Table 2

Change in measures of PDSA cycle fidelity over round of project initiation

Principle	Measure		Round 1	Round 2	Round 3	All	P value
Documentation	All PDSA cycle stages documented	Cycles adhering to principle	15	93	191	299	<0.001
		Cycle sample	30	144	247	421
		%	50.0	64.6	77.3	71.0
	’Study’ section documented in past tense	Cycles adhering to principle	10	67	176	253	<0.001
		Cycle sample	15	93	191	299
		%	66.7	72.0	92.1	84.6
Learning activity	Learning activity present in PDSA cycle	Cycles adhering to principle	15	90	189	294	NA
		Cycle sample	15	93	191	299
		%	100	96.8	99.0	98.3
Prediction	Explicit prediction documented in PDSA cycle	Cycles adhering to principle	0	3	33	36	0.001
		Cycle sample	15	90	189	294
		%	0.0	3.3	17.5	12.2
Iterative cycles	PDSA cycle within iterative series of 2 or more cycles	Cycles adhering to principle	0	48	115	163	<0.001
		Cycle sample	15	93	191	299
		%	0.0	51.6	60.2	54.5
Small-scale testing	PDSA iterative series increasing testing scale	Iterative series adhering to principle	NA	3	16	19	0.113
		Cycle sample	NA	19	45	64
		%	NA	15.8	35.6	29.7
Use of data over time	PDSA iterative series using regular data over time	Iterative series adhering to principle	NA	7	22	29	0.376
		Cycle sample	NA	19	45	64
		%	NA	36.8	48.9	45.3

Bold values are calulated as the percentage of the cycle sample that adhere to the principle.
NA, not applicable; PDSA, Plan-Do-Study-Act.