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Learning Cycle Model

The Learning Cycle Model is illustrated below (click image to enlarge). Download PDF
Learning Cycle Model

Each lean cycle includes the following major steps:

  1. The Physician Organization (PO) designates four Practice Units (PUs) to participate in each cycle and also selects a Practice Unit coach for each site.
  2. The PO designates at least one individual within the organization as a PO Lean Coach. This individual receives ongoing training from the Lean CPI Coordinating Center. In subsequent lean cycles, the PO Coach assumes more facilitation responsibilities with support from the Lean CPI Coordinating Center. The intention is to help build internal “lean muscle” within the PO over time, so it can sustain ongoing work without direct external support.
  3. Commitment to supporting a sustainable lean program is required to participate in the Lean CPI. The Lean CPI will use the evidence-based readiness framework to ensure that Physician Organizations and Practice Units are positioned to be successful with the program prior to initiating the lean learning cycle.
  4. The PO and PUs together define the process or problem area(s) to be addressed and determine the appropriate scope.
  5. The PU teams are guided to define their problem, background and current condition, through the use of Go Sees, mapping and data collection. Practice team members collaboratively develop their A3 based Problem Definition Sheet and records the various steps and changes on a PDSA Cycle Record. This is an intensive process, where all participants are required to actively participate, speak out about their part in the process, and respect the input of others.
  6. The potential improvements identified through root cause analysis are now run/tried. If the change improves the problem, it is adopted. If the change does not improve the process, the team determines what they learned from the experiment and, based on the learning, what their next experiment will be.
  7. A Lean CPI Coordinating Center coach partnered with the PO coach will visit each PU weekly to coach the team through Plan-Do-Study-Adjust cycles. The PDSA cycle is repeatedly executed to move from the current condition to the target condition. The goal of working through a learning cycle is for the POs and PUs to incorporate the lean methodology of PDSA into everyday problem solving.
  8. Monthly collaborative meetings of the PU teams and PO coaches and leadership are held to share what each clinic team has tried, learned, and what changes they plan to try next. A valuable component of this step is communication between the PUs and PO leadership. Leaders hear about challenges and successes directly from the people on the front line who are being asked to redesign their work, and can often contribute organizational resources in support. The PU teams receive input from leadership so that their changes are aligned with the organization’s mission.

Lean for Clinical Redesign Learning Cycle Model

The learning cycle model displays the weekly activities throughout the learning cycle along with the participation required from the Physician Organization and Practice Units. It should be noted when PO staff is supporting a Practice Unit the time commitment noted is for each Practice Unit.

The Learning Cycle Model is illustrated in this PDF