How to Avoid Analysis Paralysis and Underplanning in PDSAs

Posted February 23, 2017 by Josh Grant

PDSA Cycle Graphic
Reducing smoking in housing could make for a healthier Boston.

While there’s no single part of Plan-Do-Study-Act (PDSA) cycles that’s more important than the others, planning is the foundation of the work. After all, the P comes first.

But that building block can be more of a stumbling block for many stakeholders in quality improvement (QI) efforts. In some cases, teams might suffer from analysis paralysis, and in others they might move ahead before truly mapping out what they want to test or expect to achieve. In either case, the improper planning sets the tenor for the rest of the cycle and can minimize learning.

Fortunately, the steps to planning properly are fairly simple. Let’s take a look at how to ensure that PDSAs start on the right track.

Start Small
Analysis paralysis comes from overthinking. Complications and hypotheticals can prevent teams from moving forward; unintended effects are considered long before testing even begins.

That is why PDSAs are supposed to begin at the smallest possible scale. Instead of affecting 1,000 people, the first PDSA cycle should only affect one. Instead of overhauling the practices of an entire state health department program, a potential change should be tested for a subset of the program participants. This ensures that any potential drawbacks to a change are found early and can be avoided by learning from testing.

As data from tests are analyzed, the change idea should be adapted and then tested again on a larger scale. This process repeats itself until the idea is shown to have positive results with a high degree of confidence without creating unintended effects.

Be prepared
The ultimate goal of any PDSA cycle is to make a change that is an improvement. As a result, teams can sometimes want to jump straight ahead to adopting a promising sounding idea without planning to fully test the change in various situations to make sure it is truly an improvement.

Identifying and planning for change gives a team a goal to achieve and work towards together. Planning early for PDSAs creates an understanding of what should be done and how it should be studied. Without it, teams can experience setbacks as those who the changes impact push back on the changes.

Bottom line: The idea behind PDSAs is to create momentum for sustainable change. Starting small and planning for change lets you get off on the right foot. 


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