Plan Do Study Act
Timely triage can be the difference between life and death
PDSA Overview
The proposed solution applies the PDSA (Plan–Do–Study–Act) cycle to enhance the utilization of existing Emergency Department wait time improvement initiatives implemented by Alberta Health Services. Rather than introducing new systems, this approach focuses on optimizing current processes, including real-time dashboards, fast-track pathways, and workflow coordination. Through iterative testing, evaluation, and refinement, the PDSA cycle supports continuous quality improvement by identifying gaps in utilization, implementing targeted changes, and monitoring outcomes. This structured approach enables more efficient patient flow, reduces delays, and ensures sustainable improvements in care delivery for CTAS Level 3 patients.
PLAN
In the planning phase, we identified that although several initiatives already exist, such as real-time dashboards and fast-track pathways, they are not consistently utilized in practice. This results in ongoing delays for CTAS Level 3 patients. To address this, we focused on identifying gaps in workflow, limited use of real-time data, and lack of standardized processes. Our plan involves establishing clear protocols for CTAS Level 3 patient streaming, defining expectations for dashboard usage, and setting measurable targets such as reducing time to physician assessment.
DO
In the implementation phase, we introduced targeted interventions to improve utilization. Staff are trained on real-time dashboards and clinical decision support tools, and these are integrated into daily workflows. CTAS Level 3 patients are streamed into fast-track pathways, and early diagnostics such as ECGs and lab tests are initiated at triage. These changes are piloted during peak hours to assess feasibility.
STUDY
In the study phase, we evaluate both utilization and performance outcomes. We measure how often tools like dashboards and fast-track pathways are used, along with key indicators such as time to physician and length of stay. By comparing data before and after implementation, we assess whether increased utilization improves efficiency and reduces wait times for CTAS Level 3 patients.
ACT
In the final phase, we refine and sustain improvements based on our findings. This may involve adjusting workflows, improving system usability, or providing additional training. Successful strategies are scaled across the department and integrated into standard practice. Continuous monitoring ensures long-term effectiveness and ongoing improvement.
Key Assumptions
The success of this initiative is based on several key assumptions that support the feasibility and impact of our proposed solution. ​​​​
Staff Adoption
Staff will be willing to adopt new workflows and technologies following appropriate training and support
Leadership Support
Grey Nuns Community Hospital leadership will actively champion the initiative, reinforce its use, and align policies to support change.
Effective Training
Training programs will be effectively delivered and translated into daily practice.
Team Based Collaboration
Interdisciplinary teams will collaborate consistently within the new team-based care model.
Technology Adoption
Digital tools (dashboards and clinical decision support) will be consistently used and trusted in clinical and operational decision-making.
Resource & Sustainability
Adequate resources (staffing, time, and technical support) will be available to sustain implementation.