Spinning Coins

Ninon Lewis, MS; Vice President, IHI

Coin spinning game is a way to learn one of the most essential skills in quality improvement, the PDSA cycle, plan, do, study, and act. My colleague, Dave Williams, had the idea for this game. We flushed out the idea and started using it with teams. It's a really fun and very quick way to get some real experience with PDSA cycles.

Today, our learning objectives for this exercise are to, one, understand rapid cycle PDSA testing. Two, understand how theory and prediction help your learning. Three, see how to collect real-time data and measurement. And four, appreciate the opportunity to learn together. The materials for this game that you'll need are four coins of different sizes and weights. In the US, we use a quarter, a dime, a nickel, and a penny. Use whatever works for you. You also need a time piece able to capture minutes and seconds at each table. A smartphone works well for a time piece for this game. You'll also need a timekeeper. You should also have a worksheet called the PDSA Tracker with you. You'll see several questions that will prompt you to be thoughtful about the ideas you want to test.

This game works best in groups of about three to five. So team up and make sure you have the materials with you. The object of the game is to spin that coin as long as you can. You can use and test any of the four coins, any technique, and any surface, however you define what a surface is. The game is going to take roughly 25 minutes. 15 minutes for spinning, and 10 minutes to debrief what you've learned. You'll want to run as many tests as you can in these 15 minutes. However, you want to be intentional in your testing. That means consider what you believe may support the longest coin spins.

Write your change idea down in the plan section of your PDSA Tracker along with what questions you're trying to answer with this test. Then make a prediction of the time you expect to achieve. Once the plan section is complete, do the test, spin the coin. Remember the starting point is when the coin starts spinning, and it stops when the coin comes to a natural stopping point fully on your surface. During the test, capture observations in the do section of the PDSA Tracker form. After the completion of your test, document the time in the run chart included in your tracker and test again. You might think documentation is going to take you a long time, but trust us, the more tests you run, the faster you'll get at planning your tests. Are you ready? Let's do this.