The four steps for testing a change are:

Correct Answer:
D.) A and B

The best answer is "A and B." After a successful pilot, they should move on to the implementation phase. This phase includes actions to "hardwire" the change, such as making it standard policy and training new staff on it. In implementing the change, the team will continue to run PDSAs: making predictions, carrying out the test, collecting data, and refining the change based on results. (Note that compared to PDSAs in the pilot phase, these tests will require significantly more people, time, and resources.)

A and B

The best answer is "A and B." After a successful pilot, they should move on to the implementation phase. This phase includes actions to "hardwire" the change, such as making it standard policy and training new staff on it. In implementing the change, the team will continue to run PDSAs: making predictions, carrying out the test, collecting data, and refining the change based on results. (Note that compared to PDSAs in the pilot phase, these tests will require significantly more people, time, and resources.)

Model for Improvement: Plan-Do-Study-Act (PDSA) Cycles

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See also: Tips for Testing Changes, Linking Tests of Change, Testing Multiple Changes, Implementing Changes, Spreading Changes.

Reasons to Test Changes

• To increase your belief that the change will result in improvement.
• To decide which of several proposed changes will lead to the desired improvement.
• To evaluate how much improvement can be expected from the change.
• To decide whether the proposed change will work in the actual environment of interest.
• To decide which combinations of changes will have the desired effects on the important measures of quality.
• To evaluate costs, social impact, and side effects from a proposed change.
• To minimize resistance upon implementation.

Steps in the PDSA Cycle

Step 1: Plan

Plan the test or observation, including a plan for collecting data.

• State the objective of the test.
• Make predictions about what will happen and why.
• Develop a plan to test the change. (Who? What? When? Where? What data need to be collected?)  

Step 2: Do

Try out the test on a small scale.

• Carry out the test.
• Document problems and unexpected observations.
• Begin analysis of the data.

Step 3: Study
Set aside time to analyze the data and study the results.

• Complete the analysis of the data.
• Compare the data to your predictions.
• Summarize and reflect on what was learned.  

Step 4: Act

Refine the change, based on what was learned from the test.

• Determine what modifications should be made.
• Prepare a plan for the next test.

Example of a Test of Change (Plan-Do-Study-Act Cycle)

Depending on their aim, teams choose promising changes and use Plan-Do-Study-Act (PDSA) cycles to test a change quickly on a small scale, see how it works, and refine the change as necessary before implementing it on a broader scale. The following example shows how a team started with a small-scale test.

Diabetes: Planned visits for blood sugar management.

• Plan: Ask one patient if he or she would like more information on how to manage his or her blood sugar.
• Do: Dr. J. asked his first patient with diabetes on Tuesday.
• Study: Patient was interested; Dr. J. was pleased at the positive response.
• Act: Dr. J. will continue with the next five patients and set up a planned visit for those who say yes.

Quality Glossary Definition: Plan-do-check-act (PDCA) cycle

Variations: plan-do-study-act (PDSA) cycle, Deming cycle, Shewhart cycle. Understand the evolution of these variations.

The Plan-do-check-act cycle (Figure 1) is a four-step model for carrying out change. Just as a circle has no end, the PDCA cycle should be repeated again and again for continuous improvement. The PDCA cycle is considered a project planning tool.

Figure 1: Plan-do-check-act cycle

• When to use the PDCA cycle
• PDCA example
• PDCA resources

When to Use the PDCA Cycle

Use the PDCA cycle when:

• Starting a new improvement project
• Developing a new or improved design of a process, product, or service
• Defining a repetitive work process
• Planning data collection and analysis in order to verify and prioritize problems or root causes
• Implementing any change
• Working toward continuous improvement

The Plan-do-check-act Procedure

1. Plan: Recognize an opportunity and plan a change.
2. Do: Test the change. Carry out a small-scale study.
3. Check: Review the test, analyze the results, and identify what you’ve learned.
4. Act: Take action based on what you learned in the study step. If the change did not work, go through the cycle again with a different plan. If you were successful, incorporate what you learned from the test into wider changes. Use what you learned to plan new improvements, beginning the cycle again.

Plan-Do-Check-Act Example

The Pearl River, NY School District, a 2001 recipient of the Malcolm Baldrige National Quality Award, used the PDCA cycle as a model for defining most of their work processes, from the boardroom to the classroom.

The PDCA model was the basic structure for the district’s:

• Overall strategic planning
• Needs analysis
• Curriculum design and delivery
• Staff goal-setting and evaluation
• Provision of student services and support services
• Classroom instruction

Figure 2 shows their "A+ Approach to Classroom Success." This is a continuous cycle of designing curriculum and delivering classroom instruction. Improvement is not a separate activity—it is built into the work process.

Plan

The A+ Approach begins with a "plan" step, which the school district calls "analyze." In this step, students’ needs are analyzed by examining a range of data available in Pearl River’s electronic data "warehouse." The data reviewed includes everything from grades to performance on standardized tests. Data can be analyzed for individual students or stratified by grade, gender, or any other subgroup. Because PDCA does not specify how to analyze data, a separate data analysis process (Figure 3) is used here as well as in other processes throughout the organization.

Do

The A+ Approach continues with two "do" steps:

1. The "align" step asks what the national and state standards require and how they will be assessed. Teaching staff also plans curricula by looking at what is taught at earlier and later grade levels and in other disciplines to ensure a clear continuity of instruction throughout the student’s schooling. Teachers develop individual goals to improve their instruction where the "analyze" step showed any gaps.
2. The "act" step is where instruction is provided, following the curriculum and teaching goals. Within set parameters, teachers vary the delivery of instruction based on each student’s learning rates and styles.

Check

Formal and informal assessments take place continually, from daily teacher assessments to six-week progress reports to annual standardized tests. Teachers also can access comparative data on the electronic database to identify trends. High-need students are monitored by a special child study team.

Throughout the school year, if assessments show students are not learning as expected, mid-course corrections are made (such as re-instruction, changing teaching methods, and more direct teacher mentoring). Assessment data become input for the next step in the cycle.

Act

In this example, the "act" step is "standardization." When goals are met, the curriculum design and teaching methods are considered standardized. Teachers share best practices in formal and informal settings. Results from this cycle become input for the "analyze" phase of the next A+ Approach cycle.

PDCA Resources

You can also search articles, case studies, and publications for PDCA resources.

Articles

A Systematic View (Lean & Six Sigma Review) Modular Kaizen is an improvement approach that integrates quality techniques into the busy schedule of everyday activities. The Modular Kaizen approach is complementary to the PDCA and DMAIC models of quality improvement, as described in this article.

A Lean Approach To Promoting Employee Suggestions (Quality Progress) This simple, low-tech approach maintains the visual process and easily communicates where each suggestion is in the PDCA process without the need for email, databases or other technological means. 

Circling Back (Quality Progress) There still seems to be much confusion surrounding W. Edwards Deming’s plan-do-study-act (PDSA) cycle. This article examines the three main misunderstandings surrounding PDSA and PDCA cycles.

The Benefits of PDCA (Quality Progress) The brief history of PDCA and an example of PDCA in action help establish the use of this cycle for continuous process improvement.

Tell Me About It (Quality Progress) Based on the PDSA cycle, this article introduces the plan-do-study-act-export (PDSA-X) cycle, which supports the collaborative pursuit of excellence across organizational boundaries, geography and time.

Case Studies

Stewardship And Sustainability: Serigraph's Journey To ISO 14001 (Journal for Quality and Participation) By utilizing ISO 14001 and Lean Six Sigma, including the PDCA cycle, as templates for continuous environmental improvement, a variety of actions are taken to become a socially responsible organization (SRO) and minimize Serigraph Inc.’s environmental footprint

Message Received (Six Sigma Forum Magazine) The science of experimental design allows you to project the impact of many factors by testing a few of them. If the project follows the DMAIC process, you can make some adjustments to the PDCA outline, which is the approach taken by Deemsys Inc., a training organization that wanted to better understand the response rate of its email marketing efforts.

Courses

Applied Lean

ASQ's Quality 101

Lean Foundations

Webcasts

"An Introduction to the PDCA Cycle," a three-part webcast series by Jack ReVelle:

• Part 1: This introduction walks through the PDCA cycle’s origins in the scientific method, as well as its connection to the Deming-Shewhart cycles.
• Part 2: This webcast compares and connects PDCA to other methodologies, including DMAIC, lean, and ISO 9001.
• Part 3: The final webcast provides an example application of PDCA and explores the benefits of using PDCA.

Adapted from The Quality Toolbox, Second Edition, ASQ Quality Press.

What is the order of the four steps teams typically follow?

Which of the following are strategies to help members of a QI team establish common goals create a team roster?