Annex 4 - compilation of approaches

Quality improvement journey – NHS Scotland

Quality improvement journey – NHS Scotland

The improvement journey is a structured approach that supports individuals and teams to test, implement and spread sustainable improvement across a system. The journey consists of seven stages, from identification of the need through to the successful delivery of change and its spread.

Each stage provides a particular focus:

  • discover — identifying the problem to fix
  • explore — further investigating the aim and defining success
  • design — reviewing all the ideas for improving the system and establishing the priorities for improvement
  • refine — identifying what has been learned from evaluating the change
  • introduce — making the change happen
  • spread — communicating success
  • close — capturing lessons learned for the future.

Each stage consists of a series of questions for quality improvers to consider as they carry out an improvement project. These link to suggested tools and resources that will help to further explore and analyse the wider aspects of improvements being made. The journey pays particular attention to cultural aspects of change in the ‘introduce’ and ‘spread’ sections, as well as capturing learning for future projects in the ‘close’ section.

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