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Applying PDCA (Plan-Do-Check-Act)

Making improvements successfully and continuously is a very difficult task, which can get you caught up in a tangle of work with no progress. A lot of the time the process of improving can start due to a fire fighting approach. Due to the complexity and risks involved in businesses, changes made in the name of improvements can lead to unforeseen effects. Furthermore, improvement tasks can get tangled and drag on, leading to opportunity costs in other areas.

The most profitable entertainment industry, gaming, and the riskiest industry, healthcare, have managed to work through the complicated improvement process by making it systematic. They use a method called Plan-Do-Check-Act (PDCA). As the Deming, the creator of PDCA, says, ‘the key is to have clearly defined repeatable processes.’ You’ll find many similarities between PDCA and Agile in their iterative approach.

Gaming

Many of you may have noticed a select group of gamers getting very excited months before the release of a game. Why so early? They were selected to trial the beta. A small group of people are given an unfinished copy of a game that is being completed and asked to play it through and give the developers feedback. Due to the number of beta gamers, and how picky they are about the smallest of errors or glitches, a lot of feedback is given. Even the tiniest of glitches are highlighted. Within a few weeks a new patch is released for the beta game. This is tested again by the gamers for faults. These are basically the Do-Check iterations in PDCA. Game developers do not want to risk releasing a game with any glitches due to the high standards expected of them by their customers as well as the difficulty of rolling out patches across all the millions of copies they predict to sell. This method not only teases their target audience, but gives them testers or ‘checkers’ for free.

Healthcare

In the healthcare industry, change is avoided like the plague. Patients and doctors alike like consistency. However, when it comes down to the human life, improvements are paramount. In this industry, a change can have many unforeseen knock-on effects. For example, if a department of a hospital want to change the way they store patient information from paper to the cloud, it could lead to data protection issues. The NHS experienced this when they outsourced patient information. Moreover, if there is a change treatment, regulations, or guidelines, it will affect patient lives. Healthcare us PDCA on a small group of trial patients, a group of GP clinics, or even a hospital department to test their improvements systematically without disrupting patients or risking many lives. If the improvement actually makes things worse, then not many resources have been expended and the system can revert to what it was before. Furthermore, due to the evidence-based nature of healthcare, a systematic and repeatable approach such as PDCA is vital for improvements as the process can be recorded ad measured quantitatively. Like in a science experiment, the method should remain constant and one variable changes at a time in order for the final result to be meaningful and reliable. The NHS should introduce this method since they seem to be changing for the sake of change due to political or financial pressure rather than on an ad hoc basis.

Method

PDCA diagram

1. Prep

Before starting the PDCA process, specific problems need to be identified and prioritised. The next step is to form a team of people who are best suited to the area of the problem. It is very important that achievable and measurable aims are set. These need to be time specific, so techniques such as time-boxing the PDCA should be used. Measures should also be established in order to track the progress of an improvement process and to compare solutions.

2. PDCA

a) Plan

This is where the highlighted problem is picked apart. Teams should use root cause analysis techniques such as ‘5 Whys’, drill downs, and cause and effect diagrams. Teams should also gather additional information that could help to generate a solution. All information should be organised before moving to ‘Do’.

b) Do

‘Do’ actually means test or trial. In this phase, solutions should be generated and shortlisted. One way of scrutinizing possible solutions is to use the impact analysis technique. After selecting a solution, it should be piloted using few resources, on a small group or geographical error. This reduces the wastage of resources if the solution doesn’t work and reduces the number of resources and people at risk as well.

c) Check

In this phase, the team will check the improvement using the previously established measures to see how close they are to their aims. This is the beta testing of a game or a clinical audit in a GP practise. From the checking, further tweaks and improvements can be made to the solution to make the result closer to the decided aims. These improvements are trailed again and checked again. The ‘Do-Check’ iteration happens multiple times until the opportunity cost of doing the improvement outweighs the benefit of the improvement. Bare in mind, there are other improvements that need to be made and repeating the ‘Do-Check’ iterations comes at the cost of time.

d) Act

Act, or implement is when the team is satisfied with the quality of the improvement based on the measurable results in the pilot group and they are ready to upscale the improvement to the whole organisation. Teams should be aware that whole organisations are far more complex and chaotic than the limited scope of the pilot group.

3. Continuous improvement/ Kaizen

Once the improvement has been implemented fully, the team loops back to the beginning with another problem. When this is done continuously, it leads to systematic and continuous improvement of the organisation. The structured approach to improvement is its driving force.

When to use it?

PDCA should be used during continuous improvement or Kaizen projects. It is also effective when used to explore the efficacy of a range of new solutions by allowing controlled testing. This lets you compare reliable data from each solution so you can pick which one to upscale. The method is very effective at avoiding large-scale wastage of resources. Furthermore, data from a Do-Check iteration can be used to give stakeholders confidence in change that will take place in a company. However PDCA requires time and patience and shouldn’t be used for true emergency situations.

For more information about PDCA, its use and relation to Agile, and process improvement, take a look at our courses.

References

https://www.mindtools.com/pages/article/newPPM_89.htm

http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementImplementingChanges.aspx

http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/plan_do_study_act.html

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