Plan-Do-Study-Act (PDSA) Cycle

National Nursing Home Quality Care Collaborative Team Activity: Learning Session 2, Webinar 3

Steps

  1. Meet with your interdisciplinary team to:
  2. Become familiar with this PDSA Cycle Worksheet
  3. Review these examples of PDSA cycles: six minute Domestic Lean Goddess Video andSample completed worksheet (from Root Cause Analysis Toolkit for Long-Term Care)
  4. Review Donna’s Diary entries and comments for the category most similar to your performance improvement project
  5. Brainstorm 3-5 small tests of change ideas for your performance improvement project
  6. Write a short commenton Donna’s Diary in appropriate category abouta PDSA you have done, are currently doing, or are thinking about doing
  7. Use this PDSACycle Worksheet to plan the next test of change for your current focus area.

How to Use the PDSA Cycle Worksheet

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change by planning it, trying it, observing the results, and acting on what is learned. This worksheet helps to plan, conduct, analyze, and monitor progress with tests of change to help meet the aim or goal.

  • This tool should be completed by the project team.
  • Think about your test of change by answering these three questions for improvement:
  • What are we trying to accomplish (our aim)?
  • How will we know that change is an improvement (measures)?
  • What change/s can we make that will result in an improvement?
  • Decidewhatyouwillchangeintheprocess anddeterminetheinterventionsbasedonyouranalysis
  • Identify better ways to do things that address the root causes of the problem
  • Learn what has worked at other organizations (copy)
  • Review the best available evidence for what works (literature, studies, experts, guidelines)
  • Remember that the solution doesn’t have to be perfect the first time
  • Plan, conduct, and document your PDSA cycles using the attached worksheets.
  • Your team may need to complete multiple PDSA cycles in order to achieve your aim.

Plan-Do-Study-Act (PDSA) Cycle Worksheet

ModelforImprovement:Threequestionsforimprovement

1. Whatarewetryingtoaccomplish (aim)?

Create an aim/goal statement.

2. Howwillweknowthat changeis animprovement (measures)?

Develop measures that will evaluate your progress toward your aim/goal.

  1. Whatchange/scanwemakethatwillresultinanimprovement?

Define the process currently in place using process mapping or flow charting and identify opportunities for improvement that exist.

Plan
What changeareyoutestingwiththePDSAcycle(s)?
Whatdoyoupredictwillhappenandwhy?
Who willbe involvedinthisPDSA?(e.g.,onestaff memberorresident,oneshift?).Wheneverfeasible,itwillbehelpfultoinvolvedirect carestaff.
Plan asmalltestofchange.
Howlongwillthechangetaketoimplement?
Whatresourceswill be needed? / List your action steps along with person(s) responsible and time line.

Plan-Do-Study-Act (PDSA) Cycle Worksheet

Do
Carry out the test on a small scale
Document observations, including any
Problems and unexpected findings
Collect data identified as needed
During the “plan” stage / Describewhatactuallyhappenedwhenyouranthetest.

The Lake Superior Quality Innovation Network represents Michigan, Minnesota, and Wisconsin, under the
Centers for Medicare & Medicaid Services Quality Improvement Organization Program.

| Follow us on social media @LakeSuperiorQIN

Plan-Do-Study-Act (PDSA) Cycle Worksheet

Study
Studyandanalyzethedata.
Determineifthechangeresulted intheexpectedoutcome.
Werethereimplementationlessons?
Summarizewhatwaslearned.Lookfor:unintendedconsequences,surprises,successes,failures. / Describethemeasuredresultsandhowtheycomparedtothepredictions.
Act
Basedonwhatwaslearnedfromthetest:
Adapt –modifythechangesandrepeatPDSAcycle
Adopt –considerexpandingthechanges inyourorganizationtoadditionalresidents, staff, andunits
Abandon– changeyourapproachandrepeatPDSAcycle / Describewhatmodificationstotheplanwillbemadefor thenextcyclefromwhatyou learned.

Adapted from Root Cause Analysis Toolkit for Long-Term Care, “PDSA Cycle Worksheet,” Stratis Health, 2014, . Adapted with permission.

The Lake Superior Quality Innovation Network represents Michigan, Minnesota, and Wisconsin, under the
Centers for Medicare & Medicaid Services Quality Improvement Organization Program.

| Follow us on social media @LakeSuperiorQIN

This material was prepared by the Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW-MI/MN/WI-C2-15-142 072315