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QI Games: Learn How to Use PDSA Cycles by Spinning Coins

Niñon Lewis, MS, Executive Director, IHI

You may have thought your coin spinning days ended in grade school, but it turns out the activity can help you learn about theories, predictions, and PDSA cycles.

In the first video in this activity, Niñon Lewis explains what participants will do in the game and what they’ll need to play. In the second, she talks with Rebecca Steinfield, IHI Improvement Advisor, about some of the key learnings from the game. You can show these videos in a group setting to help you facilitate this activity or watch them by yourself ahead of time.

Part 1: How to Play the Coin Spinning Game

Read the video transcript.

Part 2: What We Learn in the Coin Spinning Game

   Read the video transcript.

Learning Objectives: At the end of this activity, you will be able to:
  • Explain how to conduct small, rapid PDSA cycles.
  • Discuss why theory and prediction are critical to learning when conducing a PDSA cycle.
  • Collect real-time data for measurement.

Discussion Questions:

  1. What’s your theory about what makes a coin spin the longest? Was your theory different before you started spinning coins?
  2. What did you learn by collecting data on the length of time your coin was spinning? Do you think you would have arrived at the same result without data collection?
  3. In your own words, what is the value of each step of the Plan-Do-Study-Act cycle? Use examples from the game, if possible.

David Williams, IHI Executive Director, came up with this simple game to help teams learn how to run PDSA cycles in minutes, with nothing more than a few coins.​​​


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