When a good idea for improving processes or systems strikes, it can be tempting to rapidly implement widespread changes. However, a measured and systematic approach to the implementation of changes can help to ensure that they are monitored for their impact, resources are maximised and risks are minimised.

All PDSA cycles stem from an ambition to overcome a problem, for example, to reduce labelling errors. There may be clear ideas or hunches as to what changes could lead to improvements, or it may require some additional thought. Ideas for change could be generated from analysis of incident reports or PRIMO. 

It is important to note that not all changes will lead to improvement, but all improvement requires change. Therefore, it is advisable to implement small-scale changes, for example, starting in one particular pharmacy rather than all in a group. This small-scale testing will make sure that resources are not wasted if an improvement is unsuccessful and that patients are not harmed because of an unintended outcome.  

PDSA cycles can be used once a potential solution to a patient safety issue has been identified, but they are also useful when collecting safety data prior to implementing a change and in the development of an improvement idea. The specific objectives of a PDSA cycle should be discussed and agreed on before embarking on the first PDSA stage of planning. It is very common to have multiple PDSA cycles running sequentially and occasionally simultaneously.

A template PDSA cycle form can prove useful.

The BMJ has produced a video explaining how to create a PDSA cycle. Further details are also available from NHS Improvement.