THE MODEL FOR IMPROVEMENT
The Model for Improvement,* developed by Associates in Process Improvement, is a simple yet powerful tool for accelerating improvement. The model is not meant to replace change models that organizations may already be using, but rather to accelerate improvement. This model has been used very successfully by hundreds of health care organizations in many countries to improve many different health care processes and outcomes.
The model has two parts:
- Three fundamental questions, which can be addressed in any order.
- The Plan-Do-Study-Act (PDSA) cycle** to test and implement changes in real work settings. The PDSA cycle guides the test of a change to determine if the change is an improvement.
Including the right people on a process improvement team is critical to a successful improvement effort. Teams vary in size and composition. Each organization builds teams to suit its own needs.
Forming the Team
Setting Aims
Commitment to improving critical care delivery is reflected by a strong and well- worded aim statement.
Establishing Measures
Measures should provide information-for example, did the
introduction of the ventilator bundle decrease length of time on the ventilator?
Selecting Changes
Teams must test and implement changes at four levels: patient, care team,
leadership and system, and flow in and out of the ICU in order to improve critical
care delivery.
Testing Changes
The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real
work setting — by planning it, trying it, observing the results, and acting on what
is learned. This is the scientific method used for action-oriented learning
References
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Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance.
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The Plan-Do-Study-Act cycle was developed by W. Edwards Deming (Deming WE. The New Economics for Industry, Government, Education.).