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Abstract
There is increasing recognition that organisations need to look beyond their boundaries for new innovations. However, the introduction and implementation of best practice that has been developed externally may need different processes of implementation if a successful change process is going to be achieved. Using an enhanced recovery programme as an example, we report a case study that combines the best of a top-down approach with the principles of bottom-up collaborative working to successfully embed a large-scale quality improvement programme that was commissioned to improve the adoption of enhanced recovery in elective surgery. We describe a large-scale change programme that was established, coordinated and driven from within a central ‘top’ organisation but delivered and owned locally by individual organisations working collaboratively across southeast region of England. We discuss why we believe our methodology of implementing this programme was successful, the important triggers for success and the lessons we learned from the programme.
- quality improvement
- quality improvement methodologies
- collaborative
- breakthrough groups
- healthcare quality improvement
- enhanced recovery
- large-scale change
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors Both authors have made substantial contribution to the following: conception and design, acquisition of data or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version published. Both authors have agreed to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.
Funding The ER Programme was funded by Kent Surrey Sussex Academic Health Science Network (KSS AHSN).
Disclaimer The views and opinions expressed are those of the authors and not necessarily those of KSS AHSN.
Competing interests FO is a peer reviewer for BMJ Open Quality.
Ethics approval Ethical approval for this project was not required due to it being a quality improvement project.
Provenance and peer review Not commissioned; externally peer reviewed.