Older Fallers and Young Wheezers – Getting good at Plan Do Study Act (PDSA)

Plan Do Study Act cycles – small tests of change – are increasingly used in health care as an alternative to ‘big bang’ top down change initiatives [1]. But these ‘big bang’ initiatives are so ingrained in the culture of the NHS (remember Lansley’s ‘reforms’, Friends and Family Test, and Duty of Candour) it takes a lot of unlearning to grasp the idea and have faith that small tests of change are just that: ‘Very small tests’.

So at the Quality Improvement Clinic we have been experimenting with different ways to help people build confidence to undertake very small Plan Do Study Act cycles.

In fact, we are so impressed with the way our wonderful Wessex and Thames Valley Trainee Consultant Practitioners took to this, we wanted to share their story with you in this blog!

Our trainees have been studying Quality Improvement methods with us for almost 2 years, and despite great progress, many of them still reported a lack of confidence in small tests cycles. So we set up a simulation with them, in 2 groups. Because ‘patient activation’ is something several are grappling with we chose two ‘patient activation’ scenarios.

Older Fallers

Group 1, working on the Frail Elderly Pathway looked at ‘Older Fallers’. Their task was to test how they could teach older people who are risk of falls to get themselves up safely after a fall. They used Saga’s Get Up and Go booklet as their guide.

‘Young Wheezers’

Group 2, working on the Emergency Care Pathway looked at ‘Young Wheezers’. Their task was to give families and young people confidence to inhale 10 puffs of Salbutamol if experiencing an asthma attack, before calling for medical help. Anecdotal evidence suggests that there are a number of barriers. This includes: reluctance to give a dose that is much higher than usual; and parents failing to recall what to do when their child is distressed.

The result was hilarious and instructional in equal measures, and are shown in the slides below!

Study and capture the learning

Both groups learnt a lot – in particular, when you are trying to help people help themselves, you really need to try to get into their shoes. In the case of Older Fallers, quite literally!

If you’d like QIC to help you or your team learn to do PDSA with confidence. Give us a call.

[1] See the article in Future Hospital Journal 2016, Vol. 3 No. 3, pp 199-202, The Foundations of Quality Improvement Science, Julie Reed, Nicola Davey & Thomas Woodcock