In this series of blogs, we’ve been looking at the Plan-Do-Study-Act or PDSA cycle. In this article, we’re going to look at how you can ensure that you are executing a PDSA effectively and how you go about planning for this eventuality.
You may already be familiar with the PDSA cycle as part of your improvement work. If not, please do take a look at one of our previous blogs which talks about how you set them up and the methodology behind PDSAs.
Let’s just remind ourselves of the PDSA process quickly:
Plan – When you agree on the change that will be tested and plan your actions for the cycle. At this stage, you form a team that will be managing the process and identify objectives and what you want to achieve. It’s also a good time to work out what measurements you will use to measure your changes.
Do – This stage is when you carry out the changes or test and start collecting data for analysis.
Study – This is when you study the data you have collected, based on the outcomes agreed during the Plan phase. You can review, discuss and reflect with your team about the impact of the change and decide on what you need to tweak to go forward or whether you should abandon the test.
Act – This is the stage when you act on the data that you have collected and plan the next change cycle. It must be based on the reflection of the test within the Study phase.
If you want to read in more detail about PDSAs, please see our blog.
Make sure the PDSA aligns with a change idea
The first thing you need to do when you are about to kick off your first PDSA, is to you prepare yourself and your team. One of the main ways that you can prepare yourself for effectively executing a PDSA is to ensure that your overall project aim aligns with your overall change idea.
Change ideas form the basis of what you are testing. As not all good ideas will be relevant to your overall aim, it’s vital that you ensure that the focus of the PDSA directly ties into a change idea, and therefore the overall project aim.
The NICHQ article ‘5 Tips for Testing to Optimize Your Next PDSA‘ has some really helpful tips for when you are planning your PDSA. But if you keep in mind, most importantly, not to lose sight of what your initial change idea was you will not go far wrong.
This is an area you can discuss and agree in your kick off meeting with your PDSA team. During this meeting you can focus in on the aim and how it aligns with the rest of the cycle.
Setting the scope of the test
Setting the scope of your test within your PDSA cycle is another key area of focus when you are planning and meeting with your PDSA team. When setting the scope, it’s sometimes better to think small rather than big in the first instance. These small or quick changes are the foundation of iterative improvement.
Setting the scope of your test will be key to executing a PDSA effectively, and will generally take place within the ‘planning’ stage of the cycle. This is when you should also decide which measures you will be using to evaluate your results, which will be so important later on.
The NHS England and NHS Improvement guide 'Plan, Do, Study, Act (PDSA) cycles and the model for improvement' recommends setting a clear and focused scope with measurable targets. While you will have a chance to look at the results during the study and tweak them then, the scope of your PDSA needs to be set at the beginning of the process.
Choose the PDSA team wisely
Choosing your team is really important as widespread change needs consistent buy-in. So if you want to carry out successful PDSAs, you will need a reliable team to execute them effectively.
It’s a good idea to scope out what type of people - and skills - you need when choosing who will execute your PDSA. You should also consider people's strengths and weaknesses. You can work out which skills they have, what they can bring to the project and whether you are going to be able to delegate tasks to them, and if your team will be able to pick up and run with them.
The King's Fund article 'Making the case for quality improvement: lessons for NHS boards and leaders' makes a case for the importance of choosing the right leaders within your team. This can really impact positively on the success of your PDSA and your overall improvement project.
Find out more about how to choose an Improvement team or PDSA team, or learn more about leadership and securing wider organisational buy in.
Choose the right data to measure and chart to analyse the results
It’s really important that you measure and record your PDSA cycles as they run, in order to be able to capture your learning and measure and analyse your results. But it is also equally important that you choose the right data to measure and chart to analyse the results.
The amount of data you need to collect can be overwhelming, so this is where it can be useful to have an online tool that helps you to collect and analyse your data.
Using a QI solution
Using an online Quality Improvement solution, such as Life QI can really support your PDSA efforts. It can help in many different ways: by keeping track of your activities, helping you to create and assign tasks related to your PDSA cycle to your colleagues.
Life QI also make it easier to plan and align activities and collaborate with your team, enabling you to be on track with testing your change idea at every level. As Life QI enables you to record all stages of PDSA cycle within the system - and collect data – by plotting your PDSA cycles on the system, it will allow you to see the tangible link between your changes and their impact. You can read more here.
We hope that you’ll have picked up some ideas for helping you execute your PDSA effectively. If you want to find out more about how using Life QI can support you, please do get in touch!