The 12 + 1
improvement cycle.

Twelve weeks to move the work forward. One week to ask what changed—and what should happen next.

This is a planning cadence drawn from UMD’s medical-direction approach. It is not a validated clinical intervention, a guaranteed outcome, or a fixed schedule promised to every partner. Adapt the timing to the team and the work.

Before the cycle: choose a priority.

Keep the starting question narrow. Instead of “improve communication,” consider a specific, observable process the team agrees needs attention. Establish who owns the work, who must approve changes, and how progress will be reviewed.

During the 12 weeks: connect the work.

Use routine education, case review, leadership conversations, and crew feedback to work on the same priority. Write down decisions and make it clear when a change needs formal authorization before use.

Choose a check-in rhythm that fits the organization. Do not create a new reporting burden simply to prove that the cycle exists.

During the reset: ask four questions.

1. What did we actually do?
2. What changed, and how do we know?
3. What did the team experience that our original plan missed?
4. What will we keep, change, stop, or carry into the next cycle?

Make the next step visible.

Share an appropriate summary with the team. Credit useful contributions. Give unfinished work a clear owner rather than letting it disappear into the next quarter.

Use organizationally approved tools for operational data. Keep patient information and confidential quality-review material out of public or unapproved documents.