Change management and quality improvement terms

The point at which people use a new process or tool as their standard way of working, without being reminded. Adoption is the outcome change management is measured on.

Where it fits: DMAIC: Control · PDSA: Act

Measures of whether people are using the new process, how often, and how well, tracked alongside the outcome measure rather than after it.

Where it fits: DMAIC: Control · PDSA: Study

A one-sentence statement of what a PDSA team will improve, by how much, by when, and for whom. It is the PDSA equivalent of a charter's goal.

Where it fits: PDSA: Plan

Finding out why people do not follow a process: awareness, skill, belief, workload, or tools. Each cause calls for a different fix.

Where it fits: DMAIC: Analyze · PDSA: Study

A measurement of how things are before a change, so later results can be compared to it. In change management the baseline includes readiness and adherence, not just process output.

Where it fits: DMAIC: Measure · PDSA: Plan

How consistently the current process is actually followed before anything changes. Low adherence now usually means adoption, not design, is the real problem.

Where it fits: DMAIC: Measure · PDSA: Plan

A tiered training structure used in Lean Six Sigma, usually White, Yellow, Green, and Black Belt, where each level adds depth and project responsibility.

The plain-language explanation of why a change is needed now and what it costs to do nothing, written so frontline staff can repeat it in one breath.

Where it fits: DMAIC: Define · PDSA: Plan

A diagram, also called a fishbone or Ishikawa diagram, that sorts the possible causes of a problem into categories so a team can investigate them one at a time.

Where it fits: DMAIC: Analyze

A trusted peer on a shift or team who models a new way of working and helps colleagues with it. Champions carry adoption further than announcements do.

Where it fits: DMAIC: Improve

An analysis of what a change alters by role, unit, process, and tool, and by how much, so the groups facing the biggest shift get the most support.

Where it fits: DMAIC: Analyze · PDSA: Plan

The total amount of change landing on a team in a given window, including regulatory, EHR, and staffing changes. High change load is a leading reason improvements fail to stick.

Where it fits: DMAIC: Define · PDSA: Plan

The discipline of helping people adopt and sustain a change, through sponsorship, communication, training, resistance management, and reinforcement. It is the people side of improvement work and sits alongside the process side.

The integrated plan for the people side of a change, covering sponsorship, communication, training, coaching, and resistance. It sits alongside the implementation plan, not after it.

Where it fits: DMAIC: Improve · PDSA: Act

A baseline of each group's awareness, willingness, and capability before a change, repeated later to show movement.

Where it fits: DMAIC: Measure · PDSA: Plan

The one-page document that defines a DMAIC project's problem, goal, scope, team, and timeline. A charter with the people side included also names the sponsor's role and what adoption will look like.

Where it fits: DMAIC: Define

Telling the people who gave input what happened with it and what the results were, even when the answer is that the change was abandoned. It builds the trust the next change will need.

Where it fits: DMAIC: Control · PDSA: Act

Involving the people who do the work in designing the fix or the test. Ownership built here makes sustainment much easier.

Where it fits: DMAIC: Improve · PDSA: Plan

A plan for who hears what about a change, from whom, when, and through which channel. Frontline staff should hear it from their own leader, not only from the project team.

Where it fits: DMAIC: Improve · PDSA: Do

The federal grant that funds community action agencies and sets the organizational standards they report against, including expectations for planning and continuous improvement.

The HUD-funded regional body that coordinates housing and homelessness services and reports system performance measures. Program changes in housing providers usually trace back to it.

The DMAIC document that specifies how a process will be monitored after improvement, what to measure, and what to do when it drifts.

Where it fits: DMAIC: Control

The characteristics of a process that matter most to the customer or the goal, such as critical to quality (CTQ), critical to safety, or critical to cost.

Where it fits: DMAIC: Define

The five-phase Lean Six Sigma method for improving an existing process: Define, Measure, Analyze, Improve, and Control. See the change management tools mapped to each phase on the DMAIC page.

Where it fits: Open the DMAIC map

The eight categories of waste that Lean targets: defects, overproduction, waiting, non-utilized talent, transportation, inventory, motion, and extra processing. Non-utilized talent is the one change management addresses most directly.

Where it fits: DMAIC: Analyze

Asking why a problem occurs, then asking why again for each answer, usually about five times, to move from a symptom to a root cause.

Where it fits: DMAIC: Analyze

A tool that lists the forces driving a change and the forces restraining it, so a team can decide which restraints to weaken. Weakening a restraint often beats pushing harder.

Where it fits: DMAIC: Analyze · PDSA: Study

A Lean term for the place where the work actually happens. A gemba walk means observing the process there instead of discussing it in a meeting room.

Where it fits: DMAIC: Measure · PDSA: Do

Keeping an improvement in place after the project ends. It takes a named owner, reinforcement, and adoption metrics, not only a control plan.

Where it fits: DMAIC: Control · PDSA: Act

A measure a team tracks over time to know whether a process is performing as intended. Adoption metrics belong alongside outcome KPIs, not after them.

Where it fits: DMAIC: Control

An improvement approach focused on removing waste and delivering value from the customer's point of view. In healthcare it is often practiced through PDSA cycles.

The combination of Lean's focus on waste and flow with Six Sigma's focus on variation and defects, usually taught through belt programs and run through DMAIC projects.

A short record of what helped and hurt adoption on a project, captured before the next project or cycle starts. Small lessons compound.

Where it fits: DMAIC: Control · PDSA: Act

The small, frequent actions leaders take to keep a change in place: rounding, huddle check-ins, and audits framed as coaching. They catch drift while there is still time to adjust.

Where it fits: DMAIC: Control · PDSA: Do

A bar chart that ranks causes by frequency so a team can see the few that account for most of the effect.

Where it fits: DMAIC: Analyze

A four-step cycle for testing a change on a small scale: plan the test and predict the result, do it, study what happened against the prediction, and act on what you learned. See the change management tools mapped to each step on the PDSA page.

Where it fits: Open the PDSA map

The parts of an improvement that depend on people changing how they work: awareness, skill, willingness, and habit. The process side is the design; the people side is the adoption.

A description of what "adopted" will look like in observable, countable terms, written before the work starts so there is something to measure against later.

Where it fits: DMAIC: Define · PDSA: Plan

An assessment of what each stakeholder group gains, loses, or fears from a change. It shapes the message each group needs to hear.

Where it fits: DMAIC: Analyze · PDSA: Study

A limited, real-world trial of a change in one unit or team before wider rollout. A pilot that only works with the volunteers who designed it is not proven yet.

Where it fits: DMAIC: Improve · PDSA: Do

Drawing the steps of a process as it actually runs, including handoffs and decisions, so a team can see where problems occur.

Where it fits: DMAIC: Measure

A check that people can perform the new process correctly, by observation or a skills check, rather than a record that they attended training.

Where it fits: DMAIC: Control · PDSA: Study

A short survey, three to five questions, repeated the same way over time to track how a group feels about a change. The change in answers is the finding.

Where it fits: DMAIC: Measure · PDSA: Study

Everything that keeps a new behavior in place after go-live: recognition, correction, visibility, and leader attention. Without it, drift back starts quickly.

The plan for how a new behavior will be recognized, corrected, and kept visible over time, and who will do it.

Where it fits: DMAIC: Control · PDSA: Act

Pushback against a change, from open objection to quiet workarounds. Resistance usually signals an unmet need, not a bad attitude.

The pushback expected from each group and the planned response, prepared before go-live so surprises can be treated as data.

Where it fits: DMAIC: Improve · PDSA: Do

A Pareto-style look at which few causes explain most of the pushback, so the response goes where it matters most.

Where it fits: DMAIC: Analyze · PDSA: Study

Deciding which units or teams adopt a change next, and why. Starting with the ready ones lets their results carry the case to the rest.

Where it fits: PDSA: Act

The results-based planning and reporting framework community action agencies use under CSBG. Its cycle of assessment, planning, implementation, and evaluation maps closely to PDSA.

A structured search for the underlying reason a problem occurs rather than its symptoms, using tools such as Five Whys and cause and effect diagrams.

Where it fits: DMAIC: Analyze

A high-level process summary that lists Suppliers, Inputs, Process, Outputs, and Customers, used early in a DMAIC project to set scope and spot the people involved.

Where it fits: DMAIC: Define

A data-driven improvement method aimed at reducing variation and defects, run through DMAIC projects.

The conditions where people live, work, and age, such as housing, food security, transportation, and income, that shape health as much as clinical care does. The nonprofits that address them run improvement work too.

The leader with the authority to remove barriers to a change, who supports it visibly and repeatedly. A sponsor who only signs the charter is not sponsoring.

Where it fits: DMAIC: Define · PDSA: Plan

The specific things a sponsor will say and do during a change, with dates. Visible, repeated leader actions matter more than a launch announcement.

Where it fits: DMAIC: Improve · PDSA: Do

Extending a tested change from the unit where it worked to other units or sites. Spread needs its own change plan, because each new unit is a new adoption.

Where it fits: PDSA: Act

Anyone affected by a change or able to influence it, including staff, managers, physicians, patients, and families.

A map of who is affected by a change, who has influence, who could block it, and how each group feels today. Positions shift, so revisit it as the work progresses.

Where it fits: DMAIC: Define · PDSA: Plan

The documented, agreed-upon best way to do a task, used to make performance consistent. Standard work written with staff is followed more often than standard work handed to them.

Where it fits: DMAIC: Control

Naming the person who owns the people side of a change after the project team steps back. A person, not a committee.

Where it fits: DMAIC: Control · PDSA: Act

PDSA's term for a small, time-limited trial of an idea, run so the team can learn before committing. Every test of change should predict adoption as well as results.

Where it fits: PDSA: Do

The plan for building the skills people need before go-live, including practice time and not only information.

Where it fits: DMAIC: Improve · PDSA: Do

The informal leaders on a team, such as a charge nurse or lead clinician, whose opinion moves adoption more than a memo does. Several change management tools are built around finding and equipping them.

A diagram of every step, delay, and handoff in delivering a product or service, used to find waste and see the whole flow at once.

Where it fits: DMAIC: Analyze

What the customer of a process needs and values, gathered directly from them rather than assumed.

Where it fits: DMAIC: Define

What the staff who run a process know, need, and fear about it, gathered before the change is designed. It often surfaces workarounds the process map missed.

Where it fits: DMAIC: Define · PDSA: Plan

Watching what people really do during a shift or clinic session, compared with the documented process. The gaps you see are the next cycle's material.

Where it fits: DMAIC: Measure · PDSA: Do