How to Use Plan Do Study Act (PDSA) Method in Health and Social Care

The PDSA method offers a simple, structured way to improve processes in health and social care. It helps staff make small, manageable changes and see if those changes lead to the results they want. This cycle of improvement is both practical and flexible, which makes it a favourite in NHS trusts, care homes, community services, and charities.

Health and social care settings rely on efficient and safe processes. Any inefficiency can impact people’s lives, safety, and confidence in the service. The PDSA cycle gives staff a way to tackle problems one step at a time, reducing risks and producing evidence for decisions made.

This method can be used for a range of topics—from medication dispensing safety to reducing waiting times and improving communication with service users’ families. Using PDSA does not require technical expertise, but it does need an open mind and a collaborative approach.

What Is the PDSA Cycle?

PDSA stands for Plan, Do, Study, Act. Each stage has a specific purpose, and the cycle repeats itself until the team achieves the goal.

• Plan: Identify a goal or change and map out what is needed.
• Do: Put the plan into action on a small scale.
• Study: Collect and examine results.
• Act: Decide the next step—adopt, adapt, or discard the change.

Continuous improvement is the core principle: each cycle builds on the last, allowing teams to test ideas safely and learn from any setbacks or successes.

Why Use PDSA in Health and Social Care?

PDSA helps teams test changes without disrupting daily care. Staff often have ideas for improvement, but large changes can feel risky. By testing an idea on a small scale, staff can:

• Check if the solution actually works
• Minimise negative effects on service users
• Adapt plans before rolling them out more widely

The approach promotes teamwork and learning instead of blame when things don’t turn out perfectly on the first attempt. Everyone who takes part gains new skills and confidence.

When Should You Use the PDSA Cycle?

The PDSA method is suitable for:

• Testing new ways of working in day-to-day care
• Changing paperwork, routines, or communication
• Introducing new technology in care planning
• Improving infection control
• Reducing medication errors
• Reviewing admission or discharge procedures

Any area of service that could run more smoothly or safely may benefit from PDSA. For lasting change, repeat the cycle multiple times rather than giving up or assuming that a single improvement will solve everything.

What are the Four Stages of PDSA?

Plan

During this stage, the team gets clear about the goal and the changes they would like to see. This means understanding the problem by gathering data, listening to those involved, and forming a plan based on this feedback.

Tasks in the planning phase:

• Define the problem clearly.
• Decide what “improvement” would look like (use measurable terms).
• Gather current process data (such as how many medication errors occur per month).
• Agree on a change to test (like a new step in medication handover).
• Clarify what, who, when, and where.
• Predict what you expect to happen.

It’s best to involve a range of staff, including those who deliver care firsthand, as well as managers, administrators, and sometimes service users or family members.

Top tip: Keep the test small and manageable—perhaps trialling with one person or one shift before thinking bigger.

Do

This is where you carry out the test on a small scale. Record what happens, even if things don’t go as planned.

Tasks in the Do phase:

• Run the change as outlined.
• Observe what works and what doesn’t.
• Record anything unexpected (such as interruptions, delays, or positive reactions).
• Make notes about feedback from staff, users, or families.

Being honest about setbacks is as useful as noting successes. Even if the change doesn’t have the expected impact, it teaches what works for your service.

Remember: Keep the test short-term and local to allow easy adjustments.

Study

Analysis happens here. Examine what your results show. Compare the outcome with your predictions.

Tasks in the Study phase:

• Review the data collected during the Do phase.
• Measure if improvement occurred.
• Compare before-and-after results.
• Discuss findings with everybody involved—the best lessons often come from those on the ground.
• Ask what went well, what surprised you, and what problems appeared.

Questions to help study:

• Did the new process reduce errors?
• Did service users react well?
• Was the process easier or harder for staff?

Use charts, numbers, or simple counts to show the impact.

Act

Now, use what you’ve learned to make a decision.

Possible actions:

• Adopt the change, if it worked well.
• Adapt the plan and test again, if partial improvement appeared.
• Abandon and try a different idea, if nothing improved.

Communicate what you’ve decided to everyone affected. Share results widely. If changes need to spread, repeat the cycle in new areas. Regular cycles help to refine the solution and create lasting improvements.

Real-Life Example: Medication Error Reduction

Imagine a residential care home facing repeated medication errors during shift changeovers. Staff decide to use PDSA to fix this.

• Plan: Analyse incident reports from the last month. Staff agree the problem occurs mostly during morning handovers. Plan to pilot a new written checklist for outgoing staff.
• Do: Use the checklist in one unit for three mornings. Outgoing and incoming staff fill in a short survey: How useful was the checklist? Did they forget any steps?
• Study: Survey reveals a drop in missed medications, and staff say they feel more confident. One staff member points out confusion around a checklist item.
• Act: Modify checklist wording. Test again in the same unit. Over several cycles, staff tweak the process and then introduce it across the home, cutting errors in half within a month.

Tools That Support the PDSA Process

Recording and sharing what happens strengthens learning. Several tools can help:

• Run charts (simple graphs showing progress over time)
• Data tables (listing errors, incidents, or successes)
• Written feedback forms or simple surveys
• Process mapping (drawing the steps in a process to spot where things go wrong)

Project logs, regular team meetings, or whiteboards can help track cycles and next steps. Some NHS trusts use digital tools, but a pen-and-paper approach works fine too.

Key Benefits of PDSA in Health and Social Care

By encouraging small tests of change, organisations can:

• Reduce disruption and avoid large-scale failures
• Increase staff engagement and ownership
• Tailor solutions to their own workforce and users
• Make improvements visible and measurable
• Support a learning and open culture

Staff often find the process empowering, since everyone gets to contribute. Service users may notice more responsive care and greater safety.

Engaging People At Every Stage

Change works best when everyone feels involved. Throughout each PDSA cycle, ask for input from:

• Care assistants, nurses, or other frontline staff
• Service users and their families
• Managers and supervisors
• Allied health professionals (like dietitians, OTs, or social workers)

Involving a cross-section of people leads to richer understanding and more workable solutions. Those directly affected are the best experts in what happens day-to-day.

Overcoming Common Challenges

PDSA is straightforward, but some hurdles can arise:

• Lack of time: Keep cycles small and fit them into existing routines.
• Data collection worries: Use quick methods—tick sheets or basic counts work well.
• Resistance from staff: Involve staff early and start with an issue they care about.
• Equipment or IT issues: Don’t ignore them—factor into your plan.
• Losing momentum: Celebrate each result, however small.

Addressing these practical problems helps keep the process manageable and positive.

Making PDSA Part of Everyday Work

For best results, use PDSA regularly rather than as a one-off. Some organisations create regular improvement slots in staff meetings or handovers. Make results visible—post up charts, changes, or thank-yous on noticeboards.

Try these ideas:

• Allow staff “testing days” where one new idea can be piloted
• Hold a “fail-fast” week—testing lots of small changes rapidly
• Reward teams for successful PDSA cycles, publicly sharing results

Making improvement an everyday habit builds skills, confidence, and shared purpose.

Common Pitfalls and How to Avoid Them

Some missteps can reduce the effectiveness of PDSA. Watch out for:

• Tests that are too big: Always start small; test with one staff member or patient where possible.
• Skipping the Study phase: Always pause to review what happened even if everyone is busy.
• Ignoring input from staff: Every perspective matters, especially where the process directly affects care.
• Lack of documentation: Keep simple records of each cycle, so everyone knows what has happened so far.

Sticking with small, carefully observed changes produces the best learning.

PDSA and Regulation

The Care Quality Commission (CQC) and local authorities welcome evidence of continuous improvement. Use the record of your PDSA cycles to:

• Show inspectors what changes you are testing and what impact they have
• Provide proof that you listen to service users, families, and staff
• Demonstrate a culture of safety and learning

Using PDSA sends a strong signal that your service is open to improvement.

Final Thoughts

The PDSA method gives everyone in health and social care a step-by-step way to test ideas and improve daily work. By starting small, learning from each round, and involving a broad range of people, teams can tackle real-world challenges with confidence and creativity.

Clear communication, teamwork, and a willingness to learn from both success and setbacks are at the heart of this approach. Whether enhancing a clinical process, making paperwork simpler, or improving the home environment for residents, PDSA offers a flexible and effective method to create real, positive change.