4 Benefits to Testing Before Implementing Changes

Posted June 28, 2016 by Josh Grant

QI Tips: The Benefits of Testing
Testing change ideas is key for create long-term quality improvement.

When it comes to making improvements, many people like to go from thinking to implementation in short order. After all, who doesn’t like reaching their destination quickly, especially when the goal is to change healthcare systems to create better health outcomes for children? 

But going from having an idea to implementing it skips an important part of quality improvement (QI): testing. Without proper testing, changes might not lead to improvement, or even be feasible in practice. Testing using Plan-Do-Act-Study (PDSA) cycles can ultimately make changes easier to implement and lead to greater sustainability of the change. Read on for four benefits of testing potential improvements.

Increasing confidence
An idea is only potential; it could result in positive outcomes or negative ones. Greenlighting a proposed change that doesn’t have any supporting evidence won’t inspire confidence among stakeholders or teams who are affected by it.

Testing helps increase belief that a change will result in improvement. Ideas that are refined and adapted during PDSA cycles have a record of gradual, increasing success. As the evidence accumulates, individuals will feel more comfortable with the idea in the local environment, especially when they see how it would benefit them and their target audience.

Finding flexibility
Testing creates time to adapt change to local conditions. An idea might only lead to its desired effects in one setting, which means it needs to be refined to account for specific challenges and needs in a new environment. 

There’s no way to tell what impact a change will have before it’s implemented. By running small tests that gradually increase in scale, the idea can be adapted bit by bit until it’s ready for large-scale implementation. The key is to tailor change to the setting so that it can produce a positive outcome given the unique circumstances. 

Identifying side-effects
Every action can have an opposite reaction, and QI work is no different. For every practice or system that’s changed, another one will experience some impact, unintentional or otherwise. Part of this stems from how healthcare settings are designed; everything is connected and providers often play different roles in different systems. 

PDSA cycles and testing help determine whether the change needs to be refined to address those side effects. And by testing on a small scale first, that minimizes risk and cost. Although the idea may yield positive results for its intended goal, the change may not result in improvement ultimately if it causes unintended consequences in different parts of the system. 

Minimizing resistance
People are creatures of habit and will often resist change, especially if they’re presented with something completely new. However, involving people in the planning and testing often shows them that the new way really is better and they are then more willing to embrace the new process.

Scaling tests during PDSA cycles introduces change to a wider and wider audience. With every test, a larger sample is needed in order to build confidence that the change is leading to improvement. Moreover, the idea moves closer and closer to becoming an actionable solution with each subsequent PDSA cycle, so awareness can be raised about the change within the community. Testing shows stakeholders what they’ll be doing so they won’t be surprised upon implementation. 

Want to learn more? Read more of our QI Tips.

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