Change is great!  You go first!

When changes are planned and initiated, we often launch into the work in a big way with lots of moving parts, communication challenges, confusion, and ‘push back’ as the result.  In addition we often try to layer the work onto the existing structures with people picking up extra responsibilities.  Trying to get the current system to just go faster or layer on responsibilities rarely yields results. 

Such approaches seldom work well because the current system is designed to achieve the current results (on purpose or unwittingly).  This means that innovations are not likely to fare well in the current system.  Typically, the current system exerts pressure on innovations to change to fit the status quo.  It is rare to have an existing system automatically change to support more effective education practices and frameworks.  An innovation that has been altered may be a better fit with the current system but it is likely that the EBP or EII will lose its effectiveness as a result of the adaptation process.

At the beginning of a change process, leaders and Implementation Teams cannot know everything that will be required to successfully use and sustain the innovation. However, with each step forward, the next step becomes clearer.  Steps forward result in discoveries about what’s working and what’s not.  And some discoveries will be surprising!  The challenge is to engage in a ‘trial and learning’ process of rapid improvement not a ‘trial and error’ process characterized by random acts of innovation. This module reviews the forms of PDSA improvement cycles that can guide these more systematic improvement processes.

Change and challenge go hand in hand -

“We can’t get our arms around all the people and processes that need to change – this is just too big.”

“Hey, the students show up every day.  It’s not like we can stop education, re-tool and then reopen the school.  We have to make changes as the work of educating our children goes on.”

“What if we get it wrong!  We’d better have all the pieces well thought out and totally in place before we move forward.”

Commitment to Organized Improvement Processes

People involved in change initiatives, particularly leaders and Implementation Teams, need to become comfortable and effective at learning as they go.  No matter how well planned or carefully monitored, change efforts typically do not go well at first.  Instead of floundering, change efforts can be done using improvement cycles.  By using improvement cycles, each new attempt to solve a problem or improve a practice adds value and information.  Each attempt to use an innovation leads to new learning, whether or not the outcome is completely successful.  Applying and embedding
the new learning leads to improved processes and better outcomes and increased competence and confidence for managing change.  

With clear, shared goals of ensuring that students benefit from effective practices, everyone is motivated to CHANGE to support the use of the effective practice as intended.  That means that organizational and systems change will be required to support new instructional practices, content, and frameworks.

New or repurposed structures, processes, positions, and functions will be needed at multiple levels.   Often these functional changes are possible using current resources and funding to repurpose the positions and job functions to support new ways of doing things. 

Get Started, Get Better!

Underlying the improvement cycles described in this module is the Plan, Do, Study, Act Cycle or PDSA Cycle.  PDSA is a process derived from industrial quality control research.  Deming (1986) built on an earlier process by Shewhart (1931), and then Deming and Juran used the process extensively in post-war Japan to bring their devastated manufacturing and economic system to the forefront of production capacity and quality in a relatively short time (DeFeo & Barnard, 2005). The process is now used widely in human services (Varkey, et al, 2007; Daniels & Sandler, 2008; IHI, 2010). The PDSA Cycle is used for making small incremental improvements as well as for significant ‘breakthroughs’ in performance.  The process can be used to make a small test of change, help define and refine new innovations and ways of work, be applied to scale-up efforts, and can be used to better align policies and guidelines to support new ways of work. 

Let’s take a brief look at each phase of the PDSA Cycle. 

  • The PLAN phase refers to identifying barriers or challenges and specifying how to move programs forward.
  • The DO phase refers to using those processes as intended.
  • The STUDY phase refers to monitoring the process.  Did we DO the processes as intended? The STUDY phase also includes the analysis of the data about the process and the outcomes achieved. 
  • The ACT phase refers to applying what was learned during the cycle to improve the process and the outcomes. 

When We Know Better We Can Do Better

Improvement Cycles help us identify challenges, solve problems, improve practices, and create hospitable environments for new ways of work. In this module on Improvement Cycles we discuss different uses of the PDSA Cycle.  Improvement Cycles are functional for improving fidelity and outcomes and help to increase our comfort with the fact that we don’t need to know everything to get started….because we will get better through the PDSA various processes.

Three Types of Improvement Cycles

The three types of PDSA Improvement Cycles are as follows:

  • Rapid-Cycle Problem-Solving is used to address immediate and pressing issues and to make incremental improvements quickly.  Rapid-Cycle Problem-Solving works well when there are a few examples (e.g. teachers, schools, districts) and the use of an innovation can be viewed frequently (e.g. hourly, daily, weekly).  For example, using new instructional practices (e.g. encouraging student engagement with the subject matter) or new implementation practices (e.g. coaching with competence) provide excellent opportunities to use Rapid-Cycle Problem-Solving to solve problems as the new methods are attempted in practice.
  • Usability Testing is well suited to situations where the innovation is complex and involves more people or several aspects of an organization or system working together.  In these cases, there are more examples (3 to 5 at a time) and the use of an innovation can be observed frequently (daily, weekly, monthly).  For example, 3 District Implementation Teams can be initiated and the challenges of having the DIT begin working with school staff to support teachers in schools can be noted and corrected.  Armed with these changes and improvements, 3 additional DITs can be initiated to see if the improvements are realized with a new group of DITs and to detect any further changes that need to be made.  Data from other fields indicate that most of the critical problems can be detected and corrected by the end of the third or fourth usability test.  Usability Testing quickly can identify trouble spots that otherwise would torpedo success if innovations were rolled out all at once.
  • Practice-Policy Communication Cycles are useful when whole organizations and systems are involved in change.  In these situations, the interplay among aspects of the system are difficult to predict and observations are difficult to conduct.  The goal of changes in education is improved instruction to produce improved student outcomes.  Thus, the standard for assessing what needs to change is:
    • Are school leaders and staff supporting teachers in using the innovation with fidelity and good outcomes for students;
    • Are district leaders and staff supporting schools and teachers use of the innovation with fidelity and good outcomes for students; and
    • Are state leaders and operating units supporting schools and teachers use of the innovation with fidelity and good outcomes for students?

The Practice-Policy Communication Cycle increases feedback from the classroom to the administration at school, district, and state levels.  Implementation Teams, via PDSA Cycles, assure work at the practice level (e.g. feedback from teachers) informs administrative support and resource allocation.  And it gives administrators the information they need to actively support the use of new practices as intended. (For more information, see Module 3: Implementation Teams.)

Everyday Examples

Many of us engage informally in these cycles as we think through and test out hypotheses or go about improving our lives.  How many of you have tried to get to know or inform a new leader, a new family, a new partner, or a new teacher.  We start by getting clear about what we want to do with whom (e.g. information to provide, relationship to develop).  Then we make a plan (PLAN) to get to know them better or to provide information; we engage in behavior as planned (DO) and we evaluate (STUDY) how effective our behavior was in communicating, getting to know, and helping to inform that person.  Then we make more plans based on how well our first engagement with them went (ACT). Or, we PLAN to ‘tinker’ with a favorite recipe and add, take away, or change the amount of certain ingredients.  We DO the new recipe and then STUDY the results by asking our family and friends to eat it and observing or asking them how they liked it.  Then we ACT and write down the new recipe that everyone loved, or we go back to the original recipe or try a new variation.

Transformation Zones

All three types of Improvement Cycles work well in Transformation Zones designed to help transition the system “as is” into the system “to be.”  The transition process begins with a manageable cohort that represents a small ‘slice’ of the system (e.g. two rural, two suburban, two high needs, two urban districts).  The diversity combined with the manageable scope help to uncover challenges and solve problems with innovations and implementation supports before moving ahead with scale-up or expanded use.  

The next four topics in this module take you more deeply into the PDSA work by discussing the three types of PDSA Improvement Cycles, Transformation Zones, and improvement tools and processes you can use.