AtlantiCare Leader Handbook

PDCA (Plan, Do, Check, Act

The PDCA cycle provides a framework for the improvement of a process or system. It can be used to guide the entire improvement project, or to develop specific projects once target improvement areas have been identified.

The PDCA cycle is designed to be used as a dynamic model. The completion of one turn of the cycle flows into the beginning of the next. Following in the spirit of continuous quality improvement, the process can always be reanalyzed, and a new test of change can begin. Plan – This is the largest phase of the improvement cycle, and consists of 5 steps: Define the problem – Create a problem statement and outline the scope. Is this a project for improvement or new design? Why is it important? What is the impact on the organization? How does it link to strategic goals? What are the boundaries of the project (start/end points, what is included or out of bounds)? Clarify the problem – What is the current state? What is the baseline data (outcome measures and key process measures)? Set the target – Using the established metrics from the clarify step, what are the goals you expect to achieve? Use the SMART format: specific, measurable, attainable, relevant, and timely. Analyze – Analyze the data and the current state. There are many ways to perform an analysis; choose ones that are relevant to the problem. Does the data show trends? Do you need to conduct a gap analysis to identify where differences from the ideal are? Consider a root-cause analysis if something in the process is not working. Brainstorm for possible solutions or the ideal future state – What could you do? What countermeasures are needed to address root causes? What needs to change?

Do – Determine what changes will be implemented from the plan phase and put them into action. Consider education and communication needed for a successful implementation. Will this be a pilot or full deployment?

Check – This is a crucial step in the PDCA cycle. After you have implemented the change for a short time, you must determine how well it is working. Is it really leading to improvement in the way you had hoped? What are the results? Refer back to the established metrics in Plan phase. Were the goals met? What was learned? What went well? What went wrong? What other improvements can be made? Act - After planning a change, implementing and then monitoring it, you must decide what the next steps will be. Do further improvements need to be made? If so, repeat the PDCA cycle. If the improvement was a pilot, what is the plan for further deployment? If it was successful, enact a control plan to ensure the continued success of the changes.