(The first of many rebellious acts staged by Villagers was to reject the streetscape grid devised by Manhattan city planners in 1811).
The reconfiguration and optimal adaptation is finally done in the Act stage.
Finally, the Act stage includes mitigating possible mistakes or flaws in the product or its execution processes [23].
Once tested, this change was deemed successful and plans were made to continue this process (adopt decision during the repetition of the Act stage).
As exemplified here, many PDSA cycles require several iterations of planning, doing, and studying before changes are considered successful enough to adopt during the Act stage.
This third case example highlights the transition from the Act stage of the PDSA cycle to the Sustainment phase of change.
For their next cycle, the group decided to focus on developing new procedures designed to remind officers to schedule an assessment whenever there was a positive screen (Act stage).
In the next meeting, OPs discussed their experiences (Check stage), and, if necessary, the solutions were adjusted (Act stage); this was followed by a new plan, do, check and act stage.
The decision processes detailed in Figure 3 in Ferguson (2012) should be supplemented with a stage prior to the motivation to act (stage 1) reflecting attentional processes.
During these discussions, OPs identified new barriers and suggested new solutions or adjustments to improve adherence to the guideline recommendation (Act stage).
Then, a detailed analysis was conducted and text fragments illustrating the PDCA were coded and bundled as Plan, Do, Check, or Act stage.
