1. PDSA: Plan, Do, Act, Study Marsha Spence, PhD, MPH, RDN, LDN
Department of Nutrition
Public Health Nutrition Graduate Program

2. Overview Continuous Quality Improvement (CQI) Performance Management
Plan, Do, Act, Study (PDSA)
Health Happens! CQI Strategies
Health Happens! Parent Recruitment PDSA
Conclusion

3. Continuous Quality Improvement (CQI)
Deliberate and defined process
Continuous and ongoing effort
Seeks to achieve measurable improvement
Goal is to improve:
efficiency, effectiveness, performance, accountability, outcomes

4. Performance Management
Looks at data/processes for CQI
Sets objectives
Measures objectives
Reports progress toward objectives,
Engages in specific activities when objectives aren’t being met

5. Minnesota Department of Health
Minnesota Department of Health. Quality Improvement and Performance Management. Available at:

6. PDSA: Plan, Do, Act, Study One of many CQI strategies
Focuses on improvement in a specific area or process
Deming Wheel/Deming Cycle

7. Sutton G. The Model for Improvement. Education Scotland.
Analyze data
Compare to predictions
Summarize
Sutton G. The Model for Improvement. Education Scotland.

8. Health Happens! CQI Techniques
Weekly meetings
Round-robin sharing of what worked and what didn’t work
Teacher In-Service
Parent Meetings
Child Nutrition/Physical Activity Education
Brainstorming ideas for improvement (formal and informal sessions)
Discussing alternatives
Maintaining minutes on file

9. Health Happens! Parent Recruitment PDSA Cycles
Plan
Incentives: food, prizes and free childcare Do
Directors were in charge of notifying parents about the meetings
Study
6-7 parents/meeting at first childcare center
2-3 parents/meeting thereafter
Act
New Strategy: Basic flyers were given to directors to give to parents

10. Plan Do Study Act Incentives: food, prizes and free childcare
Basic flyers were given to directors to give to parents Do
Basic flyers were distributed
Study
No change in parent attendance
Act
New Strategy: Enhanced flyers will be given to directors to distribute to parents and hang on the door

11. Plan Do Study Act Incentives: food, prizes and free childcare
Enhanced flyers were given to directors to give to parents and to post Do
Enhanced flyers were distributed and posted
Study
No change in parent attendance
Act
New Strategy: Professionally developed flyers will be put in backpacks or “home” folders of children

12. Plan
Incentives: food, prizes and free childcare
Professionally developed flyers were placed in children’s backpacks or “home” folders Do
Professionally developed flyers were distributed and posted
Study
No change in parent attendance
Act
New Strategy: Health Happens! staff will wear fruit and vegetable costumes and distribute professional flyers to parents during the afternoon pick-up the day before meeting

13. Plan Do Incentives: food, prizes and free childcare
Health Happens! staff will wear fruit and vegetable costumes and distribute professional flyers to parents during the afternoon pick-up the day before meeting Do
Staff distributed professional flyers to parents at afternoon pick-up
Study
No change in parent attendance
Act
New Strategy: Professional posters that advertise the meetings will be made and displayed at the childcare center, plus staff will distribute flyers at pick-up day before meeting

14. Plan Do Study Act Incentives: food, prizes and free childcare
Health Happens! staff will distribute professional flyers to parents during pick-up day before meeting
Posters will be displayed Do
Staff distributed professional flyers to parents at afternoon pick-up and hung posters
Study
No change in parent attendance
Act
New Strategy: Professional posters that advertise the meetings will be made and displayed at the childcare center, plus staff (in costumes) will distribute flyers at pick-up the afternoon before and the morning of the meetings.
These cycles continued with

15. Additional Cycles
Fruit and vegetable characters distributed flyers 2-3 days before, the afternoon before, and the morning of the meetings
Created sailor hats for the preschoolers with the flier attached as the feather
Created social media campaign (Twitter and Facebook)
Sent s and texts to parents who provided permission to remind them about the meetings.
Contacted churches within a 5-10 mile radius of the childcare center and informed them of the parent meeting. Meetings announced at church services and was in church bulletins.
Partnered with schools and community centers to advertise and hold meetings
Yard signs that advertised the meetings were placed in yards of childcare centers; Stickers that said “Health Happens Parent Meeting Tonight” were given to the preschoolers

16. Final Cycles
At one center, held meeting in conjunction with “parent-child snack day”; parent attendance was high, but could not be duplicated.
Due to inclement weather, created videos for each parent meeting lesson; provided flyer with link and QR code to the school. Requested that parents sign and return “attendance” slip to childcare teacher to indicate that they had watched the video.
12 parents watched the first video
17 watched the second video

17. Next Cycle to Begin August 2015
Plan
Incentives: food, prizes and free childcare for first and last meeting; drawing for grand prize based on attendance (including virtual attendance)
Health Happens! staff will distribute professional flyers with links and QR codes to directors to distribute to parents
Posters and yard signs will be displayed to advertise onsite classes and online videos
Videos will be professionally produced using “Captivate”
Attendance will be recorded by “attendance slips” and online monitoring of video site.
These cycles continued with

18. Conclusion
Continuous Quality Improvement strategies should be planned into program implementation to strengthen program components
PDSA cycles can be used to frame weekly meetings:
Plan: What will happen if we try something new?
Do: Do it!
Study: Did it work?
Act: What’s next?

19. Questions?

20. Funding for Health Happens
Funding for Health Happens! provided by grants from Blue Cross Blue Shield of Tennessee and East Tennessee Children’s Hospital Foundation