PDSA for real learning: small tests before hospital-wide rollout

Why this matters

Announcing a new workflow and reviewing it at year-end differs from testing to learn. IHI describes PDSA as planning, testing, studying consequences and deciding what to modify next, with a record for each test. ^[1] Learning should influence the next cycle rather than merely label a completed project.

Evidence and important boundaries

IHI recommends small early tests, explicit questions and predictions, followed by testing in different conditions before wider implementation. ^[2] Improvement measurement can include outcome, process and balancing measures, using quantitative and qualitative information. ^[3] PDSA is not a substitute for research designed to establish causal effectiveness.

Suggested local application

ICORP suggests selecting a manageable problem, such as clarity of transfer documentation. Define the change, predicted benefit and useful observations. Test within an appropriate, approved scope and applicable safeguards. Record unexpected findings and practical difficulties, then decide whether to adapt, test another condition or stop the idea.

What to monitor

Review whether each cycle answered its question, how results differed from predictions and how learning shaped the next test. Include unintended workload or delays. Success is not the number of completed worksheets, but better understanding and a change supported by local evidence.