The IDEAS Blog

    October 30, 2015 / Christine Shea
    Improvement work in systems

    Improvement work can be challenging particularly when the work requires challenging established systems, including our healthcare system. This concise and insightful piece captures 7 key lessons for those leading change initiatives within systems. Moving from the macro to the micro level the article provides helpful examples based on experience to inform change efforts. I think […] Read More →

    October 9, 2015 / James Handyside
    SQUIRE Guidelines Updated

    SQUIRE stands for Standards for QUality Improvement Reporting Excellence. These guidelines have just recently been revised and the new website is up. SQUIRE 2.0 provides a framework for writing up and sharing quality improvement work. They are required for publication to some journals. They may be thought of as the healthcare improvement equivalent of CONSORT […] Read More →

    October 8, 2015 / James Handyside
    Drawing Pictures of Work

    This delightful TED talk is rich with insight about the use of visual methods and team work in quality improvement. How we understand complexity requires visual representation of our mental models. Words alone are insufficient. Discussion in a meeting is insufficient. This talk would be a good set up for a process mapping exercise with […] Read More →

    October 5, 2015 / Gillian Ritcey
    “This is what you’re going to do”

    Are you having difficulty making an improvement? This comical video from P3P Professionals Limited highlights the pitfalls of a top down approach to change where leaders tell staff “this is what you’re going to do.” 

This thoughtful video can be used as a reminder of the importance of including stakeholders in change management. Use your […] Read More →

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From the IDEAS Glossary

PDSA Ramps

Each change idea requires a series of PDSA cycles to test it — possibly first with one patient/client or exam room, expanding to two or three patients/clients or rooms, and then expanding to a larger group of patients/ clients or rooms. This process of using a series of PDSA cycles to test an idea is called a PDSA ramp. The QI team can implement PDSA ramps one after the other or simultaneously.

To support an iterative approach, we need to establish a “learning loop”. This can be thought of as consciously building on what we have learned from a previous cycle to test.

PDSA ramp


The Improvement Guide: a practical approach to enhancing organizational performance / Gerald Langley et. al. , 2nd ed., page 103.

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