Plan-Do-Check-Act vs. Lean Quality Improvement Model

It could be hardly doubted that the employment of quality improvement models in the contemporary public health sector is of significantly high importance. There are numerous approaches to the improvement of organizational processes (Renedo, Marston, Spyridonidis, & Barlow, 2015). The purpose of this paper is to compare two particular models, the Quality Improvement PDCA and Lean, primarily by referencing the study by Scoville and Little (2014) in order to retrieve similarities and differences between two approaches.

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As it is stated by Weber and Sidorov (2014), change management is one of the most important fields of study in the contemporary healthcare system since it is essential to employ sustainable and efficient strategies to improve the quality of services and patient safety. In their study, Scoville and Little (2014) describe the Model for Improvement (which is also referred to as Plan-Do-Check-Act (PDCA) or Plan-Do-Study-Act (PDSA) models) as an integral part of quality improvement practices promoted by the Institute for Healthcare Improvement (IHI). The Lean model is a part of the holistic methodology that was developed by the Toyota company in the middle of the 20th century. It is possible to mention that both models share one primary goal of improving organizational processes of various kinds. However, the approach to the improvement practice differs significantly as the PDCA model is “a tool for gaining practical knowledge, it represents a radical distillation of pragmatic epistemology into a habit of immediate, sequential testing of changes” while Lean methodology strives “to devise nimble tasks, processes, and enterprises that maximize value and minimize waste in all its forms” (Scoville & Little, 2014, p. 6). It is also evident that these models could be more or less suitable for the completion of particular improvement tasks, but Scoville and Little (2014) mention that the most efficient way is to combine insights from both methodologies.

The Incorporation of the PDSA Quality Improvement Model in the Change Project

First of all, it is essential to identify that the IHI Quality Improvement model is chosen for the implementation in the proposed change project, which is to enhance the quality of nursing services provided at home. It appears to be that the PDCA cycle, which is the core aspect of the chosen model, is the most appropriate methodology for this project. The most efficient implementation strategy is to follow the four-stage pattern implied by the model. Therefore, the action plan could be described as follows: first of all, it is essential to plan out several actions to enhance the quality of nursing services (change management tools would be suitable), and then, after a period of practical implementation of these actions, it is needed to estimate the impact of the implemented actions (Weber & Sidorov, 2014). Thus, it would be possible to ensure the change is permanent and sustainable because, after the initial stage of the action plan, the PDCA cycle should be repeated in order to maximize the efficiency of the change practices and to gain additional knowledge. As it is mentioned by Scoville and Little (2014), “the daily application of experimental methods by line-level staff to recognize workplace problems and identify useful changes (kaizen, PDSA) is the driving mechanism of sustainable improvement” (p. 16). Therefore, it could be considered to be the most efficient sustainability tactic to employ in the change project.


Renedo, A., Marston, C. A., Spyridonidis, D., & Barlow, J. (2015). Patient and Public Involvement in Healthcare Quality Improvement: How organizations can help patients and professionals to collaborate. Public Management Review, 17(1), 17-34.

Scoville, R., & Little, K. (2014). Comparing Lean and Quality Improvement. Web.

Weber, V., & Sidorov, J. (2014). Implementing healthcare quality improvement: Changing clinician behavior. In Joshi, M. S., et al. (Eds.), The Healthcare quality book: Vision, strategy, and tools (3rd ed.) (pp. 423-449). Health Administration Press.

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