Chapter 7: Implementation 189assessment should be performed to identify barriers to
implementation and resources leveraged in response.
Third stage: initial implementation
This stage involves implementation strategies to develop staff
competence and create the systemic infrastructure of the new
practice or program. This is a time to administer fidelity checks and
assessments to identify the areas of practice that need further
development.
During initial implementation it may be helpful to engage a Plan-
Do-Study-Act (PDSA) process (also known as the Shewhart or
Deming cycle). Developed in the 1950’s the PDS has been helpful in
strategizing implementation of a new program or practice (Shewhart
1939, Deming 195). A central use of PDSA in carrying out the design
and initial implementation of coaching is adjusting implementation
and making changes as needed. This process comprises four phases
(see Figure 7.2, Moen and Norman, 2010):
Plan: Identifies objectives and plans to carry out the cycle (who,
what, where, when).
Do: Carry out the plan, document problems and unexpected
observations, and begin data analysis.
Study: Complete the analysis, compare data to predictions, and
summarize what was learned.
Act: Determine what changes need to be made and begin the next
cycle.