What is Improvement Science and how can it help me?

You can use plan, do, study, act (PDSA) cycles to test an idea by temporarily trialling a change and assessing its impact. This approach is unusual in a healthcare setting because traditionally, new ideas are often introduced without sufficient testing.

The four stages of the PDSA cycle: 




Plan - the change to be tested or implemented 
Do - carry out the test or change 
Study - data before and after the change and reflect on what was learned 
Act - plan the next change cycle or full implementation


When does it work best?

You may not get the results you expect when making changes to your processes, so it is safer, and more effective to test out improvements on a small scale before implementing them across the board.

Using PDSA cycles enables you to test out changes before wholesale implementation and gives stakeholders the opportunity to see if the proposed change will work.

Using the PDSA cycle involves testing new change ideas on a small scale. 
For example:

Trying out a new way to make appointments for one consultant or one clinic

Trying out a new patient information sheet with a selected group of patients before introducing the change to all clinics or patient groups

By building on the learning from these test cycles in a structured way, you can put a new idea in place with greater chances of success 

As with any change, ownership is key to implementing the improvement successfully. If you involve a range of colleagues in trying something out on a small scale before it is fully operational, you will reduce the barriers to change.

Why test change before implementing it?

It involves less time, money and risk

The process is a powerful tool for learning; from both ideas that work and those that don't

It is safer and less disruptive for patients and staff

Because people have been involved in testing and developing the ideas, there is often less resistance

How to test:

Plan multiple cycles to test ideas. You can adapt these from the service improvement guide so there is already evidence that the change works

Test on a really small scale. For example, start with one patient or one clinician at one afternoon clinic and increase the numbers as you refine the ideas

Test the proposed change with people who believe in the improvement. Don't try to convert people into accepting the change at this stage

Only implement the idea when you're confident you have considered and tested all the possible ways of achieving the change 

How to use it:

PDSA cycles form part of the improvement guide, which provides a framework for developing, testing and implementing changes leading to improvement. The model is based in scientific method and moderates the impulse to take immediate action with the wisdom of careful study. The framework includes three key questions and a process for testing change ideas.