1FOCUS-PDCA

BY

DR MUHAMMAD AKRAM

FOCUS-PDCA

A framework created by Hospital Corporation of American (HCA) for thinking about and applying different tools for CQI( Chartered Quality Institute)

• PDCA is often called the Shewhart or Deming Cycle

• Used widely in one form or another in health care and in industry.

Shewhart Cycle

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In the 1920s, Walter Shewhart, a statistician at Bell Telephone Laboratories, developed the Shewhart cycle, known as Plan, Do, Check, Act (PDCA).

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Plan

Question the capacity or capability of a process. Pose theories on how to improve the process and predict measurable outcomes.

DoMake changes on an experimental, pilot basis.

CheckMeasure outcomes compared to predicted outcomes.

Act Implement the changes on a broad scale (Gaucher & Coffey,1991).

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Plan

Do

Check

Act

Shewhart Cycle

1. Ideintify customer needs/expectations

2. Describe the current process

3. Measure and analyze data

4. Identify improvement opportunities

5. Identify root causes of problems

6. Generate and choose solutions

7. Plan and implement a pilot of the solutions

8. Evaluate results of pilot

9. Draw conclusions

10. Standardize the change

11. Monitor the change and hold the gains

The Tradiotnal PDCA Model

Deming Cycle

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Deming Cycle

• The PDCA cycle was later adapted by Deming as the Plan, Do, Study, Act (PDSA) cycle; therefore, it also is referred to as the Deming Cycle, or the Deming Wheel.

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Plan-Do-Check (STUDY)-Act Cycle(P-D-S-A)

Plan

DoCheck

Act

Deming’s Cycle (1900-1993)P-D-S-A

Study

F.O.C.U.S.

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.O.C.U.S.

→Find an improvement project (initiative): – Review related standards & documents – Analysis of collected data – Identify problems & desired outcomes

F

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→Organize ad hoc (task force) team:– Identify & involve stakeholders (e.g.

physicians, nurses, administrative …etc) – Cover all related departments to the

improvement initiative– Select team members who best do or know

the process to be improved

F. O .C.U.S.O

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→ Clarify current process & desired outcomes:– Fully understand the current process by

all team member– Draw flow chart to clarify the process

variation/problem– Collect data from all affected areas

relevant to process & desired outcomes

F.O.C.U.S.C

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→ Understand Process Variation, Root Causes & Desired Outcomes:– Identify tools needed to describe &

analyze process variation, root causes & desired outcomes

– Obtain Information from benchmark, best practice ..etc

– Identify all possible solutions to achieve the desired outcome

F.O.C.U.S.U

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→Select the best practice procedure:– Analyze alternative solutions related to

process improvement– Choose the best solution that will achieve

desired outcome– Develop approval with a summary of

required information about expected outcomes, resources needed, time-frame, responsibilities ..etc

F.O.C.U.S.S

P.D.C.A.

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P.D.C.A.

→Plan for improvement project (initiative):– Assign tasks with agreed criteria checklist &

set time frame– Allocate resources, determine responsibilities

& gain support from all who will be affected by implementation.

– Establish monitoring system to collect necessary data to keep project on the track

P

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→Do the improvement project:– Implement the best solution stated in FOCUS

process.– Empower all people involved by training,

education & moral support.– Collect data & update checklist

P.D.C.A.D

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→Check the results– If the desired outcome is obtained & lead

expected improvement.– Compare data collected from FOCUS process

with that during DO– Check for any unexpected, undesired

consequences or outcomes

P.D.C.A.C

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→ Act to hold gains or re-adjust

FOCUS-PDC – If improvement initiative is reaches;

standardize the process, adjust documents & empower people

– If improvement initiative is not reached, repeat FOCUS-PDCA cycle

– For both situations, continue to monitor the process to identify further improvement.

P.D.C.A.A

21 Thank You