Now you've set out your theory of change and generated your change ideas, it's time to start testing! PDSA cycles are used to test changes iteratively by developing a plan to test the change (Plan), carrying out the test (Do), observing and learning from the consequences (Study), and determining what modifications should be made to the test (Act).

Why do we use PDSA?

• Rapid cycle testing gives those involved the opportunity to see if the change will succeed on a small scale first, reducing the risk of implementing large scale changes that may not work or negatively impact service users, staff or the wider system.
• By making a prediction about the idea we are testing and using data and feedback to study the results, we can quickly generate knowledge about what works and doesn't work, allowing us to adapt our change ideas until they are fit for purpose.
• Testing ideas in real world settings and listening to feedback helps staff feel ownership over the changes, and ensures they work for the people closest to the problem

PDSA testing ramps

If you are seeing the improvements you hoped for from PDSA testing on a small scale, it's time to scale up and see if you see the same effects at a wider level.

For example, this might be moving from testing an intervention on one patient on one day to all patients that day, eventually spreading improvements across a whole team, service, or even wider still.

You may even have several PDSA ramps running at the same time while you test different change ideas. However, remember that if you have many different PDSA cycles running concurrently, you may not know which intervention results in the improvement.

How to get started with PDSA testing

• Download our editable PDSA cycle template to help you plan your PDSA
• Use the steps in the image above to plan and study your ideas