Plan-Do-Study-Act (PDSA) Template

 

Part 1: The purpose of Part 1 is for you to focus on your selected topic and start thinking about your plan. In 300-500 words, address the following key questions:

1. What are you trying to accomplish? (The aim statement).

 

2. How will you know if the change is an improvement? (What measures of success will you use?)

3. What changes can you make that will result in improvement? (Change concepts that will be tested).

 

 

 

 

 

 

 

 

Part 2: Using the questions in Part 2, complete the PDSA template below.
STEP: CYCLE:

PLAN
I plan to:
I hope this produces:

Steps to execute (include a minimum of five steps):

1.
2.
3.
4.
5.

DO
What would you anticipate/predict to observe (include a minimum of five observations)?

1.
2.
3.
4.
5.

STUDY
Describe how you would measure the results and compare them to the prediction.

 

ACT
What might you conclude from completing one cycle of the plan?

Describe modifications for the next cycle based on what you learned.

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