The PDSA cycle, also known as the Plan, Do, Study, Act cycle/Model, is a highly flexible framework and a valuable tool to carry out and assess change projects for quality improvement initiatives. Developed by Walter Shewhart but well promoted by W. Edward Deming, the PDCA cycle is most accessible and applied to changes in processes within clinical operations (Feldman, 2020). It also facilitates continuous testing of changes, the escalation of which is less of a problem since testing involves a trial and error approach that can quickly reveal the best practices and drop down the poor performers.
The plan-do-check-act cycle’s four stages plan, do, study, and act are designed to stage the intervention so that it can be monitored at each phase and adjusted to reflect real-world results. Applying the PDSA cycle is appropriate for qualitative and quantitative data, so the tool is somewhat flexible and undoubtedly can be considered an evaluation tool. Incorporating this statistical tool in different studies related to healthcare improvements has revealed a high positive impact on the efficiency of various processes and enhancement of quality of patient care that makes it more effective and appropriate for use within the clinical context (Bhati et al., 2023).
HSOPSC was created by the Hospital Survey & Promotion on Patient Safety, an arm of AHRQ, which is one of the top agencies in the United States aimed at enhancing the safety of the healthcare system. It involves assessing workplace aspects such as unit teamwork, supervisor/manager expectations, formal and informal communication channels, and learning from errors. The survey uses close-ended questions on a Likert scale to measure staff’s perceptions and attitudes towards one aspect of patient safety and another set on an ordinal scale to quantify such elements, including attitudes, perceptions, frequency, or occurrence of events (Ahmed et al., 2023). Moreover, the internal consistencies and the cross-factual validity of the HSOPSC have been established in various research. Cronbach’s alpha was above 0. In other words, the reliability of collected data was established well using Cronbach alpha results. Slightly above the midpoint, with an average alpha coefficient of 70 proposed by the field, it shows acceptable internal consistency. To prove that validity has been attained, construct validity was conducted through factor analysis, which shows that the survey captures different facets of the safety culture as intended.
Walter Shewhart developed the PDSA, and W. Edwards Deming is credited for elaborating it. Three critical circles of change were established: It is an effective tool for testing change and constant quality improvement, making it highly valuable. The PDSA cycle measures the effectiveness of process changes through its four phases: Kotter’s process for organisational change includes the following: planning (setting of objectives and planning for a change), doing (experimentation of the change on a limited basis), studying (evaluating the effects), and acting (modifying where necessary, and doing the change more extensively) (Green et al., 2018). NURS FPX 8030 Assessment 4 cycle does not depend on a specific scale or a unit of measurement but rather on the particulars relevant to the intervention intercession being investigated. Another strength of the PDSA cycle, and perhaps a strength born of its cyclical nature, is the ability to increase the reliability of the cycle as any given circumstance is subjected to the cyclical test. Generalisability is founded on its universality and documented effectiveness across different sectors, especially the medical field, where it shows a tangible impact of enhancing process and quality of patient care results (Burchett et al., 2020).
Scholars provided one of the most extensive attempts to administer the HSOPSC, with their study appearing in the BMC Health Services Research journal. In the context of this research, the HSOPSC survey was administered in multiple hospitals to explore the psychometric properties of the measure in individual and cross-hospital correlation. NURS FPX 8030 Assessment 4 analysis results highlighted the scale reliability with a high Cronbach alpha coefficient higher than 0. Industry averages were used for most dimensions, indicating adequate instrument reliability with an alpha coefficient of 0.70 (Schrepp, 2020). Further, the factor analysis was used to establish the reliability of the survey by providing obvious, sharply defined factors in patient safety culture. The study showed considerable differences in the perception of safety culture across the various hospitals, and therefore, implementing tar
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