We dedicated our previous article to the planning phase of the PDSA cycle. We talked about the different elements of the action plan and showed how to do it effectively in Life QI.
In this article we’ll look at the other three phases of the PDSA cycle – Do, Study and Act. We’ll talk about how to execute the plan, evaluate the results of the test and build on them. In the Life QI software these 3 steps are in one section, but let’s analyse them one by one and see what they should involve in.
Do – Executing the PDSA plan in Life QI
After planning out your PDSA cycle carefully, it’s time to move to the next stage – to test your hypothesis.
With the right team and a detailed plan about what you will do and what you wish to achieve, you are finally ready to start to implement your quality improvement initiative.
The ‘Do’ phase usually includes three activities you should go through:
- Implementing the improvement idea
- Collecting data and documenting the results
- Documenting problems during the test, unexpected observations, lessons learned, and knowledge gained
Use the run or control charts in Life QI (what you decided during the planning phase) to collect and display your data on a regular basis. It’s essential because you will use these charts to analyse the results of the change in the Study stage. We also encourage you to link your measure(s) to your PDSA in order to find all the relevant information to your PDSA cycle in one place.
To document what happened and any issues you had to face, there is a dedicated field in Life QI. Here you should describe what happened when you ran your test and note any pertinent observations.
💡 Communicate regularly with those involved in the improvement and share inspiring stories to keep everyone engaged and motivated throughout the process.
Study – Analyse the results of your PDSA in Life QI
In the Study phase you need to analyse the effects of your test and decide whether the change was an improvement in the process.
Compare the aim statement that you defined in the planning phase and your baseline data that you acquired prior to the test with the measures collected in the ‘Do’ phase. Decide if the collected data meets the expectations and determine if a measurable improvement was achieved.
Your PDSA team should also analyse the factors that might have contributed to the results. Try to understand which factors had a positive impact on the change (that you might want to consider when running future PDSAs) or try to find out why you couldn’t manage to achieve the improvements you expected to be able to mitigate those factors in the future.
In the PDSA tool of Life QI you have a dedicated field to summarise what you learned, including successes, failures or any observations and unexpected results. We suggest answering the following questions:
- Did your change idea result in an improvement?
- Was the initiative worth the investment?
- Do you see any positive or negative trends in the process?
- Were there unintended side effects? (E.g. the change had a positive outcome, but it affected negatively on another process)
Act – What’s next?
Based on what your organisation learned from the test, you can adopt, adapt or abandon the process.
PDSA cycles meant to be continuous. You have always space for improvement, even if the test had a positive outcome. And what if you didn’t meet the expected goals? View it as an opportunity to learn and continue experimenting running additional PDSAs until you find a way to improve the process.
So, what you should do?
Adopt – If your goal in the aim statement has been met, you can standardise the improvement. Start with implementing the changes in the small-scale area where you first tested and then you can also consider expanding to other departments of the organisation.
Adapt – If you think the process can be further improved, decide to gather different data or simply repeat the test because the circumstances have changed, you can ramp up your PDSA cycle (add a new PDSA cycle), refine your change idea and expectations in the planning phase and see if it takes to better results.
Abandon – If the change didn’t result in an improvement or think that a different approach would be more successful, you can go back to the planning phase in a new PDSA cycle, revisit potential solutions that you didn’t consider before, and keeping in mind the outcomes of the previous PDSA cycle you can develop a new action plan and re-start running the PDSA. It’s also worth considering whether the aim statement was realistically achievable.
When you plan a quality improvement initiative it’s important to start small and plan ahead. With careful thought given to each aspect of the PDSA cycle, ongoing communication, detailed attention to the metrics and an all-in-one platform where to plan, execute and analyse your PDSA and the progress made, you can contribute to the success of the test.