Plan, Do, Study, Act (PDSA)

Plan, Do, Study, Act (PDSA) is increasingly being used as a tool to deliver immediate and noticeable improvement in patient care.   PDSA is a cycle of improvement that involves asking three key questions:

• What are we trying to accomplish?
• How will we know that a change is an improvement?
• What changes can we make that will result in an improvement?

Use of the PDSA tool has been a feature of The Healthcare Foundation/Institute of Health Improvement 'Safer Patient Initiative' piloted in Scotland by NHS Tayside.  It has also been used to bring about change and improvement to the delivery of primary care patient services as part of the Primary Care Collaboration supported by the Scottish Executive Health Department Directorate of Delivery's Improvement & Support Team (IST).

PDSA is a tool for use by health professionals in the workplace to deliver and test changes to clinical care.  The rapid cycle change aspect is the incremental build up of small cycles of PDSA activity into larger scale systems and process improvements.  PDSA advocates users to start small.  Use of this tool requires a change in the way your team, department and organisation think about improvement.  Training and support in the PDSA approach is needed to make clinical staff and management aware of the implications and repercussions of making a change.  Local agreement on the use of the PDSA approach to quality improvement is required for its successful implementation.