Can a Plan, Do, Study, Act (PDSA) Approach Work for Patient Safety Incidents?

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Incidents in patient safety typically arise amidst several possible contributing factors and, without appropriate problem-solving strategies, can be exceedingly difficult to assess.
Using process improvement models such as PDSA (Plan, Do, Study, Act) significantly improves the likelihood of determining, addressing, and correcting key errors that lead to negative occurrences.
PDSA is a method of solving problems through planning, teamwork, thorough investigative strategies, and reflection, and is completed in a four-stage cycle. To ensure optimum results, PDSA implements a structured approach based in reasoning and promotes an ordered process for evaluating possible improvements. Regarding patient safety, PDSA, as recommended by the World Health Organization, can be vital in discovering contributing factors and improving the quality of care within health organizations.
This first stage in processing improvement strategies is based on three fundamental questions
What are we trying to accomplish?
How will we know that a change is an improvement?
What change can be made that will result in an improvement?
These questions, paired with an assembly of teamed professionals, are then used to draft an “aim statement,” which is used to identify causes, plan for alternatives, and ultimately discover improvements.
Once an aim statement is composed, the team must work to collect data, document problems, and address issues as the evaluation progresses.
Using the drafted statement from the first stage and collected data from the second stage, the team can then determine whether (and by what margin) the plan resulted in an improvement, as well as identify the value of the actions, noticeable trends, or unintended side effects.
Finally, it is important to reflect on the results. If the investigation was successful, then the team can plan to standardize the methods. If, however, the plan failed, then it will be necessary to pick up the pieces and begin again at the planning stage.
The methods and steps involved in PDSA have been designed to reduce error and focus efforts on thorough and precise investigative procedures. The stages are designed to fulfill actions in an organized manner while bolstering the team cooperation. With untold numbers of annual deaths caused by medical errors, nowhere else in the healthcare industry is PDSA more beneficial than in securing the safety and well-being of patien
The healthcare industry encompasses a myriad of specialized practices, devices, drugs, and methodologies across a vast network of organizations and providers. Enveloped within its broad boundaries are medical and clinical professionals, pharmaceutical companies, software developers, and countless other individuals and groups all with their own methods, ethical standards, and reasoning. However, the one underlying principle of the healthcare industry, of which is universally agreed, is to “first, do no harm”; to ensure the safety and care of the sick and needy. By implementing methods such as PDSA in our patient safety protocols, we can continue to foster this basic ideal of human safety and preservation.
While advancements in aviation technology have certainly played a role in improving overall safety and limiting accidents – as will improvements in healthcare technology aid in reducing patient safety incidents – it is most notably the increased attention to human factors and rigorous training that have made the most significant impact.
Entities such as the Healthcare Safety Investigation Branch (HSIB) understand the importance of adopting the aviation safety model, and focus on human factors and increased training while engaging the healthcare industry with the same quality of attention and accountability that proved instrumental in reversing the trend of fatal accidents that plagued the aviation industry 40 years ago.
To ensure that healthcare investigations can effectively learn from the aviation industry, we must work hard to emphasize the importance of following rigorous guidelines and procedures, foster environments of teamwork and collaboration, and hold ourselves to a standard of accountability that rivals any previously established in the world of healthcare.


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