Improvement Method Olympics – The Final!

Posted by: NHS Horizons - Posted on:

  1. 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.

PDSA cycle - circle with four sections Act What's next? 
Plan What will happen if we try something different?
Study - did it work?
Do - let's try it!

View a PDSA worksheet from the IHI.

Some additional resources for PDSA cycles

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

Can quality improvement improve the quality of care? A systematic review of reported effects and methodological rigor in plan-do-study-act projects: article from BMC

2. What matters to you? (method)

Asking “what matters to you” is a simple, yet profound idea for creating deeply personal engagements with patients or service users and their family members. Because patients are the true experts on their own needs and experiences asking, listening and responding to what matters to them is a key feature of person- and family-centred care. Asking “What matters to you?” has a positive impact on quality, safety, and the wellbeing of people who work in health and care.

A global movement has grown up supporting “what matters to you?”. Whilst we should be asking these questions every single day, June 9 is marked as the annual worldwide celebration of “what matters to you?”

Content from What matters to you? The Institute for Healthcare Improvement

Table with ideas for different ways of asking the question "what matters to you"

Source of graphic: British Columbia Patient safety and Quality Council

Additional resources for What matters to you?

The website showing links to the websites of organisations around the world that have championed WMTY implementation. Suggested by @WmtyWorld

Make “What matters to you?” an always event. Lots of WMTY resources. Suggested by @KarenHTurner1

The What matters to you? website, Scotland. Many more resources. Suggested by @LouWaters_QI

The What matters to you? website, British Columbia Patient Safety and Quality Council. Offers a variety of graphics. Suggested by @hchiu4quality

What matters to you? video in English and in Cantonese from New South Wales Health, suggested by @LindaSoars