Why do it
It is unlikely to get a change right the first time around. Test your change idea on a small scale. You can do this in a service, with a client or patient group, or in a specific location. This allows you to see what works well and what does not. You can also find lessons to improve or adjust your ideas.
What is it
Measure the impact and value of the change you are testing through a combination of qualitative and quantitative data. This means using measuring processes, such as counting the number of events or outputs, and engaging with service users, providers and enablers to understand the value of the change. Data helps understand whether the change has achieved the aim and if there are any unintended consequences.
During this step, you take your preferred option from the develop and design stage and:
- create a testing plan
- carry out the test
- review the insight and learning from the test
- refine the change idea
Plan, Do, Study, Act cycle (PDSA)
You may find the Plan, Do, Study, Act (PDSA) cycle helpful in considering how you carry out this step. It allows us to test ideas on a small scale. Refining as we go as we get feedback from each cycle and make decisions about what to do next. Each cycle supports you to test changes incrementally, learn from the results, adjust, and then test changes under different conditions.
Read more about the PDSA cycle on TURAS Learn.
Think about the scale or size of your test
The scale or size of the test is dependent on three factors:
- commitment within the organisation
- cost of failure
- degree of belief that the change will lead to improvement
If all three factors are low then start small.
What to do with the results of my test
The Plan, Do, Study, Act (PDSA) cycle is not just a one-time process. Once you go through all four stages, you don’t just stop there. Instead, you use what you’ve learned to plan your next PDSA cycle related to the change you are testing. Maybe you can adjust the change a little, try it with more people, or at a different time of day. Each cycle builds on the last, helping you gradually get the change working in the best possible way for the area.
It is ok if your change does not work. Where things do not work, it can provide valuable learning to inform trying again.
You may find you want to repeat this stage a few times so that you can improve it further before carrying on to the next step.
If your testing shows that big changes are needed, it might help to go back to an earlier stage. This way, you can think more about the issue or idea.
Who might you involve
It can be helpful to think about who you might need to involve or get help from during this step.
Think about:
- what skills, knowledge, and experience do you need
- what roles and responsibilities do you need in the room to think together and make decisions
- who might you need to support your work to get agreement
The skills and professions you might need to have involved in the change include:
- health and social care clinicians and professionals
- people with lived experience
- third and independent sector staff
- support staff (like data analysts, project managers, service designers, quality improvers, engagement experts, strategic planners, and organisational development professionals)
Practical support
Project management activities to be undertaken during this step of change. In addition, you can access further practical support below.
Taking the next step
Once you’ve prototyped and tested your change initiative, you’re ready to advance to the review for implementation step, where reflecting on the impact and success of your change initiative ahead of implementation can begin.
In some instances, you may not always follow the steps in order, and it may be necessary to revisit a previous step as new insights or evolving circumstances emerge.