Is PDSA the same as Audit?
Is PDSA the same as Audit?
It’s a question I’ve heard discussed many times – and so I asked Foundation Doctors at the Bristol Patient Safety Conference 2022 for their thoughts…
I offered up three options
- Always
- Sometimes
- Never
And here are the results
Now, I’ve discussed this question many times with people from different clinical backgrounds and experiences, from those starting out their medical career to consultants of many years. What I find fascinating is the conviction that people have to their answer and the rigour with which they will argue their corner.
What we can always agree on is this:
- They are both circles with four quadrants
- They are both useful
- They both part of the quality and safety landscape in healthcare
- Opinions can divide the room
But this is really where the similarities end as they are NEVER the same!
If you are of the belief that they are the same always or some of the time, you are not alone and I invite you to read on as I share what makes them fundamentally different constructs in a bid to persuade you to change your belief!
To be fair there are many influences that direct people to think they are the same some or all of the time, not least the way organisations and leaders continue to use the two approaches interchangeably in the same breath.
So as a rule of thumb to distinguish the two…
Audits usually have two cycles and two measurement points – ‘before’ and ‘after’ a change attempt, showing the gap between a standard/s and current practice.
Robust PDSAs should include at least 3 tests of change, and often many more (@QIClearn our learner median is currently 5 with a range of 3-15) – always framed within the Model for Improvement (Langley et al 1996).
QIClearn ran a successful masterclass in PDSA cycles for Clinical Audit Awareness Week 2023, please keep an eye on our twitter feed for future dates @qiclearn