Sourcebook : 2.1 How to make improvement happen

"Whether you think you can, or whether you think you can't, you're right." — Henry Ford

For most people, most of the time, what is easy and routine is what happens — until that easy routine comes apart. One case in point is how the health care system treats dying patients. In some instances, of course, it is not that the system is coming apart, but that it was never developed. Readers seeking to fix or change this system may feel — for a while, at least — like loose cannons in their own organizations. This book shows how to test creative ideas and solutions with small groups of patients and then, how to improve on those ideas to foster even more improvement. The model used is called the Plan - Do - Study - Act (PDSA) cycle; it is a practical and proven quality improvement tool. With this model, teams can start at virtually any point in the routine and change it for the better. This model is meant not to replace change models that organizations may already be using, but to streamline and accelerate improvement. Most important, health care providers can apply the model in their daily routines to improve how they care for dying patients and families.

The PDSA model requires teams to set aims, measure changes, and decide whether or not they are an improvement. The model has two parts that teams must use in order to make it work The first part requires asking (and answering) three fundamental questions:

• What are we trying to accomplish?
• How will we know that a change is an improvement?
• What changes can we make that will result in improvement?

This text is derived from the book Improving Care for the End of Life : A Sourcebook for Health Care Managers and Clinicians.