PDSA: Plan-Do-Study-Act (Rapid Cycle Improvement)

PDSA, or Plan-Do-Study-Act, is an iterative, four-stage problem-solving model used for improving a process or carrying out change. ... When using the PDSA cycle, ... SkiptoContent PDSA:Plan-Do-Study-Act(RapidCycleImprovement)-MinnesotaDept.ofHealth Training,tools,andwebinars Home:Training,tools,webinars Trainingandwebinars Publichealthand QItoolbox Resourcelibraryforadvancinghealthequity Publichealthnursingtoolsandresources CHSadministrationhandbook Publicationsandhandbooks CenterforPublicHealthPractice Home OpenMenu PDSA:Plan-do-study-act AlsoCalled:Rapidcycleimprovement,PDCA(plan-do-check-act) WhatisPDSA? Stage1:Plan Stage2:Do Stage3:Study Stage4:Act Examples Moreinformation   WhatisPDSA? PDSA,orPlan-Do-Study-Act,isaniterative,four-stageproblem-solvingmodelusedforimprovingaprocessorcarryingoutchange. WhenusingthePDSAcycle,it'simportanttoincludeinternalandexternalcustomers;theycanprovidefeedbackaboutwhatworksandwhatdoesn't.Thecustomerdefinesquality,soitwouldmakesensetoalsoinvolvethemintheprocesswhenappropriateorfeasible,toincreaseacceptanceoftheendresult.(Ifyou'reunsureabout,whoyourcustomersare,youmaywanttocreateacustomerchaintoassistinidentification.) InapplyingPDSA,askyourselfthreequestions: Whatarewetryingtoaccomplish? Howwillweknowthatachangeisanimprovement? Whatchangescanwemakethatwillresultinanimprovement?   Stage1:Plan A.Recruitteam Assembleateamthathasknowledgeoftheproblemoropportunityforimprovement.Considerthestrengthseachteammemberbrings—lookforengaged,forward-thinkingstaff. Afterrecruitingteammembers,identifyrolesandresponsibilities,settimelines,andestablishameetingschedule. B.Draftanaimstatement Describewhatyouwanttoaccomplishinanaimstatement.Trytoanswerthosethreefundamentalquestions: Whatarewetryingtoaccomplish? Howwillweknowthatachangeisanimprovement? Whatchangecanwemakethatwillresultinimprovement? C.Describecurrentcontextandprocess brainstorm Examineyourcurrentprocess.Startbyaskingtheteamthesebasicquestions: Whatarewedoingnow? Howdowedoit? Whatarethemajorstepsintheprocess? Whoisinvolved? Whatdotheydo? Whatisdonewell? Whatcouldbedonebetter? YoumighthavealreadyansweredthelasttwoquestionsifyouhaveperformedaSWOTanalysis. Tryaswimlanemap Youmayfindithelpfultoconstructaswimlanemaptovisuallydescribeyourprocess. Creatingaprocessfloworatleastdepictingthecurrentprocesscanbeveryuseful.Ifyourteamrunsintoroadblocks,youmighthavefoundwheretheproblemisoccurring—ormaybetherightpersonforidentifyingamissingstepisnotatthetable. Gathermoredetail Oncethegeneralstructureiscompleted,thesecanbesomemorehelpfulquestionstoask: Howlongdoestheprocesscurrentlytake?Eachstep? Istherevariationinthewaytheprocessiscurrentlycompleted? D.Describetheproblem UsingtheaimstatementcreatedinStepB,stateyourdesiredaccomplishments,andusedataandinformationtomeasurehowyourorganizationmeets/doesnotmeetthoseaccomplishments. Forexample:Ifyourobjectiveistomaximizeyourstaff'squalityofworklife,youmightfindevidencebysurveyingemployeesonworkplacestressors. Writeaproblemstatement Writeaproblemstatementtoclearlysummarizeyourteam'sconsensusontheproblem.Youmayfindithelpfultoprioritizeproblems,ifyourteamhasidentifiedmorethanone,and/orincludeajustificationofwhyyouchoseyourproblem(s). E.Identifycausesandalternatives Analyzecauses Fortheprobleminyourproblemstatement,worktoidentifycausesoftheproblemusingtoolssuchascontrolcharts,fishbones,andworkflowprocessmaps(e.g.,flowcharts,swimlanemaps).Theendofthecauseanalysisshouldsummarizethecauseanalysisbydescribingandjustifyingtherootcauses. Examineyourprocess,andask: Isthisprocessefficient?Whatisthecost(includingmoney,time,orotherresources)? Arewedoingtherightstepsintherightway? Doessomeoneelsedothissameprocessinadifferentway? Developalternatives Trytomitigateyourrootcausesbycompletingthestatement, "Ifwedo__________,then__________willhappen." Chooseanalternative(orafewalternatives)thatyoubelievewillbesthelpyoureachyourobjectiveandmaximizeyourresources. Developanactionplan,includingnecessarystaff/resourcesandatimeline.Trytoaccountforrisksyoumightfaceasyouimplementyouractionplan.   Stage2:Do Starttoimplementyouractionplan.Besuretocollectdataasyougo,tohelpyouevaluateyourplaninStage3:Study.Yourteammightfindithelpfultouseachecksheet,flowchart,swimlanemap,orruncharttocapturedata/occurrencesastheyhappenorovertime. Yourteamshouldalsodocumentproblems,unexpectedeffects,andgeneralobservations.   Stage3:Study UsingtheaimstatementdraftedinStage1:Plan,anddatagatheredduringStage2:Do,determine: Didyourplanresultinanimprovement?Byhowmuch/little? Wastheactionworththeinvestment? Doyouseetrends? Werethereunintendedsideeffects? Youcanuseanumberofdifferenttoolstovisuallyreviewandevaluateanimprovement,likeaParetochart,controlchart,orrunchart.   Stage4:Act Reflectonplanandoutcomes Ifyourteamdeterminedtheplanresultedinsuccess,standardizetheimprovementandbegintouseitregularly.Aftersometime,returntoStage1:Planandre-examinetheprocesstolearnwhereitcanbefurtherimproved. Ifyourteambelievesadifferentapproachwouldbemoresuccessful,returntoStage1:Plan,anddevelopanewanddifferentplanthatmightresultinsuccess. ThePDSAcycleisongoing,andorganizationsbecomemoreefficientastheyintuitivelyadoptPDSAintotheirplanning. Celebrateimprovementsandlessonslearned Communicateaccomplishmentstointernalandexternalcustomers Takestepstopreserveyourgainsandsustainyouraccomplishments Makelong-termplansforadditionalimprovements ConductiterativePDSAcycleswhenneeded   Moreinformation TheABCsofPDCAandPDSAFlowchart(PDF) PublicHealthFoundation EmbracingQualityinLocalPublicHealth(PDF) MichiganLocalPublicHealthAccreditationProgram BaldrigePerformanceExcellenceProgram NationalInstituteofStandardsandTechnology,USDept.ofCommerce BalancedScorecardInstitute PDSA[Note:Videowillautoplay] InstituteforHealthcareImprovement Whiteboard:ThePDSACycle(Part1)[Note:Videowillautoplay] Whiteboard:ThePDSACycle(Part2)[Note:Videowillautoplay] InstituteforHealthcareImprovement ShareThis ContacttheCenterforPublicHealthPractice [email protected] 651-201-3880 Howarewedoing?Pleaseprovidefeedback! 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