Implementing and evaluating change using Plan-Do-Study-Act (PDSA)

A summary of

How to cite this NCCMT summary:

National Collaborating Centre for Methods and Tools (2017). Implementing and evaluating change using Plan-Do-Study-Act (PDSA). Hamilton, ON: McMaster University. (Updated 01 September, 2017) Retrieved from http://www.nccmt.ca/knowledge-repositories/search/273.

Categories: Tool, Implement, Evaluate, Organizational change

These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.

Relevance for Public Health

Originally, the PDSA approach was developed by the Associates in Process Improvement as a general framework. The PDSA cycle can be used, for example, to optimize the implementation of an automated cancer screening outreach program as part of standard health care (See Supplementary resources: "Applying the plan-do-study-act (PDSA) approach in pragmatic research with safety net health centers."

Description

The Plan-Do-Study-Act (PDSA) framework is a model for testing change to evaluate whether a series of decisions or activities have resulted in improvement.

The PDSA framework, also known as the Model for Improvement, is at the core of the Institute for Healthcare Improvement's approach to quality improvement (IHI-QI).

The PDSA framework is based on experiential learning and guiding purposeful action. It outlines three clarifying questions and the PDSA cycle. The PDSA framework is intended to help implement and evaluate a desired change. The process typically involves conducting several different "tests of change" followed by systematically documenting, optimizing, re-testing, and re-evaluating the iterative PDSA cycles (those that are predicted to lead to sustained improvement) using the PDSA worksheet as a tool.

The PDSA cycle includes the following stages:

  • Plan: Develop a plan to test the desired change
  • Do: Carry out the test
  • Study: Observe and learn from the consequences
  • Act: Determine what modifications should be made to the test

Though the PDSA is at the core of the IHI-QI it is not synonymous with its efforts. Other notable quality improvement methods include the method of "Lean." A document that compares Lean and quality improvement is provided here.

Implementing the Method/Tool
Steps for Using Method/Tool

The PDSA framework outlines an algorithm that is designed to help ‘achieve an aim’ at any scale. As users work through the PDSA steps, the algorithm can be used as a tool for gaining practical knowledge. Moreover, it helps users to dissect their perceived understanding of how to accelerate improvement in clinical health care settings while also allowing immediate, sequential testing of changes.

The main ideas of the PDSA approach are as follows:

  • Questions are at the root of testing change.
  • Success of small changes can lead to wide-spread implementation of change.
  • Informed action drives improved results.
Who is involved

Implementing this framework could involve program leads, project leads, managers and staff.

Conditions for Use
None
Evaluation and Measurement Characteristics
Evaluation
Information not available
Validity
Not applicable
Reliability
Not applicable
Methodological Rating
Not applicable
Method/Tool Development
Developer(s)

Associates in Process Improvement
Website: www.apiweb.org

Method of Development
Release Date
Contact Person/Source
Institute for Healthcare Improvement
20 University Road, 7th Floor
Cambridge, USA 02138
Phone: (617) 301-4800 and toll-tree: (866) 787-0831
Fax: (617) 301-4848
Email: info@ihi.org

Resources

Title of Primary Resource
PDSA worksheet for testing change
File Attachment
None
Web-link
Reference
Type of Material
Document
Format
On-line Access
Cost to Access
None.
Language
English
Conditions for Use

Need to register (free).

© 2017 Institute for Healthcare Improvement


Title of Supplementary Resource
Institute for Healthcare Improvement
File Attachment
None
Web-link
Reference
Type of Material
Website
Format
On-line Access
Cost to Access
None.
Language
English
Conditions for Use

© 2017 Institute for Healthcare Improvement


Title of Supplementary Resource
Applying the plan-do-study-act (PDSA) approach in pragmatic research with safety net health centers
File Attachment
51727_Plan-Do-Study-Act_Petrik-Rev.pdf
Web-link
Reference

Petrik, A.F., Coury, J., Schneider, J.L., Rivelli, J.S., Seibel, E., D'Agostini, B., et al. (2016). Applying the plan-do-study-act (PDSA) approach in pragmatic research with safety net health centers (poster presentation). 9th Annual Conference on the Science of Dissemination and Implementation. December 14-16, 2016.

Type of Material
Poster presentation
Format
Pdf
Cost to Access
None.
Language
English
Conditions for Use

© 2016 Kaiser Permanente Center for Health Research


Title of Supplementary Resource
Comparing Lean and quality improvement
File Attachment
None
Web-link
Reference

Scoville, R. & Little, K. (2014). Comparing Lean and quality improvement. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014.

Type of Material
Document
Format
On-line Access
Cost to Access
None.
Language
English
Conditions for Use

© 2014 Institute for Healthcare Improvement


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