At the heart of QI is the Model for improvement, it is a framework designed to accelerate improvement in healthcare settings.

Think of the model for improvement as a roadmap to carry out improvement. The model has two parts.

Part one: It starts with 1,2,3.

1. Begin with an aim. The aim is the answer to the question, what is the team wanting to accomplish and in what timeframe? For example, a reduction of falls on the ward by next year.

2. What data can be used as a measure. A measure shows if a change is helping you to reach your aim. For example, a team can write down how many falls happen each week before they start their QI project, and continue to collect this data during their project – this is their measure. After the team has implemented a change they think will help to stop falls on the ward, they can study if it’s working by checking their measure – the number of falls happening each week.

3. What changes can be implemented to achieve the aim chosen. For example, making sure the floor is even to prevent someone falling.

Part two: PDSA Cycle

Once a team has established 1,2,3 they go into a PDSA Cycle. It’s called a PDSA cycle because each letter stands for a stage in the cycle. There is a Plan stage, a Do stage, a Study stage and an Act stage.

After a team has found their aim (1), measure (2) and a change they want to implement (3), they have automatically completed the Plan stage of their first PDSA cycle.

The team then moves to the Do stage, where they take the change they think will help to achieve their aim and test it out.

After a certain amount of time, the team goes to the Study stage to examine if the change has helped to achieve their aim, this is where the measure comes in. Based on what the team learns from the study stage they Act by revisiting the plan stage.

Now, teams look into a different change they can implement if the previous one hasn’t worked to achieve their aim. If the change has made an improvement, teams think of an additional change that will drive a higher level of improvement closer or better than the aim.