Module 6
In 6.3, deciding to Adopt a change is the signal that it's ready to move beyond testing. Full-scale adoption of an intervention after successful PDSA testing moves a change from ‘experiment’ to ‘standard of care.’ Without formal implementation, even well-tested changes don’t stick.
Implementation is different work than running a PDSA cycle. A PDSA cycle asks, “Does this work, and how do we make it better?” On a small scale — one provider, one shift. Implementation asks a different question: “How do we make this the new normal for everyone, every time?” Instead of testing and adapting, you’re now building the change into how the team already works.
When a Change Is Ready, Embed It In:
- Policy and procedures (formal documentation)
- Training and onboarding for new staff
- Day-to-day workflow (EMR, checklists, protocols)
- Accountability systems — monitoring completion rates, audits, dashboards
Decision Points
It works consistently and is sustainable. Data show reliable improvement. Staff are confident and engaged. Embed it into standard workflow, policy, and training.
It has potential but needs refinement. Some components work, others don’t. Staff have identified barriers. Run another PDSA cycle with modifications.
It consistently fails to improve outcomes, creates more burden than benefit, or is not feasible at scale. Learn from it — document what you learned — and move to the next change idea on your Key Driver Diagram.
Keeping the Change in Place
Implementation isn’t ‘set it and forget it.’ Someone needs to own the change going forward — checking that it’s still happening the way it’s supposed to, and catching drift back to old habits. For the ED telepsychiatry consult line, that might mean the charge nurse reviews call-response-time data monthly and flags any slide back toward paging instead of texting.