HA540 Unit 7 Room Turnover PDSA Cycle Plan Example

A Timer Board on Every Wall Lasted Nine Days: An Improvement Cycle Plan That Critiques a Unit-Wide Turnover Target at a Composite Hospital Endoscopy Unit and Plans the Change Again as Small Linked PDSA Cycles, Starting With One Room on Tuesdays

[Student Name]

Purdue University Global

HA540: Health Care Operations and Quality Assessment

Unit 7 Improvement Cycle Plan

[Instructor Name]

[Date]

The unit, the first attempt and every figure are composite and bracketed for the writer's own data.

Part One: What Happened

After the Unit 3 template removed most room holds, turnover became the limit on the unit's day. The manager announced a [15]-minute target, measured from one patient leaving the room to the next entering, and installed timer boards. Every room started on the same day. In week one, median turnover fell from [21] to [17] minutes, but staff reported rushing, a room was released before its cleaning checklist was complete, and infection prevention asked that the boards be removed. By day nine, turnover was back at [20] minutes and the boards were gone.

Part Two: Why It Failed

Reed and Card (2016) describe common misuses of PDSA: changes launched at full scale, no prediction to test, and no study of what happened before acting again. All three applied. The target set a number without changing the work; staff could only go faster at the same tasks. The unit learned only that the number was not reached. The timer measured speed, but nothing about the work itself had changed, so the only way to hit the number was to hurry. The critique is about design choices, not the manager, who acted on a real problem.

Why the Change Is Still Worth Testing

Observation of [24] turnovers found that most tasks happened in sequence after the patient left: wiping surfaces, changing linens, setting up the next scope cart, drawing up sedation medicines, labeling specimen containers and reviewing the next record. Shingo (1985), writing about die changes in factories, split changeover work in two: the part that truly needs the machine idle, and the part that a crew can finish ahead of time while the machine keeps working. Here, only cleaning and linens need an empty room. Moving the rest outside the turnover could cut it to about [14] minutes without anyone hurrying. At about [40] turnovers a day, seven minutes saved each frees [280] room-minutes, enough for about [seven] routine procedures.

What the Observed Turnovers Showed

The [24] turnovers were timed by a nursing student over [three] days, task by task. The median was [21] minutes, but the range ran from [13] to [34]. The longest turnovers all followed a case where the next scope cart was not ready or the next patient's record held an unanswered question, which sent the nurse to the phone while the room sat clean and empty. The shortest happened when a technician, by chance, had set up the next cart during the procedure. That accident is the change the plan now tests on purpose.

Part Three: Three Linked Cycles

Cycle 1. Question: can a prepared second cart and a pre-set checklist cut turnover in one room without missing a cleaning step? Scope: Room [3], [Dr. A.]'s Tuesday list, about [eight] turnovers. Prediction: median turnover [15] minutes or less, and the cleaning checklist complete in [eight] of [eight]. Plan: a technician prepares the next cart and labels containers during the procedure; the circulating nurse reviews the next record during recovery handoff. Data: turnover times from the scheduling system; checklist audit by the charge nurse. Decision rule: if both predictions hold, move to cycle 2; if the checklist fails once, stop and study. Cycle 2. Scope: Room [3] all week, [four] endoscopists. Prediction: median under [15] minutes on at least four of five days. Learning question: does the technician have time during long procedures? Cycle 3. Scope: Rooms [3] and [4], adding [two] technicians. Prediction: both rooms under [15] minutes. Learning question: does the second room compete for the same supply runner?

Study and Act Between Cycles

After each cycle the team meets for [20] minutes to compare results with predictions and decide to adopt, adapt or abandon. Results are shown on a run chart with each cycle marked, so changes over time are visible rather than averaged away (Langley et al., 2009).

Measures

Outcome: median turnover per day. Process: share of external tasks completed before the patient leaves. Balancing: cleaning checklist completion and technician overtime.

Conditions for Spreading to All Rooms

Two consecutive weeks under target in both test rooms, no missed cleaning steps and staff agreement that the pace is sustainable.

Risks

The extra technician time may not exist on short-staffed days. If it does not, the cycle will test whether the circulating nurse can take the cart preparation instead.

Who Is Involved

The charge nurse leads; the technicians and nurses of Room [3] design the cart standard; infection prevention reviews the checklist before cycle 1, which addresses the concern that ended the first attempt.

Conclusion

The first attempt asked staff to go faster. This plan changes the work, tests it small and stops if safety slips.

References

Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.

Reed, J. E., & Card, A. J. (2016). The problem with Plan-Do-Study-Act cycles. BMJ Quality & Safety, 25(3), 147-152. https://doi.org/10.1136/bmjqs-2015-005076

Shingo, S. (1985). A revolution in manufacturing: The SMED system. Productivity Press.