We can learn a lot from the practice improvement literature (Langley, Nolan, Nolan, Norman, & Provost, 1996) about how to walk before we run when implementing evidence-based innovations in our health care organizations. Specifically, the cycle known as PDSA-Plan, Do, Study, Act-informs us about how to conduct tests of before implementing a larger pilot test or spreading a change throughout an organization. This RTNP issue's Evidence-Based Practice column focuses on describing the components of PDSA cycles, suggesting how they fit into an EBP approach to improving the quality of care, and providing an actual example of how the PDSA cycle was used to implement a nursing practice change in a hospital. A PDSA cycle (see Figure 1) consists of the four components or phases stated above (Langley et al., 1996). During the first Plan phase, a project team develops specific objectives for the cycle, makes predictions about how the project will turn out, and develops a protocol for implementing the small test of change. In the second or Do phase, the test of the innovation is conducted, process issues are elicited from participants, problems or issues with implementation are shared with the project team, and, finally, team members begin to analyze initial feedback or data. Data accumulated during phase two is evaluated completely during the Study phase of the PDSA cycle. This data is then compared to the predicted or hoped for implementation processes and outcomes. If the desired processes or outcomes are not achieved, the team needs to glean the lessons learned from the Do and Study phases of the cycle. Based on the initial feedback and evaluation of data, the team determines what changes (Act) need to be made to the implementation protocol and what the next PDSA cycle will encompass. Perhaps here we should pause for a moment to talk about small tests of change. Over the past few years working with agencies to implement evidence-based practice, I learned that long pilot tests of practice changes are inefficient. My initial lessons came from attempting to implement a pilot study in an acute care agency (Fineout-Overholt, Levin, & Melnyk, 2005), and later lessons came from a home care agency. In the latter case, the author worked with home care nurses to implement a practice change in the traditional EBP research utilization model of conducting a pilot study in an entire office of the home care agency. As it turned out, had we tried a small test first-limited to a few nurses and clients for a short (perhaps a week or two) period of time-we would have picked up process issues that we could have addressed early and that would have led to a more successful outcome. Process issues can be picked up and addressed early using a PDSA approach. Learning about practice improvement models from colleagues in the home care agency who are specialists in that approach (please see acknowledgement), I was able to transfer that learning to the acute care setting with success. …