[Narrator] Hi, in this video we're going to talk about PDSA cycles which are a simple yet powerful tool for quality improvement in healthcare. Systems in healthcare environments are complex and never stop. Changes to these systems need to be thought through and carefully implemented and tested. PDSA cycles lead to a process of change that is structured and reflective rather than impulsive and chaotic.
The cycle has four stages. Plan, do, study, and act. The plan stage has three parts. The first is finding the issue for improvement. All issues are different, so there are many ways of doing this. Maybe interpreting data or staff and patient feedback. Issues pop up in unexpected places, so you've got to be on the ball to notice them.
The second part is coming up with a change that could make things better. Maybe something like improving staff teamwork or communication. Also, there may be a few different changes that could work. Decide on the one you think will work best and give it a go. The third part is predicting what will happen when you make the change. Predict some of the impacts it will have and write these down to review later.
The do stage is
Do stage
putting the change to the test carefully. First, you need to prepare for your test. For example, giving the staff training they'll need or making sure all necessary resources are in place. Once everything's in place, test the task out on a small scale. Try it out on a patient or a small group of patients first. Then, if it doesn't work, it will be easier to remove. It's also less risky. While you're doing the test, keep track of it in real time through a continuous monitoring system.
Study stage
The study stage is a reflection on the results of your test. Look at the results you collected from your monitoring system. What has changed. Who have these changes affected and how have the effects been positive or negative. Are the changes worth keeping or even developing. How do these effects differ from what you predicted would happen.
Act stage
The act stage is responding to your reflection. You need to decide whether to spread, stop, or improve the changes. If it was successful, maybe carefully spread it to more patients little by little. Perhaps it was beneficial, but there are areas that need some work. Maybe it had negative results and needs to be removed.
In healthcare, quality
Conclusion
improvement is an ongoing process. This means that PDSA cycles don't end but become linked to another cycle incorporating what was learned from the previous cycle. Using the PDSA cycle, sustainable continuous improvement can be achieved leading to satisfied staff and happy patients.
For more information and to start your own quality improvement project, visit quality.bmj.com or follow us on Twitter at BMJquality.