A PDSA cycle will rarely be a stand-alone initiative but should ideally be part of a programme of continual improvement. 

For example, if you have conducted a PDSA cycle to reduce UTIs, and your data demonstrates a reduction, that then becomes your standard, and you can then consider setting a new SMART aim and conducting a new PDSA cycle to reduce UTIs further, continuing to repeat this process, until it is considered no further improvement is possible. Then SMART aims should be set to try and maintain your new, low standard.

Remember that whilst you are focusing your improvement work on one area (falls, UTIs or pressure ulcers) you need to keep using you runtime dashboards to ensure an upward trend is not developing in one of the other areas. If it does you may want to consider changing your area of focus for a time, or if you think it is practical, you could create a second SMART aim for the new area that is causing concern, and have two improvement projects running simultaneously.

By regularly submitting monthly data, and using your runtime dashboard in conjunction with the Quality Improvement processes described above, you can see you can spot early when trends are developing in your data, and put processes in place to rectify this before it turns into a major issue.

By involving everyone at the home with engagement with the PROSPER project, hopefully everyone will take an interest in how the home is performing and want to be part of continually improving it.

Next: Prosper Toolkits