Haelo guest blogger, Kayleigh Price, blogs about implementing PDSA cycles in our everyday lives without even knowing.
We talk about PDSA all the time here at Haelo. In every learning session we hold, every work shop we run, every team visit we make, we extol the virtues of PDSA testing. To those of us who work in improvement PDSA is gospel. We live and breathe it every single day. But 18 months ago, when I first walked through the doors of Haelo I had never even heard of PDSA, and I honestly didn’t understand how it could really make that much of a difference. So, I wanted to take some time away from my day job and explain PDSA, and show you that you are probably already using it in your everyday lives without even realising it.
So, first things first, what actually is PDSA? It’s the second part of the Model for Improvement (if PDSA is the gospel, then the Model for Improvement is the bible). So, for the purpose of learning about PDSA you only really need to know 2 things. Firstly, the Model for Improvement asks us 3 key questions (What are we trying to accomplish – How will we know a change is an improvement – What changes can we make that will result in an improvement). Once we have answered these 3 questions we move on to testing the change (or changes) using PDSA: Plan, Do, Study, Act.
When we first introduce teams to PDSA no one really believes us. In fact, quite often people look at us like we are crazy. We hear ‘We know what needs to happen to improve, we have spent time discussing it, you have encouraged us to change it, why are you now telling us to go slowly and run all sorts of tests?’ If I had a penny for every time someone has said ‘I don’t need to test it, because I know it will work’ I wouldn’t need to have a job! Just quickly think about how many projects you know of that have cost a small fortune and not provided any benefit? Well, PDSA gives us a chance to fail small. It basically asks us to think about the changes we want to make, and test them at a small scale first, gathering data on how things go, the impact of the changes, how it feels to work in the new way and how it feels for our customers. In very rare occasions, our changes will have exactly the impact we thought they would straight away, and we can then begin to think about scaling up. However, more often than not, our initial plans will need to be refined or even thrown out completely. What we thought might happen, might not be what actually happens.
I promised I would show you how you are already using PDSA without realising. This is my story of how I realised I was using PDSA even though I had never heard of it.
This is my dog (if you work for Haelo, or follow me on twitter this is a face you will be used to seeing!) His name is Tico and he is nearly 3. He is pretty well trained now, but when we first got him he was…well, not! Without ever realising it, we used PDSA methodology to train him, trying things, adapting them if they worked, throwing them out if they didn’t.
Before we even picked Tico up we went out shopping. We spent an eye watering amount on a bed, blankets, teddy’s, a lead and a collar. We knew that if we wanted him to sleep downstairs (don’t judge me- he is a very hairy dog and I couldn’t cope with him in the bedroom!) we needed to have everything ready on the first night. We set up his bed and blanket, all comfy cosy in his sleeping area. Tico took one look at them, and curled himself up in to a ball next to them to sleep. No matter what we tried there was no way he was sleeping in that bed and he made it perfectly clear he wasn’t interested in the blanket either. They eventually got given to my brother when he bought a dog.
We found it very hard to stay cross when faced with this though.
And it was definitely something we should have considered. PDSA learning number 1 – If you don’t know it will work, do it as small and as cheap as you can to start off with. If we had just purchased a blanket, instead of going all out straight away and buying a bed, we could have saved ourselves £40. So, Tico doesn’t sleep in a bed, or on a blanket. He did however sleep with his teddy for the first 12 months we had him, so the first tests weren’t a complete waste.
As he got a bit older, we started thinking about letting him off the lead when we went for walks. We did a bit of training in the garden, asking him to sit, stay, come and find us when we hid. We watched how he was doing (in PDSA terms, we collected data). It all seemed to go well so we decided he was ready to go off his lead. So, we ‘scaled up’ our tests and we took him for a walk in the local woods. He got a bit excited when he saw other dogs, and refused to come back for short periods of time, but nothing that we didn’t predict. So, after refining this using a few more wood walks we decided to step up our testing again, and took him to the local country park. We went with my mum and dad and their dog and predicted that we had enough confidence in Tico to let him off his lead with another dog with no repercussions.
Unfortunately, we were wrong and this happened. Not his finest moment, and a lot easier to stay cross with!
After spending an hour scrubbing him clean in the back garden (there was no way he was going in my house that muddy!) we sat and talked about what had gone wrong. Obviously I mean my boyfriend and I talked. I’m not enough of a crazy dog lady to think that Tico can join in a conversation. Yet! We talked about what happened (or analysed, in PDSA terms) and decided that, no matter how well behaved Tico was becoming, he was still only a puppy and we had to accept that sometimes things just go wrong. And this is a really important part of PDSA. Sometimes you can be really sure of your results. You can be right at the end of your testing and ready to implement a change at scale, and something will derail you. Hopefully in your case it won’t smell quite as bad as what derailed us, but there is every chance your testing will fail at the last hurdle and you will have to review and start again.
Over time we have learned that it’s best to do things small before we make it permanent. The first time we sent him to my mums for a sleepover we left him there for a few hours first, only doing overnight once we knew he (and they) would cope with his neuroses. We have gradually built it up and now he can stay for a week or so. When we buy him new food, we buy a small box to see if he likes it before we spend £30 on a month’s supply. Through numerous PDSA’s we have learned the optimum amount of treats to feed him when we leave the house so he doesn’t notice we are going (if anyone is wondering, its 5 small treats), we know how to get him to eat a full bowl of food in one sitting (let him eat it outside- there is something Mediterranean in his eating habits) and even what time of day is best to walk him in the heat.
Another thing PDSA allows us to do is share the learning from our tests with others to save them making the same mistakes we made. If we have evidence to back up our testing, we can share this learning and all become richer for it. When people I know get new dogs, I can talk to them about what works for Tico and they can take our learning and adapt it for their new pet.
But this doesn’t just work for training your dog. If you follow a recipe to make a cake and the end result is too heavy, you amend the recipe and try again (unless you are like me- then you blame the recipe, refuse to ever make it again and never use any of that chefs other recipes just in case). If you go on a diet and don’t lose weight you don’t just give up – you amend what you are doing, maybe add in exercise and try again. All the little tweaks and changes you make in your everyday life are PDSA’s. You may not document everything you are doing, or chart what happens on a graph, but you are thinking about what you want to do (plan), doing it (do), thinking about what happened (study) and then making plans to either continue the same or make a few changes (act). Just don’t call them PDSA’s in your day to day life. Take it from me – outside of a work environment people just look at you like you need to get a life!
Oh, and don’t tell my mum and dad, but Tico’s working his way up to 10 nights so I can go on a really nice holiday next winter…