ABSTRACT
The gurus of healthcare quality improvement going back a hundred years ago, notably Walter Shewhart and W Edwards Deming, were instrumental in developing project control charts and the Plan, Do, Study, Act (PDSA) model of change to impose order and coordination over improvement projects. Many decades later people came to realize that, while enormously useful templates for improvement activities, the PDSA cycle was not often used as a longitudinal device. Instead, many projects were short-term and consisted of one or at most two PDSA cycles. The Formative Evaluation Feedback Loop (FEFL) model introduces three additional concepts to the PDSA model: ongoing cycles of activity, regular feedback to the architects of the change so that further improvement is stimulated, encompassed in an evaluation framework.
