Answer / xuezhi.sun

The PDSA Cycle or "plan-do-study-act" is a method for testing and implementing continuous improvements in quality control. Although it was developed for use by manufacturers, it is often used in health care contexts and is endorsed by the Institute for Healthcare Improvement. However, it is not as easy to use as it may seem to be.

How PDSA Works
PDSA is intended as an uncomplicated way to test and implement quality improvement changes using the scientific method. In the "plan" stage you decide on a change you would like to try, such as a new scheduling system for the nurses. In the "do" stage you implement the change on a limited scale, such as a single department. In the "study" stage you analyze the results of the experiment. For instance, you may find that the new scheduling system made it easier to match nurse availability to peak needs. In the "act" stage you implement the new system on a larger scale. Although the concept is simple, the application is not. The Agency for Healthcare Research and Quality website suggests that the PDSA Cycle requires a major commitment of time and effort.

What's In a Name
The PDSA Cycle is often referred to as PDCA or plan-do-check-act. Both acronyms are used as synonyms for the Deming Cycle or Shewhart Cycle even though the Cycle's creator Edward Deming rejected the idea that PDCA and PDSA were the same thing. Deming argued that PDCA was intended as a method for finding problems in a system while PDSA was a method for creating continuous improvements in a process. This confusion in terminology seems to be reflected in application. According to a 2013 article in "BMJ Quality and Safety," health care facilities using the term PDCA instead of PDSA also tended to misinterpret the Cycle.

Failure to Repeat
In theory, you would never use the PDSA Cycle just once, because it is supposed to be a continuous improvement tool. As soon as you complete one PDSA Cycle you start another one, using whatever you learned from the previous cycle as a starting point. The "BMJ Quality and Safety" study analyzed 73 peer-reviewed articles about PDSA Cycles in health care facilities and found that only 20 percent repeated the PDSA Cycle as intended. Most facilities would perform a single PDSA Cycle and never repeat it, or would fail to use data from previous PDSA Cycles when beginning a new one.

Mixed-Up Steps
The other problem identified in the "BMJ Quality and Safety" study was a failure to perform the four PDSA steps in the correct order. One health care facility skipped the study stage by implementing the full plan without first analyzing the results of the trial run. A facility using the term PDCA did the same thing but then checked the results after implementing the full-scale plan. The facility then changed the plan, checked the results again and changed the plan again -- a PDACACA Cycle instead of a PDCA Cycle. The Agency for Healthcare Research and Quality website states "This tool is easy to use and requires little or no training," but the "BMJ Quality and Safety" study suggests the opposite.

6. NEED OF ONGOING MANAGEMENT CYCLE( Case Study ) Sidney Greenburg was appointed the position of the director of marketing for a small electronics component manufacturer. The company had its revenues growing at the rate of 20% each year and in 1982, they were at 30 million level The president felt that the growth of the company required serious planning efforts to determining strategies product emphasis and new product development. Mr. Greenburg realising the need to develop the marketing plan developed a suggested format to obtain inputs from his regional sales managers. The format to obtain divided into two parts (a) territory brief for established status of sales activities and (b) territory plan asked for identification of key goals, strategy & resources required to accomplish stated goals. Sales forecast by products was requested for 3 plan Yrs. Tom Rosenfield was the marketing manager for Europe He was previously in the engineering department & was assigned to Europe because of his technical& Foreign language capabilities. He replied to Mr.Greenburg as follows: “While I will complete the forms on the country brief& country plan promptly I have some conceptual problems with them time& time again we have been requested for projected figures I remember putting together a presentation for the Executive Vice-President (VP) & Treasurer last year. Great we educated those guys but what are the results of such formality? The projections have not yielded specific results, resources are used at a minimal level & we are not generating needed sales. So it is my contention that while goals projections& forecasts provide immeasurable guidance for a company with stable sales & developed product lines, for us a fledglings (young) industry, they distract from the job at hand. My plan has always been to hit the market- as hard I am able & I believe this should hold true for all other regional managers. We have large amounts of resources held up in ineffective’ marketing planning efforts such as these need to redirect these efforts to self rather than compile data. We need more people beating the pavement (action) rater than sitting on their desks developing plans& strategies (contemplation) Sell, sell, sell. Get the backing as big as possible. Planning is wasteful. Let us concentrate on aggressive sales & optimize sales volume at any cost. A. What has Mr.Greenburg not done to accomplish his planning tasks? B. Is Mr.Rosenfield right in making his comments in response to Mr. Greenburg’s request? C. Is Mr. Rosenfleld performing his management function. D. What would you do if you were Mr.Rosenfleld’s boss?

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