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PDSA Cycles

PDSA Cycles. Kyrie Shomaker, MD February 3, 2009. Features: Small-scale Temporary Methodical. Allows you to: Adjust your belief in the change Gain buy-in Try it out. Plan. Act. Study. Do. PDSA Cycles. Example 1. Example 1. Overall aim: To use non-work time more efficiently

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PDSA Cycles

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  1. PDSA Cycles Kyrie Shomaker, MD February 3, 2009

  2. Features: Small-scale Temporary Methodical Allows you to: Adjust your belief in the change Gain buy-in Try it out

  3. Plan Act Study Do PDSA Cycles

  4. Example 1

  5. Example 1 • Overall aim: • To use non-work time more efficiently • Most pressing problem: • Too many trips to the store and nothing for dinner • Ideas for change: • 1) Buy more stuff • 2) Make a weekly dinner menu

  6. Plan Act Study Do Example 1

  7. BreakthroughResults A P Evidence & Data S D A P S D A P S D A P Learning and improvement Theories, hunches,& best practices S D PDSA Ramps

  8. Appropriate Scope for PDSA Readiness to Make Change

  9. Example 2: Duty Hours

  10. Example 2: Duty Hours

  11. Example 2: Duty Hours Improvement Planning FormName: Duty Hours Improvement Aim: To eliminate duty-hours violations for all residents on pediatric rotations; including compliance with 30-hr, 80-hr, 10-hr, and “no new patients” rules. Measures (goals): Self-reported violations (hours log), violations reported by chief phone call, violations reported on RRC survey

  12. Key Points • For initial cycles, • Use the smallest scale possible (“cycle of one” is best!) • Failed cycles are good learning opportunities when small • For implementation cycles, • Test under many different conditions (busy days, different staff, things nay-sayers worry about)

  13. Activity • Given an aim and a list of brainstormed ideas, have each group come up with an initial PDSA cycle to test a selected change

  14. Make your own PDSA • Aim • To free up more beds in the Children’s Hospital by increasing throughput. • Problem • Even when the discharge date is known in advance, patients often do not vacate their room until afternoon, creating delays in the work-up and management of incoming patients. • Ideas for change: • Complete the brief summary and any other necessary paperwork the night before • Schedule a ride for the patient in the morning • Round on the patients to be discharged first (beginning at 9am) • Round on the patients to be discharged earlier (i.e. before morning conference) • Have the night team discharge the patient • Tell the charge nurse the night before that the patient is to be discharged • Communicate the discharge goals to the family/nurses in writing (i.e. the “discharge board”) • Communicate the discharge goals to the nurses with an anticipate discharge order (i.e. “anticipate discharge when…”) • Move the patients out of their rooms to a waiting area once they are discharged so the rooms can be cleaned and used again • Other ideas?

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