Designing the Small Test of Change: PDSA Exercise. IHI Model for Improvement. The PDSA Cycle: View from 30,000 Feet
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1 Designing the Small Test of Change: PDSA Exercise Southern California Patient Safety Collaborative August 9, 2011 Pacific Palms Conference Resort, Industry Hills, CA Andrea B. Silvey, PhD, MSN Chief Quality Improvement Officer, Health Services Advisory Group, Inc. IHI Model for Improvement Aim Measure Selecting the change Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Act Plan Small tests of change Study Do 2 The PDSA Cycle: View from 30,000 Feet The Engine Act What changes are to be made? Next cycle? Study Plan Objective Questions and predictions (why) Plan to carry out the cycle (who, what, where, when) Do Complete the Carry out the plan analysis of the data Document problems Compare data to and unexpected predictions observations Summarize what Begin analysis was learned of the data for Improvement 3 1
2 Multiple PDSA Cycles Result in Improvement 4 Views from the Front Lines In your experience, what has been the most difficult stage of carrying out the PDSA cycle? What made it difficult? If you ve never used the PDSA model for improvement, what difficulties do you think you might encounter when you try to use it? 5 The Tennis Ball Game 6 2
3 How to Play Break up into groups of 5 6 people Select Timer, Scribe, and Leader Using your tennis balls, spend 5 minutes designing a process that meets the following specifications: Each ball must be touched by each person at least once The ball cannot be passed to the person directly next to you The balls must be moved from person to person 7 How to Play (Cont d) The goal is to build a process that meets the design specifications in the shortest time possible. Implement and time your process. Improve your process and time it again... Improve your process and time it again... After 5 minutes we will get the best time from each team for comparison. You will have another 5 minutes to improve your process and then report your new best time. 8 What Did You Do? Formed a team Designated roles Brainstormed Designed a process Measured its performance Benchmarked its performance Analyzed the process design Redesigned your process Measured your new process, etc. 9 3
4 Learning From Tennis Balls Before you can improve a process, you need to know how it works. Listen to all the members of your team, especially those who are the closest to the process. Share improvement ideas. Try them! 10 More Learnings If at first you don t succeed, try again. Look at others who perform the process well, both internally and externally. Borrow their ideas. Try again. Keep going. It s not the best people who succeed, it s the best team s process. 11 Questions I wish I had an answer to that because I'm tired of answering that question. Yogi Berra 12 4
5 Contact Information Andrea B. Silvey, PhD, MSN Chief Quality Improvement Officer Health Services Advisory Group Phoenix, AZ (602) This material was prepared by, the Medicare Quality Improvement Organization for California, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. CA-10SOW
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