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.