Share ideas & resources for improving health & self-management support
The PDSA cycle is a method for rapidly testing a change - by planning it, trying it, observing the results, and acting on what is learned. This is a scientific method used for action-oriented learning.
After changes are thoroughly tested, PDSA cycles can be used to implement or spread change. The key principle behind the PDSA cycle is to test on a small scale and test quickly. The PDSA philosophy is to design a small test with limited impact that can be conducted quickly (days if not hours!) to work out unanticipated “bugs”.
Repeated rapid small tests and the learning’s gleaned build a process ready for implementation that is far more likely to succeed.
1. Plan – In this phase, your objectives are defined and your team makes predictions about what will happen, and why it will happen. Your team will answer the following questions:
2. Do – In this phase, your team will carry out the plan and collect the data. This will include documenting experiences, problems, and surprises that occur during this test cycle.
3. Study – In this phase, your team will analyze the test cycle and reflect on what you have learned. You will compare results with the predictions made in the planning stage, and draw conclusions based on the collected data.
A team learns from the test: What worked and what didn't work? What should be kept, changed, or abandoned? This new knowledge is used to plan the next test. The team continues linking tests in this way, refining the change until it is ready for broader implementation within the practice.
People are far more willing to test a change when they know that changes can and will be modified as needed. Linking small tests of change helps overcome an organization's natural resistance to change and ensures team buy-in.Tips for working with PDSAs
People generally want to solve their problems with one change and they try to implement the whole change with one plan. These are common pitfalls to avoid:
Plan: Over next 2 weeks, Dr A to use the Teach Back approach with at least 10 patients and ring them 3-5 days later to ask patients if they found it helpful or annoying.
Do:Task completed during first two weeks of June.
Study: Patients were surprised to be phoned, but appreciated being asked their opinion. None of the patients found the question annoying and 5 found it helpful commenting that it had clarified something they hadn’t understood.
Act: Dr A is interested to read a paper or presentation about this approach and keep using it with his patients over the next month.
(This could lead to another PDSA with Dr A sharing his findings with the rest of the staff at a practice meeting)
Question: Do our patients with long-term conditions find a care plan useful?
Plan: For 1 week ask all patients with significant long-term conditions if:
Design a short questionnaire with above questions. GPs to give to patients at end of consultation and ask at the time or give patients to fill in and place in box at reception).
Study Hypothetical , tell us what you find
Act Discuss findings with team and use information generated to inform the design and use of Care Plans.