Plan-Do-Check-Act (PDCA) Cycle

Also called:

PDCA,

Plan–Do–Study–Act (PDSA) cycle,

Deming cycle,

Shewhart cycle.

The Plan Do Check Act (PDCA) cycle is the operating principle of ISO’s management system standards.

It’s formal structure includes processes that regularly examine performance and ensure that the system continues to provide ongoing benefits.

The plan–do–check–act cycle is a four–step model for carrying out change.

Just as a circle has no end, the PDCA cycle should be repeated again and again for continuous improvement.

When to Use Plan–Do–Check–Act

1. As a model for continuous improvement.
2. When starting a new improvement project.
3. When developing a new or improved design of a process, product or service.
4. When defining a repetitive work process.
5. When planning data collection and analysis in order to verify and prioritize problems or root causes.
6. When implementing any change.

Plan–Do–Check–Act Procedure

A. Plan

• Recognize an opportunity and plan a change.
• Establish the objectives and processes necessary to deliver results in accordance with the expected output (the target or goals).
• By establishing output expectations, the completeness and accuracy of the specification is also a part of the targeted improvement.

B. Do

• Test the change.
• Carry out a small-scale study.
• Implement the plan, execute the process, make the product.
• Collect data for charting and analysis in the following “CHECK” and “ACT” steps.

C. Check

• Review the test, analyze the results and identify what you’ve learned.
• Study the actual results (measured and collected in “DO” above) and compare against the expected results (targets or goals from the “PLAN”) to ascertain any differences.
• Look for deviation in implementation from the plan and also look for the appropriateness and completeness of the plan to enable the execution, i.e., “Do”.
• Charting data can make this much easier to see trends over several PDCA cycles and in order to convert the collected data into information.
• Information is what you need for the next step “ACT”.

D. Act

• Take action based on what you learned in the study step: If the change did not work, go through the cycle again with a different plan. Use what you learned to plan new improvements, beginning the cycle again.
• Carry out corrective actions on significant differences between actual and planned results. Analyze the differences to determine their root causes.
• Determine where to apply changes that will include improvement of the process or product.
• If you were successful, incorporate what you learned from the test into wider changes.

When a pass through these four steps does not result in the need to improve, the scope to which PDCA is applied may be refined to plan and improve with more detail in the next iteration of the cycle, or attention needs to be placed in a different stage of the process.

The improvement process then continues from this new baseline of performance.

The QI process improvement model is one that teams will follow to define and solve problems and improve processes.

Like any model, it will not be followed exactly the same way every time.

The PDCA cycle is but one of many ways to conduct QI activities, but it currently is the most commonly used method in health care.

An example of the PDCA cycle used in a healthcare setting

• QI requires a balanced approach where planning, doing, checking and acting are all given equal attention.
• Acting without sufficient planning, and trying to jump directly from problem identification to the solution, compromises success so that major changes may be required.
• This situation can be minimized with sufficient and comprehensive planning.
• Data collection and analysis methodologies should be built into every process within the healthcare system.

Regards,

Dr. Bassem Assi