Improvement work thrives with a team. People involved in parts of the process or system that you are trying to improve bring diverse perspectives and expertise that can fuel more effective ideas for change that are more likely to be sustained while building will to make improvements. 

When forming a team, it is vital to apply an equity lens to identify team members and to engage the individuals who will most benefit from the improvement on the team. 

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An aim statement answers the first question of the Model for Improvement: What are we trying to accomplish? 

The aim: 

• Is time-bound and measurable (how much? by when?) 
• Defines the specific population whose lives will be affected by the improvement effort
• Identifies where the improvement is taking place

Engage the individuals who will most benefit from the improvement in defining the aim.

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Measures help teams answer the second question of the Model for Improvement: How will we know that a change is an improvement? 

Teams use feedback in the form of quantitative and qualitative data to learn if a specific change leads to an improvement. Ensure that the individuals who will most benefit from the improvement contribute to identifying measures that reflect improvement from their perspective.

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To answer the third question of the Model for Improvement — What change can we make that will result in improvement? — teams identify potential ideas for change. 

Ideas for change may come from those who provide input into, work in, or are recipients or customers of the system, or from the experience of others who have successfully improved. Engage the individuals who will most benefit from the improvement in identifying and co-designing potential changes.

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The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change on a small scale (e.g., one patient, one day) in the real-world setting — by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning.

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After testing a change on a small scale, learning from each test, refining the change through multiple PDSA cycles, and testing under varying conditions (morning/night, holiday/non-holiday, etc.), the team will want to implement changes they are confident will result in improvement. “Implementing” means making the changes permanent by establishing the infrastructure necessary to support and sustain those changes over time. 

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After successful implementation of a change or set of changes for one population or unit, the team can then spread the changes to other parts of the organization or to other organizations.

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