On the Road with PDSA
A Message from Lexi Abel, MPH
NICHQ Project Manager
My first “official” exposure to the Model for Improvement came when I joined the NICHQ team earlier this year. As part of the standard orientation for new employees, I was given a copy of “The Improvement Guide” by Langley, Moen, Nolan, Nolan, Norman, and Provost. This is NICHQ’s quality improvement “bible.”
As I began reading about the Plan-Do-Study-Act (PDSA) Cycle, the concepts seemed oddly familiar, as if I had known them all my life. And, in fact, I had.
I’ve always loved sports and structure, so when I decided to take up the sport of triathlon, I knew it was a great fit! The intensity that triathlon brings to my life is energizing. I love having a goal to push myself towards – one that makes me stronger and faster while giving me an opportunity to meet people and travel.
After my first two seasons of competing in triathlon, I was slowly getting faster, but not making any big breakthroughs. I started thinking more critically about my training routine and realized I need to make some changes. At the end of each season, I would set goals for the following season and start anew. Although I was training hard, I was barely reaching or not reaching my season goals, which left me thinking I was not training smart.
So, I started to make changes. A new coach helped me map out a training plan, one that varied throughout the month and season. While my old training plan was consistent from week to week and month to month, my new training plan kept me guessing. The routine that I loved (running/biking/swimming the same way, same speed, same distance) was holding me back and I had to shake things up in order to improve. Under my new regimen, my body is left guessing. There will never be a Tuesday night track workout or a swim workout that is the exact same as another one from that month and I cycle different routes, mileage, and speeds throughout
Feeling better about my training plan, I turned my attention to nutrition. Through small tests of change, I dialed in my nutrition plan by experimenting with different electrolyte drinks during training until I found one that worked for me. With training and nutrition squared away, I was ready to race.
I’ve come to realize that, without ever knowing it before, my training process has been a real-life example of the Model for Improvement: I set goals, keep track of my progress, and test changes that I believe will lead to an improvement. What was once only intuitive to me now has a name and framework. And I will never think about training the same way again.
The new plan proved to be effective last season. My goal was to do an Olympic distance triathlon (1500m swim, 25mi bike, 10k run) in less than 2 hours and 30 minutes. The second race of the season I raced a 2:22. I continued to get faster and at the end of the season I qualified to be on Team USA and compete at the World Triathlon Championships (for amateur athletes).
I’ve also learned that I need to push myself to be comfortable with what’s uncomfortable. That’s the nature of change. I’m sure it’s much less comfortable for an institution to change a complex process than it is for me make adjustments on the road or in the pool.
But I know I’m not going to get any better unless I push myself to change. No two races are ever going to be the same, so I’m learning to have the mental agility to adjust, and being more flexible has allowed me to become a better athlete.
The fifteen weeks I have until the World Championships are going to be filled with focused, varies, and challenging worouts - each its own PDSA cycle. Here we go!