Plan Do Study Act (PDSA) Form
Cycle #: 2
Start Date:July 28, 2013 End Date: August 4, 2013
Project Title: Action Planning for Patients with Diabetes
University/Organization Name:Brookfield West facility
Health System Sponsor Name: Improvement Health System
Objectives of this Cycle:
Test a Change
Short objective of cycle:Find out if we can conduct effective action planning during five patient visits, including whether we can accomplish the action planning,and whether the patients will carry out their action plans
PLAN
Test/Implementation Plan:
What change will be tested or implemented?Using action planning in the diabetic visit
How will the change be tested or implementation be conducted (consider small scale early)?Nurse Kang will use action planning with Dr. Ann Jorgenson’s first five patients with diabetes seen during the week of July 28, 2013
Who will run the test or implementation? Nurse Kang will do the action planning and make follow-up calls to find out whether patients are carrying out their action plan
Where will the test or implementation take place? Initially atBrookfield West facility in the exam room with follow up by phone
When will the test or implementation take place? During the patient’s visit, when Nurse Kanginteracts with the patient during the week of July 28, 2013; follow up calls to patients seven days after the visit (calls on Monday, August 4, 2013)
Predictions:
1.Action planning can be worked into the regular visit with five patients.
2. At least three patients will carry out the action plan.
Data Collection Plan:
What information is important to collect?1. Whether the action plan was done in the visit 2. Whether the action plan was used by the patient
Why is it important?To increase confidence that we can do action planning that helps patients change behavior, we want to get a high success rate
Who will collect the data?Nurse Kang
Who will analyze the data prior to Study?Dr. Jorgenson and Nurse Kang
Where will data be collected?Tally sheet at the nurse’s station
When will the collection of data take place?After each visit and on Monday, August 4, 2013
How will the data (measures or observations) be collected? By hand, tick marks on tally sheet
DO
Observations: In four of the five cases, we were able to get to action planning during the visit. The fifth patient declined to plan an action. Four of the patients seemed to react positively to the idea of action planning given the explanations we offered.
Record observations not part of the plan: The fifth patient was experiencing a lot of additional stress last week and was feeling overwhelmed. The patient seemed open to action planning some time later in the year.
Did you need to tweak the original Plan? No.
Begin analysis of data (graph of the data, picture): Use tally sheet.
STUDY
Questions:Copy and paste Questions and Predictions from Plan above and evaluate learning. Complete analysis of the data. Insert graphic analysis whenever possible.
- Prediction:Action planning can be worked into the regular visit with five patients.
Learning (Comparison of questions, predictions, and analysis of data):One patient refused to participate. The experience reminded us to listen carefully in these discussions.
- Prediction:At least three patients will carry out the action plan.
Learning (Comparison of questions, predictions, and analysis of data):When Nate Kang called to follow up with the four patients who made an action plan, he was able to reach three on the following Monday. Two had tried their action, but the third patient had not, being occupied with an ill child. The two who had tried their action said they were willing to do more and appreciated the follow-up call.
Summary (Look at your data. Did the change lead to improvement? Why or why not?): Nate Kang called two of the patients three times to get through. He can’t do the follow-ups with all the patients. We need a good way to record whether the action plan was attempted and what happened.
The action planning discussion seems to go pretty well. The quick follow-up call also seems like a good idea as a reminder for the patients. (We had only thought of the quick follow-up as a way to check our test, not as a regular practice to help patients.)
We need a way to track in the patient record when patients complete the action in their plan — this could be something to test in a future cycle.
ACT Describe next PDSA Cycle:Based on the learning in “Study,” what is your next test?
The next test will involve using our medical assistant to help with follow-up calls on the action planning, under Nate’s supervision, for three patients. We are concerned about the work load on Nate as we look to use self-management action planning with all of our diabetes patients.