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Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Model for Improvement

Plan-Do-Study-Act cycle.

The Model for Improvement, developed by Associates in Process Improvement, is a simple, yet powerful, tool for accelerating improvement. The model is not meant to replace change models that organizations may already be using, but rather to accelerate improvement. This model has been used very successfully by hundreds of health care organizations in many countries to improve many different health care processes and outcomes.

The Model for Improvement has two parts:

Part 1. Three fundamental questions that can be addressed in any order:
  1. What are we trying to accomplish?
  2. How will we know that a change is an improvement?
  3. What changes can we make that will result in improvement?
Part 2. The Plan-Do-Study-Act (PDSA) cycle: This process is used to test and implement changes in real work settings. The PDSA cycle guides the test of a change to determine if the change is an improvement.

Setting Aims

Improvement requires setting aims. The aim should be time-specific and measurable; it also should define the specific population of patients that will be affected.

Establishing Measures

Teams use quantitative measures to determine if a specific change actually leads to an improvement.

Selecting Changes

All improvement requires making changes, but not all changes result in improvement. Therefore, organizations must identify the changes most likely to result in improvement.

Testing Changes

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method used for action-oriented learning.

Implementing Changes

After testing a change on a small scale, learning from each test, and refining the change through several PDSA cycles, the team can implement the change on a broader scale—for example, on an entire pilot population or on an entire unit.

Diffusing Changes

After the successful implementation of a change, or package of changes, on a pilot population or an entire unit, the team can diffuse the changes to other parts of the organization or in other organizations.

Resources

Institute for Healthcare Improvement. How to Improve Exit Disclaimer: You Are Leaving www.ihs.gov .

Langley, G.L.; Nolan, K.M.; Nolan, T.W.; Norman, C.L.; Provost, L.P. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance Exit Disclaimer: You Are Leaving www.ihs.gov .

Deming, W.E. The New Economics for Industry, Government, Education Exit Disclaimer: You Are Leaving www.ihs.gov .

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