Rapid Cycle Improvement 

Structuring quality improvement goals using the BCAP Typology is followed by

PDSA  (Plan, Do, Study, Act) cycles, which test changes in systems and processes.

PDSA cycles guide teams through a quick turnaround analysis and improvement

process. Typically, the health plan develops an overall aim for the project and then

develops specific aims, measures, and changes for each typology category. This

method helps BCAP participants divide large quality improvement projects into

manageable pieces and encourages testing the specific components of the typology

separately.

For example, DC Chartered Health Plan set an aim to improve screening rates by

implementing the standardized screening at a provider clinic. The following cycles

outline how DC Chartered Health Plan optimized a provider site intervention

through cycles of change:

Cycle 1: The health plan hosted several meetings to introduce the developmental 

screening program and to better understand workflow at the health center 

pilot site. They determined the need to decrease the administrative burden

on the health center for successful implementation.

Cycle 2: To streamline the screening process, a color coded file cart, which included

the screening tool questionnaires sorted by age group, was developed for 

each exam room.  Once completed, the questionnaires were faxed back to 

the health plan for scoring and follow up.

Cycle 3: To further assist the clinic staff in quickly picking the correct tool for each 

child, a  cheat sheet  was developed and included on each patient file 

indicating the appropriate screener to use.

Cycle 4: Individually faxed screens were difficult to read and unreliable. Bundled 

completed screens sent through interoffice mail was more reliable and 

efficient.  Once familiar with the screening tool, the clinic staff found the 

 cheat sheet  to be too redundant and unnecessary and so it was removed 

from patient files.

This example shows how a health plan can incrementally roll out a quality

improvement pilot, test changes, and make modifications to improve processes.

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