Plan Do Study Act

This section will guide you through the steps that will lead to long-term improvements in your residents care. You will learn how to identify:

  • What you want to change
  • How you will measure it
  • What changes can result in improvement

Before You Begin

Before you start planning and implementing changes around your care homel, have a look at the Getting Started and Measurement pages. These will equip you with the basic concepts to begin your quality improvement journey.

All improvement requires change. Not all change results in improvement!

Once you have identified what you want to change, the Plan-Do-Study-Act (PDSA) Cycle is a useful frame to help your team plan your intervention, test it on a small scale, and reflect before adjusting it or spreading it more widely. It provides you with a log of your improvement process, your reflections, and a transferable plan for other teams to share.

You can download a blank version of the PDSA tool here


What do you want to achieve? Use clear targets for improvement, such as numerical goals that should be met when the change has been implemented. Throughout the toolkit goals and audit targets have been signposted, or you might like to choose your own, based on your baseline measurements.

What realistic changes can be made that will lead to clear improvement?

  • Don’t just do the same things better!
  • Think creatively
  • Make small changes that will be embedded in the system
  • Can you use existing technology and data?
  • Is existing documentation fit for purpose?
  • Consider the obstacles there might be the staff doing what’s needed.

Decide when you are going to do informal audits, who will do what, when and where.

Below you can download some of the PDSA record sheets that have been shared by HSCP colleagues who were involved in the SPSP pilot work. You will see from reading these PDSAs that each one progresses from the next and that future action is planned on past reflection.

PDSA 1 Ed session Test 1

PDSA 1 Ed session Test 2

PDSA 1 Ed Session Test 3

PDSA HCSW Work book Test 1

PDSA PU Champion Test 1

PDSA PU Questionaire Test 1

PDSA PU Questionaire Test 2


Implement the change within your chosen area. Observe and measure as planned.

Analyse your new measurements against the baseline, and the experiences of staff. Look at failures – these help you to learn how the process can be improved.


Based on the process of planning, doing, and studying the improvement implementation, plan how to change the next cycle of the implementation. If the implementation was completely successful this cycle, now look to fully embed it within your system and roll it out to further areas.