of people
  • Basic knowledge of Process Improvement tools.
  • A way to document and track the process, a paper or computerized method with graphs and chart.
  • Possible Quality Improvement tools to use: Affinity Diagram, AIM Statement, Cause & Effect (Fishbone) Diagram, Control Charts, Histograms, Process Mapping, Run Charts 

Plan

Document the Plan

Document what you plan to do. Describe the problem and state the objective.

Determine Nessecary Changes for Improvement

After identifying the major causes of the problem using the Model for Improvement, determine the necessary changes to improve the process. What will you do to improve?

Make Predictions

Make predictions about what might happen and why.

  • "If we do __________, then __________ will happen.

Develop a Plan

Develop a plan to test the change. Identify the following elements:

  • What is going to happen? (What are you testing?)
  • When is it going to happen?
  • How long will it last?
  • Who is responsible for making it happen?
  • What types of data will be collected? Who will collect it? How will it be collected?

Do

Implementation of the plan outlined during the Plan stage.

Carry Out the Test


  • Verify all systems are ready for data collection. 
  • Prepare staff regarding what will be happening during the "Do" phase. 
  • Train the individuals involved on how to collect the data. 

Document Problems and Observations

Document problems or unexpected observations. Include a space or way for staff to write down observations of occurrences during the day that may affect the data.

    • Were you able to follow the instructions in the Plan phase? If not, why not?
    • What occurred that interfered with the planned process?

Analyze the Data

  • Was the data collected per instructions?
  • Are there any gaps?
  • Use a bar graph, run chart, histogram or another tool to display data for easier analysis

Study

What did you learn?

Complete the Analysis

  • Are there patterns? 
  • What is the data telling you?

    • Compare Collected Data to Your Predictions

      • Was the test similar to or different from your predictions? 
      • What was unexpected in your findings? 

    Summarize

    • Summarize what was learned.

    Act

    Refine the change based on what was learned from the test.

    Determine if Modifications Need to be Made.

    Adapt, Adopt, or Abandon

  • Adapt - Make any necessary modifications to your data collection or teaching instructions.
  • Adopt the tool and the findings if everything meets expectations.
  • Abandon the test and begin again if the test did not accomplish what was expected.
    NOTE: This does not mean that you have a bad outcome. Only abandon if you did not measure what you intended to measure.
  • Prepare a plan for the next test.
    •  
    A PDSA planning worksheet outlining a test to observe providers and nurses to understand workflow disruptions and delays in patient care.
    PDSA cycle planning form detailing a direct observation study to identify causes of delays in patient care due to provider and nurse availability.

    Based on the example above, the team determines from data analysis that providers and nurses are unavailable most of the time due to 2 reasons:

    1. Too many interruptions from Pharmacy representatives.

    2. Attendance at mandatory meetings

    The team would initiate a new PDSA cycle to reduce wait times by minimizing or eliminating the interruptions mentioned above.

    The cycle would continue until the goals are met.

    Three sequential circular diagrams representing the Plan-Do-Study-Act (PDSA) cycle in continuous quality improvement.
    Illustration of iterative PDSA cycles demonstrating continuous quality improvement through repeated cycles of planning, doing, studying, and acting.

    PDSA Worksheet.docx

    PDSA Worksheet.pdf

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