Making system-wide changes all at once to integrate equity measures can be cumbersome and ineffective. To successfully integrate, it is best to start small by test piloting changes within existing practices. A process called PDSA (Plan, Do, Study, Act) is an effective method by which to introduce change on a small scale. 

The PDSA Process:

• Plan the health equity initiative thoroughly.
• Do the work required to implement the initiative in a pilot test.
• Study the outcomes from the pilot test and make changes accordingly.
• Act on the feedback from the pilot program and implement the initiative.

Utilizing the PDSA process, this roadmap provides insight on how to identify the causes of inequities, design the care and payment transformations to address those causes, and demonstrate ways an organization can commit to measuring how transformations affect those differences in care and outcomes.