PDSA Planning Worksheet




PDSA Planning Worksheet

Practice Name:__________________Cycle start date:_________ Cycle end date:__________

Describe the change you are testing and state the question you want this test to answer:


What do you predict the result will be?



What measure will you use to learn if this test is successful or has promise?


Plan for change or test: who, what, when, where




Plan for what data/evaluation is needed: who, what, when, where


DO: Report what happened after you carried out the test. Describe observations, findings, problems encountered, special circumstances.



Study: Compare results from this completed test to your predictions. What did you learn? Any surprises?
Act: Modifications or refinements for the next cycle; what will you do next?







Adapted from IHI http://ihi.org