We’re continuing on our Plan-Do-Study-Act (PDSA) series and today are taking a closer look at “Do” and “Study.” As a reminder, the PDSA framework helps organizations implement a Continuous Quality Improvement (CQI) process. You can find a full overview of PDSA in this blog and this video. We break down “Plan” here.
Now that you have a clear plan developed, with an aim statement, planning diagram, process map, and data collection plan, it is time to implement your intervention.
This step in the process is what most organizations know and are already doing. Organizations are delivering interventions every day with their services, whether intentionally or unintentionally. What makes the “Do” step in this process transformational is wrapping it around the other three steps to guide the work and understand the impact.
Be sure before you begin implementation, you have thoroughly reviewed your process map to understand all the steps in the process your intervention will impact. Be sure, too, that you have detailed all the data points you will need to collect to fully answer your questions and measure your impact.
Before fully implementing, make sure you have completed the following steps:
- Create or update policies and procedures and communicate to all staff who play a role in the process you plan to change. Use your process map as a guide to understanding which staff will be involved in implementing the change and how.
- Develop or update data collection tools as needed to make your data collection plan possible.
- Meet with staff to inform of changes made. It can be helpful to explain the process up to this point so staff understand the importance of the implementation in the broader CQI framework. Remember, the “Do” step is only effective if all staff are on board and implement the change as planned.
- Train staff on how to implement changes. Keep in mind even small changes in routines can sometimes be difficult to adjust to. Ensure all staff are clear on the intervention and their responsibilities before implementing any planned changes.
Once these steps are complete, carry out your intervention. For the duration of the planned intervention, ensure changes remain in action – it can be easy to fall back into old habits!
Throughout implementation, collect data to understand the impact your intervention is having per your data collection plan. As you go, your team should also document problems, unexpected effects, and general observations.
The study phase of the cycle occurs after you have completed your intervention. You then analyze the data to study what did or did not occur. Organizations will want to review their predictions and assumptions before conducting the test.
- Complete data analysis
- Compare data to predictions
- Summarize the information
Organizations often skip over this step in the process or do not spend enough time thoughtfully reviewing the data. For some organizations, their data can be considered “high stakes” and there is a tendency to want to focus on the positive changes/ results that occurred and glance over the changes that did not occur or the benchmarks that were not met. During this phase, it is so important for an organization to be transparent and honest with themselves when reviewing the data. Remember, Continuous Quality Improvement is all about learning. Often, we learn just as much when interventions do not have the effects we thought they would as when they do.
First, complete the data analysis. As you are analyzing, compare the data you are seeing to your predictions outlined in the “Plan” phase. Use your analysis to answer the following questions:
- Did your plan result in an improvement? By how much/little?
- Was the action worth the investment?
- Do you see trends?
- Were there unintended side effects?
- What is interesting?
- What questions does this raise for us?
- What is significant about this information?
- What else do we want to know?
- Is this the right data?
- Is it meaningful?
- How does it tie back to who we serve/ support?
- How does it address our mission and cause?
As you analyze, pair your data with staff observations. Pay special attention to data that is surprising or does not make sense. Examine these pieces and use expertise on your team to understand why the data you are seeing might be surprising.
Based on your data, create a summary of your findings. Explain what happened, and why you think the intervention had the impact it did. Keep in mind, that the “Study” phase might reveal new questions. Note these for further analysis. Some findings may open the door to a new PDSA cycle. These questions are valuable takeaways from the process as well!
In the next step of the Continuous Quality Improvement PDSA process, we will explore what to do with what you have learned: the “Act” step.
At Transform Consulting Group, we follow this consistent approach when helping you find solutions to accelerate your impact. If you are looking to improve the quality of a service or program to facilitate positive change, contact us today!