​After testing a change on a small scale, learning from each test, and refining the change through several PDSA cycles, the change is ready for implementation on a broader scale-for example, for an entire pilot population or on an entire unit.

Implementation is a permanent change to the way work is done and, as such, involves building the change into the organization. It may affect documentation, written policies, hiring, training, compensation, and aspects of the organization's infrastructure that are not heavily engaged in the testing phase. Implementation also requires the use of the PDSA cycle.

See also: Testing Changes, Tips for Testing Changes, Linking Tests of Change, Testing Multiple Changes, Implementing Changes, Spreading Changes.

Example

Testing a change:
Three nurses on different shifts use a new medication reconciliation and order form.