The process decision program chart (PDCP) systematically identifies what might go wrong in a plan under development. Countermeasures are developed to prevent or offset those problems. By using PDPC, you can either revise the plan to avoid the problems or be ready with the best response when a problem occurs.
When to Use PDPC
- Before implementing a plan, especially when the plan is large and complex.
- When the plan must be completed on schedule.
- When the price of failure is high.
- Obtain or develop a tree diagram of the proposed plan. This should be a high-level diagram showing the objective, a second level of main activities and a third level of broadly defined tasks to accomplish the main activities.
- For each task on the third level, brainstorm what could go wrong.
- Review all the potential problems and eliminate any that are improbable or whose consequences would be insignificant. Show the problems as a fourth level linked to the tasks.
- For each potential problem, brainstorm possible countermeasures. These might be actions or changes to the plan that would prevent the problem, or actions that would remedy it once it occurred. Show the countermeasures as a fifth level, outlined in clouds or jagged lines.
- Decide how practical each countermeasure is. Use criteria such as cost, time required, ease of implementation and effectiveness. Mark impractical countermeasures with an X and practical ones with an O.
Here are some questions that can be used to identify problems.
- What inputs must be present? Are there any undesirable inputs linked to the good inputs?
- What outputs are we expecting? Might others happen as well?
- What is this supposed to do? Is there something else that it might do instead or in addition?
- Does this depend on actions, conditions or events? Are these controllable or uncontrollable?
- What cannot be changed or is inflexible?
- Have we allowed any margin for error?
- What assumptions are we making that could turn out to be wrong?
- What has been our experience in similar situations in the past?
- How is this different from before?
- If we wanted this to fail, how could we accomplish that?
A medical group is planning to improve the care of patients with chronic illnesses such as diabetes and asthma through a new chronic illness management program (CIMP). They have defined four main elements and, for each of these elements, key components. The information is laid out in the process decision program chart below.
Dotted lines represent sections of the chart that have been omitted. Only some of the potential problems and countermeasures identified by the planning team are shown on this chart.
Process Decision Program Chart Example
For example, one of the possible problems with patients’ goal-setting is backsliding. The team liked the idea of each patient having a buddy or sponsor and will add that to the program design. Other areas of the chart helped them plan better rollout, such as arranging for all staff to visit a clinic with a CIMP program in place. Still other areas allowed them to plan in advance for problems, such as training the CIMP nurses how to counsel patients who choose inappropriate goals.
Excerpted from Nancy R. Tague’s The Quality Toolbox, Second Edition, ASQ Quality Press, 2004, pages 428-430.