Plan Do Study Act Cycle Graphic

The ImproveCareNow Network uses ongoing, rapid improvement cycles to test changes and determine whether they result in an improvement. We use a tool called the PDSA cycle. Everyone uses them: care teams, the PAC, the Parent Working Group, our staff and leadership. We all use PDSAs to think carefully about and record what we want to improve (our SMART aim) and what changes to test as possible improvements.


Remember from this post, that the first step is to ask "What do I want to improve?" The answer to that question becomes the aim, which is written and rewritten to make it SMART so success (or let's face it, failure) can be easily measured using a simple tool like a run chart. I was trying to come up with something cool to help illustrate how a run chart works. And since my parents are both geologists I landed on a seismograph.

A seismograph records data continuously and that allows geologists to see when something changes (like shifting tectonic plates). A run chart also records data in a continuous or semi-continuous way and that allows someone like me to capture changes in my total number of LOOP contributors. By adding annotations to my run chart I can begin to associate changes in my data with what I'm testing at the corresponding time.

For me, the kinds of things I'm testing are: Will a 1:1 email to a LOOP guest blogger result in a new contributor? Will sending a contributor invitation directly from LOOP to a guest blogger results in a new contributor? Will asking a person to contribute based on a personal recommendation result in a new contributor? Will posting a catchy ad on the ICN Exchange extolling the benefits of contributing to LOOP get me any new contributors?

QI Fundamentals teaches us to start small, hence the Power of One! One test. One patient, one parent, one doctor, one LOOP contributor. One day. Why? Little changes are easier to test. There is usually not much risk or cost in carrying them out. And in some cases, having proof that what you're doing works (yeah, run chart!) can be very useful in convincing people you're not crazy (er, overcoming resistance). I mean when you're talking about implementing a change at the system level, where it affects hundreds or thousands of people - it can be (should be) hard to get buy-in from people without some proof that it is a good move.

So those are the thinking steps involved in a PDSA - asking the question, zeroing in on the aim, considering what to test and documenting it all on the PDSA form. Once that's done, then comes the action!

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