BY

DR MUHAMMAD
AKRAM

FOCUS-PDCA
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 FOCUS-PDCA
A framework created by Hospital Corporation of
American (HCA) for thinking about and
applying different tools for CQI( Chartered
Quality Institute)
• PDCA is often called the Shewhart or Deming
Cycle
• Used widely in one form or another in health
care and in industry.
Shewhart Cycle
 In the 1920s, Walter Shewhart, a statistician
at Bell Telephone Laboratories, developed
the Shewhart cycle, known as Plan, Do,
Check, Act (PDCA).

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 Plan
Question the capacity or capability of a process. Pose
theories on how to improve the process and predict
measurable outcomes.

Do
Make changes on an experimental, pilot basis.

Check
Measure outcomes compared to predicted outcomes.

Act
Implement the changes on a broad scale (Gaucher &
Coffey,1991).

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 Shewhart Cycle
The Tradiotnal PDCA Model

11. Monitor the change

and hold the gains 4. Identify improvement
opportunities
3. Measure and Plan
analyze data
5. Identify root causes
of problems
2. Describe the
current process
Act Do 6. Generate and choose
solutions
1. Ideintify customer Check
needs/expectations
7. Plan and implement
a pilot of the solutions
10. Standardize the change
8. Evaluate results of pilot
9. Draw conclusions

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Deming Cycle
 Deming Cycle
• The PDCA cycle was later adapted by
Deming as the Plan, Do, Study, Act
(PDSA) cycle; therefore, it also is referred
to as the Deming Cycle, or the Deming
Wheel.

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 Plan-Do-Check (STUDY)-Act Cycle
(P-D-S-A)

Act Plan

Check
Do
Study

Deming’s Cycle (1900-1993)

P-D-S-A

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F.O.C.U.S.
 F.O.C.U.S.

→ Find an improvement project

(initiative):
– Review related standards & documents
– Analysis of collected data
– Identify problems & desired outcomes

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 F. O
O .C.U.S.

→ Organize ad hoc (task force) team:

– Identify & involve stakeholders (e.g.
physicians, nurses, administrative …etc)
– Cover all related departments to the
improvement initiative
– Select team members who best do or know
the process to be improved

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 C
F.O. C .U.S.
→ Clarify current process & desired
outcomes:
– Fully understand the current process by
all team member
– Draw flow chart to clarify the process
variation/problem
– Collect data from all affected areas
relevant to process & desired outcomes

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 U
F.O.C. U .S.
→ Understand Process Variation, Root
Causes & Desired Outcomes:
– Identify tools needed to describe &
analyze process variation, root causes &
desired outcomes
– Obtain Information from benchmark, best
practice ..etc
– Identify all possible solutions to achieve
the desired outcome

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 F.O.C.U. S . S
→ Select the best practice procedure:
– Analyze alternative solutions related to
process improvement
– Choose the best solution that will achieve
desired outcome
– Develop approval with a summary of
required information about expected
outcomes, resources needed, time-frame,
responsibilities ..etc

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P.D.C.A.
 PP.D.C.A.
→Plan for improvement project
(initiative):
– Assign tasks with agreed criteria checklist &
set time frame
– Allocate resources, determine responsibilities
& gain support from all who will be affected
by implementation.
– Establish monitoring system to collect
necessary data to keep project on the track

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 P. D
D .C.A.
→Do the improvement project:
– Implement the best solution stated in FOCUS
process.
– Empower all people involved by training,
education & moral support.
– Collect data & update checklist

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 C
P.D. C .A.

→Check the results

– If the desired outcome is obtained & lead
expected improvement.
– Compare data collected from FOCUS process
with that during DO
– Check for any unexpected, undesired
consequences or outcomes

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 P.D.C. A .A
→ Act to hold gains or re-adjust
FOCUS-PDC
– If improvement initiative is reaches;
standardize the process, adjust documents
& empower people
– If improvement initiative is not reached,
repeat FOCUS-PDCA cycle
– For both situations, continue to monitor the
process to identify further improvement.

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21 Thank You