Accelerate Improvement: Ask, "What Can We Do by Next Tuesday?"

Teams can accelerate improvement and learning by setting a time frame for small-scale tests of change.

In rapid cycle improvement work, the Plan-Do-Study-Act (PDSA) model is applied: tests of change are introduced on a small scale and their effects assessed; changes that lead to improvement are spread and developed, while those that don’t are stopped even though they contributed to the learning process.

Not all changes lead to improvement, but all improvement requires change.

In contrast to hospitals that consume valuable time in trivial nitpicking of policies or waiting for more staff, new equipment or approval from the top, teams that include a time frame (e.g., by asking, “What can we do by next Tuesday?”) compel themselves to start testing changes with the resources at hand.

People are also much more willing to test a change when they know that changes will be modified as and when needed. Rapid testing overcomes inertia, generates new and (often) better ideas quickly, allows for fast dismissal of what doesn’t work, avoids “too much meat in the game” (excessive emotional investment) and offers opportunity for others to apply successful changes elsewhere (stealing shamelessly!).


1 Lynn J, Schuster JL, Wilkinson A, Simon LN. Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians [Internet]. Oxford University Press, USA; 2008.