PDSA A3 Template From On The Mend

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Title: Fresh Eyes: Subject Start Date:

Owner: Team: Expert(s): Revision Date:


PDSA Revision #:
Coach:

Background / Current Conditions Analysis / Root Cause

PLAN
Countermeasures to Root Causes

DO
PLAN

Study (Planned vs. Actual Results)

STUDY
Problem Statement

Act/Adjust

Goals/Targets

ACT/ADJUST

Stakeholder
Signatures:

PDSA A3 TEMPLATE

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