Since the early 2000s there have been a number of large-scale initiatives in the UK and across the world to improve the quality and safety of their health care systems.

Much as been learned about the complexities and challenges of this work. There are now a number of guides available for those considering and planning to take effective practices from one location or setting to make them common practice across a health care system or area.

Factors to consider:

  • Motivation
  • Foundation
  • Aim
  • Nature of the intervention
  • Nature of the social system
  • Network building (communication and support)

The following questions should be considered in the months leading up to the launch of a large-scale improvement effort:

  1. What is your goal for change?
  2. What would it look like if that change had come about?
  3. What are the key themes that make sense to people and that they will feel passionate about?
  4. What might make ‘a sufficient mix’ of reasons to engage?
  5. What are the multiple processes and systems that need to change?
  6. Have you considered the diversity of your stakeholders and how the change will affect all the members of your system?
  7. Who are the small number of key stakeholders who, if properly engaged, could lead the various change efforts in these multiple processes and systems?
  8. How might we frame the issues in order to engage each of these?


< The Improvement Journey