1. Sreeraj Sasi – Improvement Advisor
DCIP Learning Session 1
The Model for Improvement (MFI)
PDSA Cycles
Sreeraj Sasi – Improvement Advisor

2. The Model for Improvement (MFI)

3. The Model for Improvement (MFI)
Building the scene (Aim)
Measurement
Next steps (audit bundle presentations)
Testing changes (PDSA)

4. The Model for Improvement (MfI)
Testing changes (PDSA)

5. Uses for PDSA
Checking your understanding of your system

7. Uses for PDSA Checking your understanding of your system
Testing changes within your system

8. Action orientated PDSA

9. Gold Standard for Improvement
“Satisfactory prediction of the results of tests conducted over a wide range of conditions is the means to increase the degree of belief that the change will result in improvement.”
Improvement Guide, 2009, p. 141

10. Principles for testing a change
Test on a small scale and build knowledge sequentially
Collect data over time
Include a wide range of conditions in the sequence of tests
Improvement Guide, 2009, p

11. Sequential building of knowledge with multiple PDSA cycles
Breakthrough results/ implementation P D S A
Evidence and data P D S A
Wide scale testing P D S A
Test under different conditions P D S A
Follow up tests
Very small scale test(s)
Theories, hunches and best practices
Improvement Guide, 2009, p. 146

13. Anatomy of a PDSA (learning) Cycle
Plan
Objective
Questions and
predictions
Plan to carry out the
Cycle (4W)
Plan for data collection
“It is not the plan that is important, it is the planning.”
- Dr Graeme Edwards

14. Anatomy of a PDSA (learning) Cycle
Plan
Objective
Questions and
predictions
Plan to carry out the
Cycle (4W)
Plan for data collection
“They say no plan survives first contact with implementation. I’d have to agree”
- Andy Weir, The Martian Do
Carry out the plan
Document problems
and unexpected
observations
Begin analysis
of the
data

15. Anatomy of a PDSA (learning) Cycle
Plan
Objective
Questions and
predictions
Plan to carry out the
Cycle (4W)
Plan for data collection
“I didn’t fail a thousand times I found a thousand ways how not to make a light bulb”
- Thomas Edison
“Things didn’t go exactly as planned, but I’m not dead, so it’s a win”
- Andy Weir, The Martian
Study Do
Complete analysis of
the data
Compare data to
Predictions
Summarise
learnings
Carry out the plan
Document problems
and unexpected
observations
Begin analysis
of the
data

16. Anatomy of a PDSA (learning) Cycle
Act
Plan
Adopt, Adapt
Abandon
Objective
Questions and
predictions
Plan to carry out the
Cycle (4W)
Plan for data collection
“If the plan didn’t work you should change the plan but never the aim”
- Anon
“If plan A didn’t work there are 25 other letters in the alphabet”
- Anon
Study Do
Complete analysis of
the data
Compare data to
Predictions
Summarise
learnings
Carry out the plan
Document problems
and unexpected
observations
Begin analysis
of the
data

17. Anatomy of a PDSA (learning) Cycle
Act
Plan
Adopt, Adapt
Abandon
Questions and
predictions
Study Do
Compare data to
Predictions
Document problems
and unexpected
observations

18. Hints for Planning Useful Tests of Change
Scale down the size and decrease the time required for the initial test.
Use small scale tests to build the case for others to follow
Break the testing down into more manageable pieces
Think a couple of cycles ahead of the initial test (future tests, implementation).
Use temporary supports to facilitate the change during the test.
Be innovative to make the test feasible.

19. 2. Describe any improvement work you have carried out as a result of the bundle data

20. 4. How might you further improve your data or practice systems
4. How might you further improve your data or practice systems? What else might you change?

21. Sharing Successes (and Failures)3 2 1

22. Aim
Steal Shamelessly

23. The Model for Improvement (MfI)
Building the scene (Aim)
Measurement
Next steps (audit bundle presentations)
Testing changes (PDSA)

24. Key messages (Data) Small regular data capture (data is current)
The results are not “good/bad”
The data is for sharing/not to be hidden away
There will be variation – no kneejerk reactions (examine the underlying pattern)
Learn from the positive deviants (rather than resting on your laurels) as well as “outliers”
The key is the conversation

25. Key Messages (PDSA) PDSA is not just about auditing.
Use PDSA to test changes.
Think small
Prepare to fail (you will learn)
Share successes and failures
Steal shamelessly