Model for Improvement
& PDSA Cycles
Numerous improvement methodologies are used nationally and internationally, to improve processes of care or patient outcomes. Clinical Practice Improvement (CPI) is a commonly used methodology to address identified problems in the clinical area. It involves identifying, defining and diagnosing a problem, before developing solutions and implementing interventions that may address the identified issues. Possible solutions are then tested using small-cycle testing called “Plan, Do, Study, Act” (PDSA) cycles. ,
It is important to measure the impact of changes in order to verify that your interventions have made a difference. PDSA cycles were originally known as the Shewhart cycle, “Plan, Do, Check, Act”, and based on manufacturing models. They were later modified by Edwards Deming to PDSA cycles.
There are three main concepts to consider when undertaking improvement. This is demonstrated well with the Model for Improvement below. , This model was developed by Associates for Process Improvement and is used by the Institute for Healthcare Improvement (IHI) as their framework to guide improvement work.
Figure 1: Model for Improvement & PDSA (image adapted)
To learn more about the Model for Improvement and PDSA cycles, please refer to the Institute for Healthcare Improvement website. You may need to take a moment and register with the IHI for more in-depth information.
Video Links (IHI)
- Model for Improvement Part 1 ~3 mins
- Model for Improvement Part 2 ~3 mins
- PDSA Part 1 ~4 mins
- PDSA Part 2 ~4 mins
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 Nolan T, Resar R, Haraden C, Griffi n FA. Improving the Reliability of Health Care. IHI Innovation Series white paper. 2004; Boston: Institute for Healthcare Improvement. Available from: http://www.ihi.org/resources/pages/ihiwhitepapers/improvingthereliabilityofhealthcare.aspx
 Moen RD, Norman CL. Circling Back: Clearing up myths about the Deming cycle and seeing how it keeps evolving. Quality Progress. American Society for Quality, November, 2010 Available from: http://www.apiweb.org/circling-back.pdf
 How to Improve [internet]. Cambridge MA: Institute for Healthcare Improvement; 2016. Available from: http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx