Annex 4 - compilation of approaches

Model for improvement

The model for improvement was developed by Associates in Process Improvement as a tool for accelerating improvement and has been adopted by the Institute of Healthcare Improvement as its primary framework for improvement in healthcare. The model has two parts: three fundamental questions, which can be addressed in any order; and the Plan-Do-Study-Act cycle to test changes in real work settings in order to determine if the change is an improvement.

Use of the model is widespread within the NHS due to its simplicity and ability to bring about rapid testing of ideas. Some criticism of its effectiveness has been raised, suggesting that it is poorly applied and often pursued through time-limited, small-scale projects, led by professionals who may lack the expertise, power or resources to instigate the changes required.

The model for improvement ensures that teams know the purpose behind what they are trying to accomplish, understand what success will look like and identify those changes that will result in improvement. It also guides them through the process of establishing appropriate measures, creating changes, evaluating changes, implementing changes and spreading changes.

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