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The PROBLEM with Plan-Do-Study-ActcyclesJulie E Reed,1 Alan J Card2,31 NIHR CLAHRC NWL, ImperialCollege London, London, UK2 Department of Management,University of Notre Dame, NotreDame, Indiana, USA3 Evidence-Based HealthSolutions, LLC, Notre Dame,Indiana, USAC orrespondence toDr Julie E Reed, NIHR CLAHRCNWL, Imperial College London,Chelsea and WestminsterHospital, 369 Fulham Road,London SW10 9NH, 23 November 2015 Published Online First23 December 2015 cite:Reed JE, Card Qual Saf2016;25:147 improvement (QI) methods havebeen introduced to healthcare to supportthe delivery of care that is safe, timely,effective, efficient, equitable and costeffective. Of the many QI tools andmethods, the Plan-Do-Study-Act (PDSA)cycle is one of the few that focuses onthe crux of change, the translation ofideas and intentions into action. As such,the PDSA cycle and the concept of itera-tive tests of change are central to manyQI approaches, including the model forimprovement,1lean,2six sigma3and totalquality provides a structured experimen-tal learning approach to testing , concerns have been raisedregarding the fidelity of application ofPDSA method, which may underminelearning efforts,5the complexity of itsuse in practice56and as to the appropri-ateness of the PDSA method to addressthe significant challenges of article presents our reflections onthe full potential of using PDSA inhealthcare, but in doing so we explorethe inherent complexity and multiplechallenges of execut

Nov 23, 2015 · the PDSA cycle and the concept of itera-tive tests of change are central to many QI approaches, including the model for improvement,1 lean,2 six sigma3 and total quality management.4 PDSA provides a structured experimen-tal learning approach to testing changes. Previously, concerns have been raised regarding the fidelity of application of

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