Ideas generation and testing change (PDSA)

'All improvement requires change, but not every change is improvement'. (Langley et al 2009)

The Model for Improvement is a systematic approach to testing your ideas for making improvement.

It is a widely recognized process in healthcare and frequently creates positive outcomes for improvement.

It’s popular because it requires a fast approach of testing ideas to see if they work.

Test small, fail quickly and move on to a new idea, or hopefully see results and begin to spread the change


PDSA Cycle

Use plan, do, study, act (PDSA) cycles to test an idea by trialling a change on a small scale and asses its impact, building upon the learning from previous cycles in a structured way before wholesale implementation.

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.


It is often necessary to run sequential iterations of a PDSA cycle to rapidly and incrementally refine your theory of change. These sequential iterations of related PDSA cycles make up a PDSA ramp. Ramps are typically used to take a very small scale test and incrementally build on it with follow up tests, larger scale tests of change and eventually the implementation of changes.

Action plan

Action Plans are simple lists of all of the tasks that you need to finish to meet an objective. They differ from To-Do Lists  in that they focus on the achievement of a single goal.

Action Plans are useful, because they give you a framework for thinking about how you'll complete a project efficiently. They help you finish activities in a sensible order, and they help you ensure that you don't miss any key steps. Also, because you can see each task laid out, you can quickly decide which tasks you'll delegate or outsource, and which tasks you may be able to ignore.

© 2018 BCUQI

Privacy statement/GDPR:

 BCUHB is not responsible for external link content nor external Twitter comments.

 Several external organisations' logos are used: they all link to their respective websites.

BCUHB staff should not include any patient identifiable information or use any health board system passwords including nadex passwords when using any areas of this website.

Unless otherwise indicated, the design and content of this site is the property of BCUQI which is part of Betsi Cadwaladr University Health Board. Permission should be sought prior to any use of the design and content from this or other pages contained in this site.

The BCUQI Team (part of the Betsi Cadwaladr University Health Board) may share your personal information within the team and relevant health board staff for the purposes of administration of Members' Area/Forum as well as booking onto events.  By booking a place at events using this site, or applying for membership, you agree to this policy and for your data to be retained indefinitely for the purpose of Quality Improvement work and consent to us contacting you in future. This booking may involve an external provider, in which case their Privacy Policy will apply. You may contact us for more information about any data  or photographs we hold, including asking us to delete these, by contacting us by email (