Dec 182014
 
Sarah Puntoni

Sarah Puntoni

Like you, the title of this blog is a sentence I never thought I’d be saying, but, in a roundabout sort of way, it turns out that Mr Potato Head can teach us a thing or two about applying PDSA cycles.

Still not convinced? Let’s take a look at the reasons why, starting from the beginning.

I first came across the idea of using Mr Potato Head for PDSA cycles when discussing different exercises used by our Improving Quality Together (IQT) leads.

So, last week it was my turn to get Mr Potato Head out of his cardboard box for the session I was leading on person-centred care with Abdominal Aortic Aneurysm (AAA) screeners. The task? For groups to assemble him mirroring the image in front of them, which you can see below.

Mr Potato Head

Here’s how it worked. Each team were assigned roles of:

  • Timekeeper
  • Assembler
  • Recorder – state the theory being tested, predict accuracy and record the results
  • Quality (accuracy) Inspector

Once roles were assigned, it was time to begin the first of five rounds.

Round 1 – Simulation
Establishing a baseline. Asking each team to build their first Mr Potato Head and record their time and accuracy, this is an important benchmark for what will follow – assembling Mr Potato Head as quickly and as accurately as possible.

Round 2 – 1st PDSA
Considering their baseline, they set out on their first PDSA, agreeing a theory for what time and accuracy they could achieve together, before setting off to test the theory and record the outcome of their first PDSA.

Rounds 3, 4 and 5 – PDSA cycles
Each round, they identified a theory that could be tested to improve on accuracy and/or time of the task. Each time recording their data and plotting it over a run-chart.

 

So, what can we learn from our time with Mr Potato Head? There are four main bits of wisdom I think he has imparted on us:

1. Shows how a PDSA cycle fits with any improvement goal

Plan-Do-Study-Act cycles are a simple way to test any theory and monitor its impact as fast, continuous cycles of improvement. Any change can be tested in this way, no matter how small they may seem, even smiling or introducing ourselves to every service user and their family.

2. Demonstrates collecting real-time data can be extremely useful

Only by recording the real-time data of every PDSA cycle, can we track our impact and focus our efforts. Data collection doesn’t have to be complicated or onerous, it’s just meant to help us understand how reliably we’re applying the changes and the impact they’re having. If I’m trying to ensure I smile and introduce myself to every patient, a simple self reported tick sheet style data collection could be enough to tell me if I am consistent in my approach.

3. Shows the importance of collaborative learning

Working as a team means we can build on each other’s strengths and expertise, and therefore achieve better results. By working collaboratively we can ensure any change is a coordinated effort avoiding variations in our service provision. If everyone in my team is working towards assembling the perfect Mr Potato Head, or consistently and reliably smiling and introducing themselves to patients, I am more likely to maintain this attitude and be reliable in my approach.

4. Our improvement goals and strive for quality are never ending

There is always more we can do to improve, and our idea of quality is always changing. Our definition of accuracy and quality when we set off on our baseline is different of what we expect by our third PDSA. Our expectations change as our improvement becomes reliable and our efforts generate results. If I know I am reliably introducing myself to every service user, and this is reflected in a better first impression, I can then decide to concentrate on ways to ensure this first impression is a lasting one by designing a new theory for testing. Perhaps I need to check how people would like to be addressed every time I first meet someone? The PDSA cycle goes on.

What do you think, should you be spending a bit more time with Mr Potato Head? I think you should definitely give it a go.

Sarah Puntoni is Healthcare Improvement Lead Officer at 1000 Lives Improvement. You can follow her on Twitter @SarahPuntoni.

Come and find out more about Improvement Methodology over on our website here.

Don’t forget to join the conversation and  follow us on Twitter @1000LivesPlus.

  3 Responses to “4 things Mr Potato Head can teach us about applying PDSA cycles”

  1. miked@nhselect.org.uk'

    Brilliant blog Sarah

  2. Perhaps time spent on theory could be better spent actually nursing patients ?

  3. Dominique.Bird2@wales.nhs.uk'

    Hi Toni – thanks for your comment. I’d agree with you that time spent on theory alone will not help our teams provide high quality patient care, which is why we focus on taking the theory into practice, supporting teams through their quality improvements in IQT. I would also highlight that if we continue to just focus on dealing with the situations in front of us, and not give teams the time out to reflect and look for ways to improve the service, we will continue to fire-fight. I’d be happy to answer any further questions if you had any and wanted to discuss further.

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