[Narrator] Every time you start out on a journey, whether it be by land or sea, you need to have some way to guide your journey, some roadmap, a compass if you will, that gives you direction and gives you some sort of sense of where you're going. Well, we have that at the IHI. It's called the model for improvement. The model for improvement gives us the foundation and the framework for doing improvement work. It is really structured around several key components, basically two major sections of the model for improvement. 

First of all, what is your aim? How will you know that a change is an improvement is the second question, which gets to measurement. The third question deals with, what changes can you actually put in place to achieve the aim? So these three things continually loop together. And we always check ourselves against our aim. How good, by when is typically one of the things we ask in an aim statement. How good do you want to be? And then by when? It's not good enough just to say that we want to be in the top decile, top quartile, but by when? Let's give a date. The measures-- are you going to look at process and outcome measures? And then what changes are you actually going to put into place that you can track with data and then match back up against your aim? This then gets carried out in daily work with a team through something called the PDSA cycle or Plan, Do, Study, and Act. 

The three questions give us the framework that we always go back to. What are we trying to accomplish? How will we know a change is an improvement? What changes can we actually make? PDSA cycles is where we do our testing on a day-to-day basis. We go out and we take the ideas. We put them into a PDSA cycle. We plan it. We do it. We study it. That is, we get the data. We come back up and look at this question. And then we act. That is, we're going to change our plan based on the feedback we obtained. And then we're going to go through another cycle. This then becomes our model and our framework for how we're going to actually carry out improvement strategies. It gives us our guide and our roadmap.