Examples of Plans and Charts – COVID‑19

Sample PDSA forms

Example 1

The following example illustrates how the Plan-Do-Study-Act (PDSA) form can be completed per the specific goal to increase COVID-19 vaccination rates among Black patients aged 65 and older with diabetes:

Quality improvement (QI) questionInput by QI team member
What is your goal (or planned change)?Increase COVID-19 vaccinations in Black patients 65 or older with diabetes by 20% over the next 3 months.
What is the timeline for implementing the PDSA?April to July
Who is going to implement the change (eg, physician A, nurse B, medical assistant C) and what exactly will each individual do?Dr. Lopez and her nurse Mr. Johnson will implement the project. Mr. Johnson will identify patients who are 1) 65 years and older; and 2) have diabetes through an algorithm developed by IT or manual chart review. Mr. Johnson will call patients to inquire as to if 1) they have registered and/or received their 1st COVID-19 dose; and 2) they have returned in the appropriate amount of time to receive their 2nd dose. If they have not received the 1st dose, Mr. Johnson will register them for an appointment to receive the 1st dose of their vaccine. If they have received the first dose but not the 2nd, Mr. Johnson will determine the appropriate amount of time after which the patient should return to the clinic for their second dose. If the patient has fears or concerns, Mr. Johnson will alert Dr. Lopez. Dr. Lopez will assess the patient’s fears or concerns through evidence-based behavioral and social science theory. If needed and available, Dr. Lopez will connect the patient to a patient navigator for help with this. After the patient’s concerns are addressed, Mr. Johnson will provide educational materials to the patient and reassess their willingness to receive their 1st and 2nd doses of the COVID-19 vaccine. Mr. Johnson will proceed to register the patient for an appointment following this final exchange.
Which patients will be involved (eg, all patients seen by physician A over the course of the PDSA)?All Black patients aged 65 and over with diabetes. Because of the pandemic, patients may not be scheduling regular office visits. Calling these patients for vaccinations may also reaffirm the need for chronic disease management.
How will you measure the change?Mr. Johnson will have a report run weekly for COVID-19 1st and 2nd dose vaccination rates in Black patients aged 65 or older with diabetes.
How will you report information about the PDSA to the team (eg, weekly Zoom meeting, emailing a Run Chart to staff)? Or to the whole practice (eg, hosting monthly virtual lunch and learns to present the plan to the practice staff)?Dr. Lopez and Mr. Johnson will review the data each week and determine the best mode of communication to both the team and the practice.

Example 2

The following example illustrates how a PDSA form can be completed per a specific goal to increase distribution of COVID-19 patient education materials:

QI stepPlan
Goal (or planned change)
  • Increase COVID-19 patient education material distribution to 100% of patients seen
  • The entire month of April with weekly reports
  • Registration personnel, medical assistants, nurses, physicians, patient navigators
  • Train participants on patient education available
  • Choose materials tailored to practice patients
  • Develop a data collection tool for participants to tally material distribution
  • Each participant distributes a different educational material (eg, registration hands out education on mask-wearing and physical distancing, medical assistants hand out education on symptoms, nurses hand out education on where to get tested and how to isolate, physicians hand out education on vaccines, and patient navigators hand out education on 2nd dose follow-up)
  • Participant count or tally each time they distribute materials
Patients considered
  • All patients seen during February
  • Champions review data collection tools and report counts and percentages to team, weekly
Presentation of final results
  • Virtual meeting over participants to review and discuss results
  • Invite feedback on process (material distribution, data collection tools and methods)
  • Recognize participant efforts with virtual gift card

Tracking Change: The Run Chart

The following is an example of a Run Chart from a DRIVE participant, with COVID-19 vaccination rates charted by month.

Download DRIVE Run Chart

Download Run Chart Template

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