Quality improvement using Plan-Do-Study-Act Strategies for local quality improvement

What is PDSA? Plan-Do-Study-Act (PDSA) is a structured, straightforward approach to implementing quality improvement projects/initiatives in practices. This approach works on many changes from improving a patient care process to executing a new workflow and practices of all sizes. Institute for Healthcare Improvement. Science of Improvement: How to Improve. 2016.

Four steps to using Plan-Do-Study-Act 1 1 PLAN: develop the initiative 1 2 DO: implement your plan 3 STUDY: check the results 4 ACT: make further improvements

Tools/Resources for using PDSA for your quality improvement projects Setting QI Goals Worksheet PDSA Planning Worksheet Gap Analysis Worksheet PSDA Evaluation Worksheet Practical Tips for a real-life PDSA Practice Assessment Tool Run Chart Process Map Toolkit A3 Template

Helpful hints for a successful PDSA project Start Small – to gain familiarity with the process and comfort with the methodology. Use other analysis tools to approach a larger improvement project including a fishbone diagram, a scatterplot, or the StepsForward Lean Healthcare module. Use SMART goals

How is it working at other practices? Brooklyn, NY Steps in Practice Summary - University Physicians Group in Staten Island and Brooklyn, NY University Physicians Group started their first PDSA cycle in 2014 to address suboptimal diabetes outcomes during the previous year. They started with a simple patient-facing questionnaire that targeted patients’ understanding of diabetes and their care plans. It revealed a gap in what doctors believed their patients understood and what patients actually understood about their health condition. With the information provided in the questionnaire, the group was able to use the PDSA process to accomplish two things: improve communication with patients regarding their disease and improve outcomes for patients with diabetes. Plan – The group’s plan relied on medical assistants to educate and coach patients with diabetes. A pilot program of 150 patients were enrolled to receive this new diabetes communication and education workflow. Do – Current medical assistants were trained to ask patients a set of questions and they began implementing these questions into their conversations with the pilot group of patients. After 3 months of the pilot program, the patients were resurveyed to check initial impact. Results were favorable. The practice will be collecting data on an ongoing basis and are going to start the Study phase of the project soon. That will help them identify what improvements need to be made to their initial pilot.

Robert Dobbin Chow, MD, MBA, MACP “ I thought I had a good handle on managing my diabetic patients but I learned about facilitating good decision-making by my patients, coaching behavioral changes and gaining insight into patient compliance. I also learned about how to engage my office staff into optimizing OUR care of OUR diabetic patients. . ” Robert Dobbin Chow, MD, MBA, MACP Baltimore, MD embed video

For additional resources, frequently asked questions and implementation support, visit www.stepsforward.org!