DCIP Learning Session 1 The Model for Improvement

DCIP Learning Session 1 The Model for Improvement (MFI) PDSA Cycles Sreeraj Sasi – Improvement Advisor

The Model for Improvement (MFI)

The Model for Improvement (MFI) Building the scene (Aim) Measurement Next steps (audit bundle presentations) Testing changes (PDSA)

The Model for Improvement (Mf. I) Testing changes (PDSA)

Uses for PDSA • Checking your understanding of your system

Uses for PDSA • Checking your understanding of your system • Testing changes within your system

Action orientated PDSA

Gold Standard for Improvement “Satisfactory prediction of the results of tests conducted over a wide range of conditions is the means to increase the degree of belief that the change will result in improvement. ” Improvement Guide, 2009, p. 141

Principles for testing a change 1. Test on a small scale and build knowledge sequentially 2. Collect data over time 3. Include a wide range of conditions in the sequence of tests Improvement Guide, 2009, p. 145 -153

Sequential building of knowledge with multiple PDSA cycles Evid A P data d n ea enc A P S D S D Breakthrough results/ implementation Wide scale testing Test under different conditions Follow up tests Very small scale test(s) Theories, hunches and best practices Improvement Guide, 2009, p. 146

Anatomy of a PDSA (learning) Cycle Plan Objective Questions and predictions Plan to carry out the Cycle (4 W) Plan for data collection “It is not the plan that is important, it is the planning. ” - Dr Graeme Edwards

Anatomy of a PDSA (learning) Cycle Plan Objective Questions and predictions Plan to carry out the Cycle (4 W) Plan for data collection “They say no plan survives first contact with implementation. I’d have to Do Carry out the plan Document problems agree” and unexpected -observations Andy Weir, The Martian Begin analysis of the data

Anatomy of a PDSA (learning) Cycle Plan Objective Questions and predictions Plan to carry out the Cycle (4 W) Plan for data collection didn’t go exactly as “I“Things didn’t fail a thousand times I’m notways dead, so Iplanned, found a but thousand how Study Do it’s win” Complete of a Carry out the plan bulb” not toanalysis make a light the data Document problems Compare data to Predictions Summarise learnings -and Andy Weir, The Martian - Thomas Edison unexpected observations Begin analysis of the data

Anatomy of a PDSA (learning) Cycle Act Plan Adopt, Adapt Objective Abandon Questions and predictions Plan to carry out the Cycle (4 W) Plan for data collection “If the plan A didn’tworkthere you should are 25 change other letters the plan in the but Study Do alphabet” Completenever analysis of the Carry outaim” the plan the data Compare data to Predictions Summarise learnings Document problems and unexpected observations Begin analysis of the data - Anon

Anatomy of a PDSA (learning) Cycle Act Plan Adopt, Adapt Abandon Questions and predictions Study Do Compare data to Predictions Document problems and unexpected observations

Hints for Planning Useful Tests of Change • Scale down the size and decrease the time required for the initial test. • Use small scale tests to build the case for others to follow • Break the testing down into more manageable pieces • Think a couple of cycles ahead of the initial test (future tests, implementation). • Use temporary supports to facilitate the change during the test. • Be innovative to make the test feasible.

2. Describe any improvement work you have carried out as a result of the bundle data

4. How might you further improve your data or practice systems? What else might you change?

Sharing Successes (and Failures) 2 0 3 1

Aim Steal Shamelessly

The Model for Improvement (Mf. I) Building the scene (Aim) Measurement Next steps (audit bundle presentations) Testing changes (PDSA)

Key messages (Data) Small regular data capture (data is current) The results are not “good/bad” The data is for sharing/not to be hidden away There will be variation – no kneejerk reactions (examine the underlying pattern) • Learn from the positive deviants (rather than resting on your laurels) as well as “outliers” • The key is the conversation • •

Key Messages (PDSA) • • • PDSA is not just about auditing. Use PDSA to test changes. Think small Prepare to fail (you will learn) Share successes and failures Steal shamelessly