Whereas the focus of the PDSA cycle is experimentation, the focus of the SDSA cycle is standardization. The idea behind this is simple and powerful. You run experiments (PDSA tests of change) until you reach your measured aim. Then, once you are able to achieve the desired level of performance, you want to maintain these gains by continuing to do the right things the right way. This calls for the adoption of a standard method and its continued use until the time comes to make new improvements.
The SDSA (standardize-do-study-act) cycle is the approach you take once you have successfully done one or more PDSA cycles and have enough experience and measured outcomes to determine that you have reached your original aim. The purpose of using the SDSA approach is to hold the gains that were made using PDSA cycles and to standardize the process in daily work.
Once you have reached the point where you should switch from the PDSA cycle to the SDSA cycle, that is not the end of the story. As new technologies arrive, and as your microsystem gains additional process practice and insight, you may need to move from SDSA back to PDSA again, to learn additional information and to test new ideas and processes. This back-and-forth process—between experimentation and standardizing—will result in higher levels of efficiency and an ability to hold your gains. Never think that once a process is in the SDSA cycle it will stay constant. Ongoing review and evaluation will tell you whether the best-known practice is in place and may reveal that you need to move back to PDSA, as shown in Figure 14.5.
FIGURE 14.5. THE BACK-AND-FORTH RELATIONSHIP OF PDSA AND SDSA.
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