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Editable PDSA Cycle Template

The document outlines a model for improvement using the Plan-Do-Study-Act (PDSA) cycle. It begins by asking three fundamental questions: what are we trying to accomplish, how will we know a change is an improvement, and what changes can we make to achieve our goal. Ideas for changes are then tested using the PDSA cycle, which involves planning a test of the change idea, carrying out the test, analyzing the data, and deciding whether to adopt, adapt, or abandon the change. The template provides sections to document the plan, observations during testing, analysis of results, and next steps.

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Brothers 6
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162 views4 pages

Editable PDSA Cycle Template

The document outlines a model for improvement using the Plan-Do-Study-Act (PDSA) cycle. It begins by asking three fundamental questions: what are we trying to accomplish, how will we know a change is an improvement, and what changes can we make to achieve our goal. Ideas for changes are then tested using the PDSA cycle, which involves planning a test of the change idea, carrying out the test, analyzing the data, and deciding whether to adopt, adapt, or abandon the change. The template provides sections to document the plan, observations during testing, analysis of results, and next steps.

Uploaded by

Brothers 6
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Model for Improvement – Template

Step 1. The 3 Fundamental Questions


1. What are we trying to accomplish?
(By answering this question we will develop our goal for improvement)

2. How will we know that a change is an improvement?


(By answering this question we will develop measures to track achieving our goal)

3. What changes can we make that can lead to an improvement? – list your ideas for change
(By answering this question we will develop the ideas we would like to test to achieve our goal)

Idea 1

Idea 2

Idea 3

1
PDSA Template
Step 2. Complete this template for each PDSA cycle you undertake
Planned Start Date Planned Finish Date

PDSA #: This PDSA Title: Owner:


Objective for this PDSA Cycle:
What are we trying to improve (aim), by how much (goal) and by when (timeframe)?

Plan: Fill the sections below as part of planning


Change Idea: Describe the change we plan to test (refer to the 3rd fundamental question above).

Questions: What question(s) do we want to answer on this PDSA cycle?

Prediction: What do we think will happen?

Prediction on Change:

Prediction on Question:

Data: What data will we need to test our prediction(s)? How will it be collected?

2
Task to be completed for Test Who When Where and How

Do: Carry out the change or test; Collect data and begin analysis.
Was the cycle carried out as planned? Yes No

Record data, observations and feedback.

What problems or unexpected events were encountered?

Study: Complete analysis of data


What do the data show?

Was our prediction(s) confirmed? If not what did we learn?

Compare the data to what was predicted and summarise the learning

Act: Decide the next step.

3
Decide to Adopt, Adapt, or Abandon.

Adapt: Improve the change and continue testing plan.


Plans/changes for next test:

Adopt: Select changes to implement on a larger scale and develop an implementation plan and plan for sustainability

Abandon: Discard this change idea and try a different one

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