Evaluation of the Implementation of Plan-Do-Study-Act cycle in the vascular collaborative improvement project at University Hospital of Leicester (UHL) – Qualitative study

Abstract

Abstract Introduction: This dissertation project aimed to evaluate the implementation of PDSA cycle method in a current quality improvement project at University Hospital of Leicester (UHL). The study aimed to investigate the application of PDSA method and explore the factors that worked as facilitators and obstacles to the improvement approach in healthcare. The Quality improvement project at (UHL) is the vascular improvement which aimed to increase theater productivity and utilization by reducing late start and cancellations. Methodology: This dissertation project used qualitative methodology. With two data collection tools of semi-structured interviews and questionnaires. Six interviews were conducted with the QI members and 7 questionnaires were collected from the front-line staff. The data were analyzed using thematic analysis. Results: Overall, the data revealed many features of PDSA was employed in the implementation process with many factors that facilitated and limited the project outcomes. The findings illustrated that, PDSA implementation in healthcare can have many facilitators and barriers. Some of the factors that assisted the implementation of the QI project were good QI communication and clinical engagement. On the other hand, barriers were found in communication with frontline staff, relationships, culture, covid-19 impact and sustainability. Conclusion: Although the vascular improvement has not satisfied the intended aim yet, the learning and development was found to be a major element in the implementation process. It is vital to consider the barriers that worked at each cycle as many emergent and unpredictable events occurred and lead to changes in the planned cycles. Healthcare can be a complex system and improvement can be challenged by serval factors. It is also vital to note on the value of ownership of change by frontline staff to ensure sustainability.