PDSA worksheet Patient Satisfaction Scores

PDSA WORKSHEET

NR392

NAME:

Aim Statement

Aim Statement (Measurable goal including what, when, how much, and for whom)

Example: Within the next two months, the rate of falls will decrease by 50% for patients on this unit.

Type your Aim statement here:

Plan

1. Describe the situation and problem that needs improvement.

2. Describe the change that should be implemented. (For Week 6 only, provide one scholary source supporting the intervention. Provide reference at the end of this worksheet.)

3. Describe the predicted outcome.

4. Identify who will be involved in implementing the change.

5. Identify who will evaluate the change.

6. Describe how the outcomes will be evaluated.

7. Identify when this implementation will begin.

8. Identify the target date for completion.

Do

1. Describe the implementation in detail.

2. Describe any problems or unexpected events that occurred during implementation.

Study

1. Describe in detail the outcome(s) of the implementation.

2. Describe how the problem was improved or not improved.

3. Identify whether the goal was met by the target date or delayed.

4. Describe how the actual outcome compared to the predicted outcome.

Act

1. If the problem improved, describe how it will be maintained in the future. If the problem was not improved, describe how the plan will change in the next PDSA cycle. State at least two actions.

Reference (Week 6 only):