Today’s first quarter final vote is between PDSA cycles and the 5 Whys
- PDSA cycle (tool)
We can use PDSA cycles to test an idea for change by temporarily trialling a change and assessing its impact. There are four distinct stages to the PDSA cycle:
- Plan – the change that needs to be tested or implemented
- Do – carry out or test the change
- Study – data before and after the change and reflect on what is learned
- Act – plan the next change cycle or full implementation
We may not get the results you expect when making changes to our processes, so it is safer, and more effective to test out improvements on a small scale before implementing them across the board. As with any change, ownership is key to implementing the improvement successfully. If we involve a range of colleagues and service users in trying something out on a small scale before it is fully operational, we will reduce the barriers to change.
Some additional resources for PDSA cycles
https://www.youtube.com/watch?v=szLduqP7u-k The PDSA cycle 101: video from BMJ Quality
What’s in a name: PDSA or PDCA? by @JoyFurnival
Plan, do, study, act (PDSA) cycles and the Model for Improvement by NHS England and NHS Improvement, suggested by @HassanmahmoodDr
Benefits of PDSA cycles by Jason Williams in LifeQI
An example of using a PDSA process to improve the quality of pledges that people made following a training programme by @NikkiDQIC
Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study: BMJ Quality and Safety article suggested by @julie4clahrc
A systematic review of the application of the plan–do–study–act method to improve quality in healthcare: BMJ Quality and Safety article suggested by @julie4clahrc
2. Five Whys (tool)
By repeatedly asking the question ‘why?’ (using five as a rule of thumb), we can peel away the layers of an issue, which can lead us to the root cause of a problem. The reason for a problem can often lead into another question; we may need to ask the question fewer or more than five times before we get to the origin of a problem. The real key is to avoid assumptions and logic traps and encourage the team to keep drilling down to the real root cause.
This example from Lothian Quality gives an example of 5 whys.
Some additional resources for 5 Whys
5 Whys: getting to the root of a problem quickly by MindTools suggested by @phwandjes
The 5 whys and fishbone diagramming video suggested by @Winn_on_health
Using the 5 whys for life design (using 5 Whys to think about your goals and ambitions in life) by Life Design Log
The problem with ‘5 whys‘ BMJ Quality and Safety article by @AlanJCard, suggested by @JulieEReed