Things I Learned as a Practice Transformation Coach that I Wish I Knew as a Practice Manager: PDSAs Are Not Comparable to Root Canals

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Things I Learned as a Practice Transformation Coach that I Wish I Knew as a Practice Manager: PDSAs Are Not Comparable to Root Canals

If you work in the healthcare field, I’m sure that at some point or another you have participated in a quality improvement project where you utilized a PDSA (Plan-Do-Study-Act). PDSA is a four-stage model for improvement that provides a structured experimental learning approach for testing changes. It encourages practices to take a methodical approach to solving problems by thoroughly learning systems, utilizing process mapping to learn current practice processes, and brainstorming potential solutions to problems. After the ‘planning’ session, a core group of people will test the change for a short amount of time, analyze the results during the testing period, and if it all goes well implement a new process.

During my time as a practice manager I disliked PDSAs. The process was tedious, and most often than not, many of my colleagues (like myself) felt that it was an additional/unimportant task that needed to get completed in the mountain tasks. Most of my PDSAs were derived from the administration level, and typically there was minimal insight from the care team on the best approach to solve a problem or implement a new process. Sound familiar?

As I trained to become a Practice Transformation Facilitator, I had the opportunity to re-learn the PDSA process, and oddly enough I have become a huge PDSA promoter. PDSAs can actually be really fun and make a huge impact on patients and the care team. If done correctly, PDSAs are excellent opportunities for care teams and administrative staff to be creative and innovative in the way they deliver care. PDSAs can improve health outcomes as well as reduce provider and care team work load. Unfortunately, many practices that I meet have a cumbersome PDSA process and like my experience is avoided at all cost.

Below are the ‘Top 5’ things I have learned as a Practice Transformation Facilitator that I wish I knew when I worked at my clinic when implementing PDSAs.

PDSAs should be short and sweet
1. I was once a part of a PDSA that lasted an entire year. No joke. By the end of the PDSA our team had forgotten what we were trying to accomplish in the first place. PDSAs are intended to be done with a small group of people in a short amount of time. Try to limit your PDSA for 1-2 weeks and only test the change with a provider, a small care team or a pod. It will make the process that much smoother, faster and the team will be far more engaged.
Getting the ball rolling…
1. Starting a PDSA can be overwhelming. During my coaching sessions with practices, I often use the following three questions to get people to understand the purpose behind the work.
  1. What are we trying to accomplish?
  2. How will we know that a change is an improvement?
  3. What changes can we make that will result in an improvement?
Simple PDSA worksheets exist
1. There are some excellent PDSA worksheets that simplify the process. If your current PDSA worksheet is a 10-page paper that asks twenty different questions, you might be making a simple process a lot more complicated than it needs to be. HealthTeamWorks has excellent tools to simplify the development and execution of a PDSA. Give us a call!
Schedule time for the right people to be at the table
1. I have been a part of PDSAs where it was developed by administration heads with little to no input from the team that was going to be directly impacted. This often resulted in failed PDSAs. Administration leads missed critical points in the current process and the care team involved wasn’t engaged during the implementation period. When you are designing your PDSA include those individuals who will be directly impacted in the development. If you need provider insight, bring a provider to the table. Better yet, ask your teams areas that they wish they could improve and develop a PDSA around that. You will learn far more information and obtain greater participation and engagement from your practice team.
Communicate PDSAs
1. Trust me, you want to communicate what you are trying to improve with the rest of your practice. Not only will you get additional insight, but it helps create a culture of innovation and creativity within your practice. In my experience as a Practice Transformation Facilitator, practices that shared the PDSAs they were implementing AND the outcome of them were far more open and willing to change.