PDSA Worksheet

Plan Do Study Act

Organization:
Date: 5/28/09

PURPOSE/OBJECTIVE OF CYCLE:

What are we trying to accomplish? All dental records will be complete

How will we know that a change is an improvement? When all dental records are filled in

What change can we make that will result in an improvement? Get dentist to document before pt leaves.

PLAN: the change, data collection and predict

The Change
 What are we testing? Change in steps of dental visit

 Who are we testing the change on? The dentist

 When are we testing? May 27, 2009

 Where are we testing? Dental room

Predictions
 What do we expect to happen? The dentist will complete 100% of the forms before the patient leaves.

Data
 What data do we need to collect? Review of exam and progress note forms.

 Who will collect the data? Lynn

 When will the data be collected? Immediately when the patient leaves. Completed forms must be brought up to Lynn.

 Where will the data be collected? At reception desk

DO: Carry out the change/test; collect data and begin analysis
 What was actually tested? Encounter Form for; diagnostic procedure codes, Dentist signature, legible progress note, SOAP format, next procedure to be
done, behavior documented, patient ID (name, DOB, HRN), and next appointment slip filled out. Exam Form for; signed by patient and dentist, all hard
tissue recorded on teeth diagram, soft tissue exam, periodontal screening (PSR/CPITN), and patient ID (name, DOB, HRN). Oral Surgery for; consent form
check boxes checked, signature of patient and dentist, Tooth number and description, and patient ID (name, DOB, HRN).

 What happened? 5 records were reviewed and were 100% compliant.

 Observations

 Problems

STUDY: Complete analysis of data, summarize what was learned, and compare the data to predictions.
100 % chart review done. 100% were completed and signed by patient and dentist.

ACT:
 What changes should we make before the next test cycle? Nothing

 What will the next test cycle be? Re-evaluate on next trip to Micmac clinic

 Are we ready to implement the change? Yes, with each dentist.

 PDSA Worksheet
Plan Do Study Act

Organization:
Date: 5/19/09

PURPOSE/OBJECTIVE OF CYCLE:

What are we trying to accomplish? All dental records will be complete

How will we know that a change is an improvement? When all dental records are filled in

What change can we make that will result in an improvement? Get dentist to document before pt leaves.

PLAN: the change, data collection and predict

The Change
 What are we testing? Change in steps of dental visit

 Who are we testing the change on? The dentist

 When are we testing? May 18, 2009

 Where are we testing? Dental room

Predictions
 What do we expect to happen? The dentist will complete 100% of the forms before the patient leaves.

Data
 What data do we need to collect? Review of exam and progress note forms.

 Who will collect the data? Lynn

 When will the data be collected? Immediately when the patient leaves. Completed forms must be brought up to Lynn.

 Where will the data be collected? At reception desk

DO: Carry out the change/test; collect data and begin analysis
 What was actually tested? Encounter Form for; diagnostic procedure codes, Dentist signature, legible progress note, SOAP
format, next procedure to be done, behavior documented, patient ID (name, DOB, HRN), and next appointment slip filled
out. Exam Form for; signed by patient and dentist, all hard tissue recorded on teeth diagram, soft tissue exam, periodontal
screening (PSR/CPITN), and patient ID (name, DOB, HRN). Oral Surgery for; consent form check boxes checked, signature of
patient and dentist, Tooth number and description, and patient ID (name, DOB, HRN).

 What happened? 5 records reviewed

 Observations

 Problems

STUDY: Complete analysis of data, summarize what was learned, and compare the data to predictions.
100 % chart review done. All necessary documents were completed and signed by patient and dentist.

ACT:
 What changes should we make before the next test cycle?
None at this time
 What will the next test cycle be?
 Are we ready to implement the change?
PDSA Worksheet
Plan Do Study Act

Organization:
Date: 5/8/09

PURPOSE/OBJECTIVE OF CYCLE:

What are we trying to accomplish? All dental records will be complete

How will we know that a change is an improvement? When all dental records are filled in

What change can we make that will result in an improvement? Get dentist to document before pt leaves and assistant to review
for completeness.

PLAN: the change, data collection and predict

The Change
 What are we testing? The dental assistant will make sure the forms are complete and brought to front desk before the
patient leaves.

 Who are we testing the change on? The dental assistant

 When are we testing? May 7, 2009

 Where are we testing? Dental room

Predictions
 What do we expect to happen? The dental assistant will make sure the forms are complete and brought to front desk
before the patient leaves.

Data
 What data do we need to collect? Review exam form for soft tissue exam.

 Who will collect the data? Lynn

 When will the data be collected? Immediately when the patient leaves. Completed forms must be brought up to Lynn.

 Where will the data be collected? At reception desk

DO: Carry out the change/test; collect data and begin analysis
 What was actually tested? Exam form for soft tissue exam and chart accompanying patient on discharge.

 What happened? Observations 100% reviewed and compliant

 Problems

STUDY: Complete analysis of data, summarize what was learned, and compare the data to predictions.
100 % chart review done. 100% compliant.

ACT:
 What changes should we make before the next test cycle? Continue same form review when dentist here next

 What will the next test cycle be? Same as this.

 Are we ready to implement the change? Yes

 PDSA Worksheet
Plan Do Study Act

Organization:
Date: 5/6/09

PURPOSE/OBJECTIVE OF CYCLE:

What are we trying to accomplish? All dental records will be complete

How will we know that a change is an improvement? When all dental records are filled in

What change can we make that will result in an improvement? Get dentist to document before pt leaves.

PLAN: the change, data collection and predict

The Change
 What are we testing? Change in steps of dental visit

 Who are we testing the change on? The dentist

 When are we testing? May 5, 2009

 Where are we testing? Dental room

Predictions
 What do we expect to happen? The dentist will complete 100% of the forms before the patient leaves.

Data
 What data do we need to collect? Review of exam and progress note forms.

 Who will collect the data? Lynn

 When will the data be collected? Immediately when the patient leaves. Completed forms must be brought up to Lynn.

 Where will the data be collected? At reception desk

DO: Carry out the change/test; collect data and begin analysis
 What was actually tested? Encounter Form for; diagnostic procedure codes, Dentist signature, legible progress note, SOAP
format, next procedure to be done, behavior documented, patient ID (name, DOB, HRN), and next appointment slip filled
out. Exam Form for; signed by patient and dentist, all hard tissue recorded on teeth diagram, soft tissue exam, periodontal
screening (PSR/CPITN), and patient ID (name, DOB, HRN). Oral Surgery for; consent form check boxes checked, signature of
patient and dentist, Tooth number and description, and patient ID (name, DOB, HRN).

 What happened? 2 of 8 records returned for soft tissue exam not documented

 Observations

 Problems

STUDY: Complete analysis of data, summarize what was learned, and compare the data to predictions.
100 % chart review done. 2 patients left before record complete. Missing documentation of soft tissue exam. All necessary
documents were signed by patient and dentist

ACT:
 What changes should we make before the next test cycle?
 More training of the dental assistants of required documentation. All records will be completed before the patient leaves.
 What will the next test cycle be? 5/7/09

 Are we ready to implement the change? Yes