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The Problem Faced by Bays Healthcare When Using PDSA Methodology

Laura Lopez Naranjo

Monica Macias Mestre

Angelica M Manrique

Armando Rodriguez

Dr. Julio García

Miami Regional University

December 21, 2022.

The Problem Faced by Bays Healthcare When Using PDSA Methodology

Quality improvement (QI) methodologies have gained traction in healthcare to support its secure, efficient, cost-favorable, effective, equitable, and timely delivery. According to the National Council of State Boards of Nursing (2009, among the majority of the QI mythologies, the Plan-Do-Study-Act (PDSA) cycle remains part of the few cases that emphasize the desire for change; the translation of the ideologies and the intentions associated with the action. Consequently, the cycle of PDSA and its concept regarding the iterative tests about change, as cited by Magnan (2021), are crucial in various approaches linked to QI, such as its improvement model, total quality management, lean, and six sigma. PDSA offers a structured experimental mode of learning for carrying out changes. In the past, there were concerns regarding the PDSA application’s fidelity that may lead to the undermining of the efforts dedicated to learning, the complexity of its usage, and its suitability in handling the major challenges of improving healthcare (Katowa-Mukwato et al., 2021). This paper explores the PDSA problem of failure in investing in rigorous and tailored use and the measures that can be applied to improve safety and quality when using the method in Bays Healthcare (BH).

PDSA's problem of failure in investing in rigorous and tailored use

A problem that needs to be addressed regarding the PDSA in BH is that it can be used as a standalone methodology. As stated by Arbour et al. (2021), PDSA should be used as part of the QI methodologies where the reality about it may be affected by a broader methodological-based approach that is being implemented for the sake of realizing improvement or learning. In this regard, an essential role in the broader methodological approach is carrying out investigations before using the PDSA to effectively understand the problem and its framing. Thus, Reed & Card (2016) said that investigations might entail the mapping process, effects linked to failure mode cause and effect evaluation, engaging the stakeholders, including the interviews, analysis of data, and reviewing of the evidence available.

Elsewhere the narrative that has been part of PDSA regarding its use within the healthcare environment, such as BH, for this case, is based on the fact that it is simple and, as such, anyone can use it. On one angle, the National Council of State Boards of Nursing (2009) noted that this could be true, and the simplicity linked to the methodology of PDSA, together with its use in various situations, may be considered part of its main strengths. Regardless of the same, Magnan (2021) pointed out that the simplicity linked to PDSA leads to significant challenges when it comes to its successful use. In this regard, the users must be informed about how to adapt to its use in handling many issues and stages during the cycle of project improvement. In this case, it demands a wider repertoire of knowledge applied together with the basic model of PDSA. Ba

Though the methodology of PDSA is simple conceptual-wise, as already said earlier does not imply that it is always challenging. Besides the same, Katowa-Mukwato et al. (2021) acknowledged that PDSA remains a powerful strategy, and the projects that utilize it successfully may solve many quality issues apart from assisting them in shaping the culture of their respective organizations. Thus, the effort needed in applying PDSA to attain success, according to Arbour et al. (2021), has a notable return on investment. However, the supportive-based contexts and resources needed to attain success, like expertise, sustained effort, finances, and buy-in, often need to be revised. Similarly, scarce human labor and financial aid have been a thorn in many projects, including BH. In this case, apart from undermining the organization's culture, contribution to change fatigue and cases of disillusion where the project needs to generate major investment. National Council of State Boards of Nursing (2009) then advised that the need for within the project level and the pragmatic-based level for the resource needs towards attaining the successful use of PSDA towards the project are effectively understood, including proper management.

The barriers to practicing PSDA in a healthcare environment such as BH are “getting on with it” and “doing, doing, doing,” which are not easy to overcome. To ensure the successful application of PDSA, Magnan (2021) noted that it must be backed by significant investment in resources, leadership, and expertise, all geared for change. At the moment, the scholars, including Katowa-Mukwato et al. (2021), can support the desired rigor of planning and the studies, including understanding the way of managing the upcoming learning while simultaneously holding talks with the broader stakeholder groups. In this regard, Arbour et al. (2021) advised that BH working in cooperation will greatly benefit the effective PDSA use and is also crucial in establishing realizing learning institutions.

Possible Safety and Quality Healthcare Improvements that BH Can Realize When Using PSDA Methodology

The healthcare sector is in such a status that the likelihood of an error occurring is indeed huge. For example, Reed & Card (2016) acknowledge that effective planning reduces such errors. BH adopting this tool, as cited by the National Council of State Boards of Nursing (2009), dramatically eliminates mishaps in healthcare operations. Similarly, it contributes towards enhancing the air quality delivered to the clients. Not forgetting, it will ease the operations linked to management within the BH facility.

Another way BH may use PDSA to improve its safety and quality, leading to improvement in healthcare, is to prevent shocks and the surprise on several occasions. For instance, Magnan (2021) noted that the cycle of PDSA may lead to enough stock for the BH to carry out its daily operations. At the time of emergency or cases involving operation, the cycle of the PDSA stands a chance in assisting in attaining smoother accomplishment. Besides shock prevention, PDSA may assist BH in identifying the problems. In this regard, Katowa-Mukwato et al. (2021) opined that the cycle of PDSA in a successful manner will assist in identifying the glitches that will be eminent during the process. The moment the cycle of PDSA is repeatedly run, several problems become rid out during the process. Consequently, this will lead to the attainment of the aspects of effectiveness and efficiency within BH.

A way to enhance quality and safety towards improving healthcare for BH is the modification of the processes. PDSA cycles may assist in modifying the current processes. In turn, this will decrease the likelihood of operational and technological obsolescence (Arbour et al., 2021). On the same note, modification and updating are vital within the healthcare sector. In this regard, Reed & Card (2016) pointed out that medical tools face myriads of technological advancements as time progresses.

PDSA methodology stands a chance of contributing to the injection of the lean process in BH. In this case, the National Council of State Boards of Nursing (2009) said that it will contribute to minimizing waste to a greater extent. The issue regarding waste in the healthcare sector lately has become a nuisance. Wide varieties of medicine exist that stand to expire within a short period. On the same note, the resources, including needles, water, and cotton, should be disposed of in the desired environment for effective medical operations (Magnan, 2021). Further, the inculcation regarding the lean via the PDSA process will aid in maintaining aspects of such kind within the BH.

While seeking to realize its improvement in the quality and safety of health care services, BH can use the PDSA methodology to ensure continuity in testing. As cited by Katowa-Mukwato et al. (2021), continuity in testing often occurs during the cycles of PDSA. This occurs within the do stage. Thus the test will bring out the adept types of practices that the management of BH will consider following. Apart from ensuring continuity, BH can use the PDSA methodology to ensure cash flow to attain quality and safety in healthcare service delivery. As emphasized by Arbour et al. (2021), the healthcare sector is also generating profits besides its human element. If the patients are handled from a customer's perspective, then PDSA can ensure a better name for BH in the healthcare sector before its rivals.

Conclusion

The objective served by the PDSA methodology depends on learning as fast as possible if the intervention functions in a certain setting and making effective adjustments to increase the likelihood of attaining the intended improvement. Contrastingly to controlled trials, PDSA enables new knowledge to be founded on the experimental type of process. In case the problems are known based on the initial plan. It is possible to revise the theory to be founded on the knowledge and the eventual experiment to determine if it has resulted in the solution to the underlying issue. The same will also entail identifying any more issues required for handling. Within the complex setups regarding healthcare, like the case of the BH selected for this proposal, the adaptability and flexibility in this case concerning PDSA are essential elements for attaining safety and quality in the delivery of healthcare services by the organization.

References

Arbour, M. C., Floyd, B., Morton, S., Hampton, P., Sims, J. M., Doyle, S., ... & Sege, R. (2021). The cross-sector approach expands screening and addresses health-related social needs in primary care. Pediatrics,  148(5).

Katowa-Mukwato, P., Mwiinga-Kalusopa, V., Chitundu, K., Kanyanta, M., Chanda, D., Mwelwa, M. M., ... & Carrier, J. (2021). Implementing evidence-based practice nursing using the PDSA model: process, lessons and implications. International Journal of Africa Nursing Sciences,  14, 100261.

Magnan, S. (2021). Social determinants of Health 201 for health care: Plan, do study, act. NAM perspectives,  2021.

National Council of State Boards of Nursing. (2009).  Nursing pathways for patient safety e-book. Mosby. Retrieved November 18 2022, from https://books.google.com.pk/books?id=MM1G77dPAHQC&...

Reed, J. E., & Card, A. J. (2016). The problem with plan-do-study-act cycles.  BMJ quality & safety,  25(3), 147-152.