Quality Improvement Zone

The Model for Improvement is a simple powerful tool for accelerating improvement.  It is comprised of 2 key parts:

• 3 fundamental questions that drive all improvement; and
• The Plan-Do-Study-Act (PDSA) cycle. 

Combined, the three questions and the PDSA cycle form a framework to support continuous improvement.

An Improvement Team would use the tool as a framework for applying the five fundamental principles of improvement:

1. Knowing why there is a need to improve
2. Being able to interpret if improvement is happening through measurement
3. Developing an effective change theory which will result in improvement
4. Testing a change before moving to implementation
5. Knowing when and how to implement a change

The first 3 questions enable the improvement team to explore what it is they want to achieve, what change ideas might make a difference, and what they should measure to show improvement. Some literature refers to this part of the model as the “thinking” part.

What are we trying to accomplish?

Having identified an improvement, it is important to outline this as an aim statement. The aim statement should be :

• Specific

• Timebound (realistic end point)

• Aligned (to organisational priorities) and

• Numeric (quantifiable).

How will we know that a change is an improvement?

Improvement teams should identify a suite of Outcome, Process and Balancing measures. These measures track their progress against the improvement aim.

Outcome measures relate to the aim of the project, and measure of the performance of the system under study. Process measures track the specific steps or changes in a process which can influence the outcome. Balancing measures are measures which track any unintended consequences of the improvement effort.

What changes can we make that will result in improvement?

It is important that the whole team work together to generate ideas. There are a variety of tools available to improvement teams to better understand their system and identify potential change ideas. For example Process Mapping, Cause and Effect Diagram, Pareto Charts and Force Field Analysis.

We would also recommend the development of a Driver Diagram for each improvement project.

The second part of the model is the PDSA cycle and is sometimes referred to as the “doing” part. This part outlines the steps taken to test a change idea.