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Using the Plan, Do, Study, Act Cycle

Changes are introduced using the PDSA cycle – Plan, Do, Study, Act – meaning small tests of change can be carried out in an actual work place setting.  In improvement work, we have learnt that to try something new in a reliable way, it is best to start small – one person, one setting, one service provider.

Even if something has been shown to work in other settings, take the time to do a small-scale trial.  There are almost no solutions that work in all situations. Testing allows us to adapt actions to particular settings. To test a new procedure or technique, we need to ‘plan, do, study and act’ as explained below. 

PDSA Plan Stage

Plan what you are going to do differently – ‘who, what, where and when’.

PDSA Do Stage

Carry out the plan and collect information on what worked well and what issues need tackling.

PDSA Study Stage

Gather relevant team members as soon as possible after the test for a short informal meeting.   Analyse the information gathered and review the aim of the new procedure or technique against what actually happened.

PDSA Act Stage

Use this new knowledge to plan the next test. Agree the changes and amend the outcome measures if necessary.  We should continue testing using the PDSA cycle to refine the new procedure or technique, until it is ready to be fully introduced. But, do it quickly (think in days, not weeks).  When the change has been 90 to 95% reliable, adopt the change and share with others and spread to other similar work areas.

But don’t assume that a change can simply be ‘rolled out’ once it has been successfully tested. The introduction needs to be managed at every stage.  There is no hard and fast rule for how quickly to introduce the change.  Once it has been introduced in a new area, test the change again.

The PDSA cycle in practice: Early Learning South Auckland case study video

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