skip to main content columnskip to left navigationskip to horizontal navigation

Research Division

Family Medicine

PDSA Cycle Step 2
Forming Teams


Including the right people on a process improvement team is critical to a successful improvement effort. Teams vary in size and composition. Each organization builds teams to suit its own needs.
  1. Review the aim.
  2. Consider the system that relates to that aim: What processes will be affected by the improvement efforts?
  3. Be sure that the team includes members familiar with all the different parts of the process managers and administrators as well as those who work in the process, including physicians, pharmacists, nurses, and front-line workers.

Effective teams include members representing three different kinds of expertise within the organization: system leadership, technical expertise, and day-to-day leadership.



There may be one or more individuals on the team with each kind of expertise, or one individual may have expertise in more than one area, but all three areas should be represented in order to drive improvement successfully.

System Leadership

  1. Teams need someone with enough authority in the organization to institute a change that has been suggested and to overcome barriers that arise.
  2. The teams system leader understands both the implication of the proposed change for various parts of the system and the more remote consequences such a change might trigger.
  3. This person must have the authority to allocate the time and resources the team needs to achieve its aim.

Clinical Technical Expertise

  1. A technical expert is someone who knows the subject intimately and who understands the processes of care.
  2. An expert on improvement methods can provide additional technical support by helping the team determine what to measure, assisting in design of simple, effective measurement tools, and providing guidance on collection, interpretation, and display of data.

Day-to-Day Leadership

  1. A day-to-day leader is the driver of the project, assuring that tests are implemented and overseeing data collection.
  2. It is important that this person understands not only the details of the system, but also the various effects of making change(s) in the system.
  3. This person also needs to be able to work effectively with the physician champion(s).


Go to Step 3: Establishing Measures
Go to Step 4: Testing Change/Testing the Intervention
Go to Step 5: Implementing Change
Go to Step 6: Spreading Change


icon for left menu icon for right menu