A quality council reviewed the following results from a performance improvement project: Diabetic retinal eye exams 1. Target 2. Q1 3. Q2 4. Q3 >80% 60% 58% 62% Which of the following should happen next?

The performance data from three consecutive quarters (60%, 58%, 62%) are consistently and significantly below the target of >80%. This indicates that the current intervention is not effective. Before deciding to continue, implement, or change the plan, the quality council must understand why the project is failing. The next logical step in the Plan-Do-Study-Act (PDSA) cycle is to "Study" the results in-depth. This involves reviewing additional data to identify barriers, root causes, and specific areas of failure, which will inform any future decisions.

A. Continue the pilot for another quarter: Continuing a failing pilot without analysis is inefficient and unlikely to yield different results.
B. Implement the change: Implementing a change that has proven ineffective would be a poor use of resources and would not achieve the desired quality improvement.
D. Plan for the next change: Planning a new change is premature without first understanding why the current intervention failed. Analysis must precede planning.

1. Ransom

S. B.

Maulik

S.

& Nash

D. B. (Eds.). (2022). The healthcare quality book: Vision

strategy

and tools (5th ed.). AUPHA/HAP. (Chapter 11 discusses the PDSA cycle and the importance of the "Study" phase for analyzing data and understanding process performance before proceeding.)

2. Agency for Healthcare Research and Quality (AHRQ). (n.d.). Plan-Do-Study-Act (PDSA) Cycle. AHRQ. Retrieved from https://www.ahrq.gov/health-literacy/quality-resources/tools/literacy-toolkit/health-lit-universal-precautions-toolkit-2e-tool21.html (This resource explains that the "Study" phase involves analyzing data and comparing results to predictions to understand what happened.)

3. Langley

G. J.

Moen

R. D.

Nolan

K. M.

Nolan

T. W.

Norman

C. L.

& Provost

L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass. (Part II

The Model for Improvement

emphasizes that learning from data collected during tests of change is a critical step before planning subsequent cycles.)