Author: z617322

Plan-Do-Study-Act Cycles

CONTINUOUS IMPROVEMENT TOOLKIT

Purpose
A Plan Do Study Act (PDSA) cycle is simple four step cycle that focuses on testing a change idea at a small scale to evaluate whether or not that change idea delivers an improvement. This allows a team to ensure that change idea delivers the desired improvement before implementing it more widely. After each PDSA cycle has been completed, those completing the cycles should decide whether to adopt the idea (if it’s delivered the desired improvement), adapt the idea (if it’s delivered a small improvement but could be developed further to deliver an even bigger improvement) or abandon the idea (if it’s not delivered any improvement at all).

How to use PDSA Cycles
Rather than implementing a change idea without knowing what it’s impact may be, PDSA Cycles can be used to turn ideas into action in a disciplined way. When testing new ideas through PDSA cycles, you can build knowledge about the impact of a change idea on a system, ensuring change ideas work in practice and deliver maximum improvements before implementing these permanently.
At a high level, the four stages within PDSA Cycles is included below, with further details included throughout this document:
Plan: A plan of what is to be tested including questions to be answered, predictions and answers to the questions and a plan for collection of data to answer the questions
Do: Carry out the test of change according to the plan, recording observations including unexpected outcomes/observations
Study: A comparison of the data against the predictions made in the plan and study the results
Act: Make a decision about the next course of action—adopt, adapt or abandon
In order to achieve best results, it’s highly recommended that multiple cycles be used to test each change idea. This will allow teams to continue to make incremental improvements to the change idea and how it’s implemented it within each cycle.

After you’ve identified change ideas that could potentially lead to an improvement, decide which one you think is most likely to lead to an improvement, and plan how you are going to test it using PDSA Cycles. This should include:
Decide how you are going to test the change idea. To start with, test on a really small scale, for example by trialling the change idea with one service user or for one day only, building on this for future testing cycles if it’s successful.
Confirm which individuals/team is responsible for trialling and evaluating the change idea
Determine which data you will need to collect in order to measure whether or not the change idea has led to an improvement
Predict what you think will happen. When you evaluate whether or not the change idea has led to an improvement you will revisit this prediction.
Use the PDSA Template on the last page of this document to log information relating to the PDSA Cycle. You will revisit this template throughout the cycle.

Test the change idea on a small scale. For initial PDSA cycles, keep these tests very small-scale and evaluate these to assess their initial impact, before considering testing on a larger scale if that is worthwhile.
Whilst testing, ensure you are gathering the data you need to show you whether or not you’ve delivered an improvement (you will have already identified which data you need to collect during the planning stage).
In addition, record any other relevant observations from colleagues or service users which may provide an insight into whether or not the change idea has worked. You should also consider whether or not the change idea has created any unexpected outcomes or consequences and record these.

Compare the data you collected whilst testing the idea with the prediction you made during the planning stage.
Reflect the additional observations you collected whilst testing the idea, including details of any unexpected outcomes. Consider who has been affected by the change idea, and whether it’s a positive or negative change.
Use the information described above to analyse your results and assess the impact your change idea has had.
Summarise your findings on your PDSA Template.

After you’ve studied the impact of your test, make a decision about the next course of action. Based on how successful the impact of the change idea was compared to your predication, you can either:
Adopt the idea: Implement the change idea permanently by spreading the change idea gradually across your service. For best results, you should only implement an idea when you’re confident you have considered all the possible ways of delivering the maximum improvement.
Adapt the Idea: Make modifications and run another small-scale test using a new PDSA Cycle.
Abandon the idea: If the change idea has been shown to have no potential to achieve the desired improvement, don’t do another test on this change idea, and consider which other change ideas may deliver your desired improvement.

Blank Template
Follow this link to download the template below, which you can use to plan and log information relating to your PDSA Cycle. As well as using this to log your progress on a cycle, this can be shared with other teams/organisations who may be interested in the improvement you’ve delivered.