Transcript Conducting PDSA Change Cycles (Plan-Do-Study-Act) April 2009 Follow-up Calls (Call #5) Based on the fall 2008 CATES Training Series Contra Costa County, San Bernardino.

Conducting PDSA Change Cycles
(Plan-Do-Study-Act)
April 2009 Follow-up Calls (Call #5)
Based on the fall 2008 CATES Training Series
Contra Costa County, San Bernardino County, & Sutter County
October 24, November 7, and November 14, 2008
Call Facilitators:
Beth Rutkowski, MPH, and Sherry Larkins, Ph.D.
UCLA Integrated Substance Abuse Programs/
Pacific Southwest Addiction Technology Transfer Center
Agenda
1. This month’s topic: Conducting PDSA
Change Cycles
2. Q-A period
3. Discuss the issues you face in
planning and conducting a change
project.
4. What will prevent you from using the
process improvement methods we
have discussed?
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Review
1. Conducting a Walk-Through
2. Gathering Baseline Data
3. Setting a Change Objective
4. Using the Quick Start Road Map
5. Conducting PDSA Change Cycles
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What Happens Prior to
Implementing a PDSA Cycle?
1. Management decides on a change
objective
2. A Change Leader convenes a team
3. Team works to understand the problem
4. Team brainstorms a number of possible
changes
5. Possibilities are prioritized and one is
selected for testing
6. The test occurs in one portion of the
agency
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Rapid-Cycle Testing
Rapid-Cycle changes
Quick experiments; doable within 2 weeks
PDSA cycles
Plan the change
Do the plan
Study the results
Act on the new
knowledge
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Plan
• Define the change behaviorally…
precisely what will be done?
• Who will implement the change?
• What preparation needs to be done
before starting the change?
• Clarify who will measure the change
and who will review the data regularly
to share with the team.
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Do
• Note the start date for the cycle
• How long will the initial test last?
• How often will the team meet to
assess progress and review data?
• During the test, the team considers
what improvements might need to be
made to improve the results
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Rapid-Cycle Testing - Example
Rapid-Cycle change
 “Barrier question” PDSA
cycle with 2 counselors
PDSA cycles
 Plan: Design question
 Do: 2 counselors use on 5
clients each
 Study: 70% of clients attend
2 post-assessment sessions
compared to 50%
 Act: Try on another 20 clients
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Study
• After the agreed upon test period the
team reviews the results
• Change leader assembles and graphs
the data for the team
• The team deliberates what it has
learned
• Based on the learning, the team
considers whether a change in
strategy is in order
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Act
• In light of what has been learned, the
team decides what to do next
– Make an adjustment in the strategy to
get closer to the objective
– Increase the objective if the initial target
has been met and the team believes
even more progress can be made
– Combine another change with the
existing strategy to start a new cycle
– Abort the existing strategy and start a
new cycle
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It is important to remember…
• It often takes more than one cycle to
achieve your objective.
• By changing only 1 thing at a time you
know the impact of your change.
• Sometimes several changes are
necessary to maximize the improvement
you seek.
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Change Cycles
A P
S D
Changes That
Result in
Improvement
Cycle 4
Cycle 3
Hunches
Theories
Ideas
A P
Cycle 2
S D
Cycle 1
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Keys to PDSA success
1. Be clear about your target objective
2. Implement only 1 change at a time
3. Make sure all participants are
implementing the change as planned
4. Implement the change in a small portion of
the agency
5. Study the results data before making a
modification to the plan
6. Do not hesitate to start a new cycle when
the data indicates or the team is convinced
that a modification will improve results
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And last…
Keep measuring and
studying the results until
you reach your objective
and determine you have
improved as much as
you can
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Next Steps
May 2009 Calls (Final Month!)
7th at 2:00pm and 15th at 11:00 am
Topic:
Sustaining Change and Resources for
Continued Learning
Check out the NIATx web site at www.niatx.net
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