Build in time to debrief the exercise and share information.

• Test vs. Talk – Teams frequently spend too much time planning and not enough time testing and learning. Testing leads to learning that facilitates future tests and improvement. Testing reveals considerations that cannot be predicted.
• Paralell Testing – Discourage parallel testing of change ideas in the exercise. This can lead to multiple participants testing different ideas but not learning together.
• Competition – While competition between teams is not introduced in the aim, teams frequently become competitive and challenge winning teams and times that are significantly better than others. Note the competition that emerges and inquire if it is helpful for improvement work.
• Collaboration – It’s very common for teams to never think to visit another team to learn ideas and share knowledge. Ask why no one visited another team and highlight the missed opportunity.
• Documentation – Ask how much time it took to complete the PDSA tracking form and run chart for each test. Note that documenting improvement does not need to be a burden. Some participants will fail to document their PDSAs and run chart data or abandon it; inquire why and discuss the missed learning.
• Testing Considerations – Teams will often ask about several testing considerations including switching testers and changing test ideas versus iterative testing on a single idea. Each consideration offers a chance to discuss various considerations you might encounter when doing PDSA testing.
• Collaborative or Networked Learning – If participants are participating in an IHI Breakthrough Series Collaborative or networked learning process, it can be helpful to show the group’s aggregate mean scores along with a small multiples for each table. Note the variation represented in the group and connect how this is similar to the variation noted in teams or sites participating in collaborative or networked improvement initiatives.