PDSA Cycle

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The Plan-Do-Study-Act (PDSA) cycle is used in quality improvement to test change ideas. There are four parts to a PDSA Cycle:

  • Plan: Plan a change
  • Do: Try the change
  • Study: Observe the results
  • Act: Act on what is learned 

PDSA Cycle - PlanPlan

In the “Plan” part of the cycle you want to have the following components:
  • Objective 
  • Questions that the PDSA will help answer 
  • Plan to carry out the test and what data to collect
  • Predict what will occur
Here’s an example:
  • Objective: Disseminate a healthy weight assessment to parents at four preschools in the community.
  • Question: Will handing out the healthy weight assessment to parents of preschool children during the school registration process increase dissemination?
  • Plan: We will meet with Fairfield School District’s Health Services Manager and preschool staff to discuss how dissemination of the healthy weight assessment will work at schools and hand out the healthy weight assessment for completion and return during the school registration process. Staff will track the number of parents that receive and complete the assessment
  • Prediction: The healthy weight assessment will be disseminated to and completed by 75 percent of parents of pre-school students at registration. 

PDSA Cycle - DoDo

In the “Do” part of the cycle you want to have the following components:
  • Carry out plan
  • Document problems and observations
  • Begin data analysis
Here’s the example, continued:
  • Carry out plan: Provided the healthy weight assessment to all preschool staff at three schools to disseminate to parents and have parents complete during preschool registration.
  • Document problems and observations: 115 healthy weight assessments were handed out.
  • Begin data analysis: 90 completed healthy weight assessments were returned.

PDSA Cycle - StudyStudy

In the “Study” part of the cycle you want to have the following components:
  • Complete data analysis
  • Compare data to predictions
  • Summarize learnings
Here’s the example, continued:
  • Complete data analysis; compare data to predictions: Our prediction was accurate! Of the 115 healthy weight assessments handed out, 90 were completed (78 percent). 
  • Summarize learnings: Overall we had positive reactions to the healthy weight assessment from parents. 

PDSA Cycle - ActAct

In the “Act” part of the cycle you want to have the following components:
  • What changes are to be made for the next PDSA cycle?
Here’s the example, continued:
  • Action selected: Continue using this process at subsequent preschool registrations, but also focus attention on the parents who did not complete the healthy weight assessment. 
  • Next test: Track any missed students and determine a test to disseminate the healthy weight assessment to their parents at the beginning of the school year. 

Basics of Testing Change

  • Test small
  • Start with volunteers
  • Test under a wide variety of conditions
  • Tests must have a question, a prediction, a plan for data collection 
  • Learn as you go
Initial PDSAs are typically very small tests. For example, you may test a change with one child, in one classroom, in one school. By testing small, you remove some of the barriers typically associated with large-scale change, like fear and uncertainty. Instead, PDSAs let you adopt a “let’s try it” attitude and work toward reaching your goal while minimizing risks.

What to learn more? NICHQ is ready to help your organization advance its improvement agenda through innovative approaches and practical solutions. Contact us at communications@nichq.org.