In quality improvement, which option correctly lists the steps in the PDSA cycle?

• A. Plan, Do, Check, Act
• B. Plan, Do, Assess, Act
• C. Prepare, Do, Study, Act
• D. Plan, Do, Study, Act

Answer: (D)

The main idea is a four-step loop that drives real improvement by testing changes and learning from the results: plan a change, implement it on a small scale, study the data and what happened, and act on what you learned to refine or adopt the change for the next cycle. The third step, studying the results, is about analyzing both the outcomes and the process to understand whether the change produced the intended improvement and why. This emphasis on learning from data, not just verifying that the plan was followed, is what makes the sequence Plan, Do, Study, Act the best fit.

Act uses what you learned to decide the next move—adopt the change, modify it, or abandon it—so the cycle continues with a new plan based on those insights. The other phrasing shifts the meaning: using Check or Assess tends to imply verification rather than structured learning from outcomes, and Prepare or similar terms don’t capture the same testing and learning rhythm.