PDSA forms and PDSA practice
In last week’s post I sketched the benefits of formal documentation of Plan-Do-Study-Act cycles.
While you don’t need to write out a form to practice Plan-Do-Study-Act, you do need to carry out a core set of actions.
“To be considered a PDSA cycle, four aspects of the activity should be easily identifiable.
1. Plan: the learning opportunity, test, or implementation was planned and included:
a. Questions to be answered
b. Predictions of the answers to the questions
c. Plan for collection of the data to answer the questions
2. Do: the plan was attempted. Observations are made and recorded, including those things that were not part of the plan.
3. Study: time was set aside to compare the data with the predictions and study the results.
4. Act: action was rationally based on what was learned.”
(Langley et al. (2009) The Improvement Guide (2009), 2nd edition, Jossey-Bass: San Francisco, pp. 98-99)
Many teams in healthcare use daily huddles.
In clinical areas, a team will use the daily huddle to look at the patient schedule for the day. Everyone on the team gets on the same page.
The daily huddle sets the aim for the unit’s day and that’s a powerful habit.
The huddle also allows the team to flag specific issues for attention and action (like a patient with latex allergies in ambulatory surgical center setting), to organize work assignments and to identify any changes to work flow based on equipment problems or staff substitutions and absences.
This video clip of a primary care team in a U.S. military medical facility shows good clinical huddle practice.
What if this ‘look forward’ huddle included a brief review of the previous day?
In other words, what about a move from a ‘look-ahead’ clinical huddle (Plan Do) to a ‘look-ahead and look-back’ clinical huddle (Plan Do Study Act)?
From ‘Plan-Do’ to ‘Plan-Do-Study-Act’
We can use the four aspects highlighted in The Improvement Guide to describe a daily huddle that embodies Plan Do Study Act.
If you have a team that uses a “Plan-Do” daily huddle, consider extending the huddle to Plan-Do-Study-Act. You can vary the agenda order to address Study-Act at the start of the huddle based on the previous day before you tackle today’s Plan-Do.
If you test PDSA huddles, let me know what you learn! (firstname.lastname@example.org)