PT  - JOURNAL ARTICLE
AU  - Fatai Ogunlayi
AU  - Philip Britton
TI  - Achieving a ‘top-down’ change agenda by driving and supporting a collaborative ‘bottom-up’ process: case study of a large-scale enhanced recovery programme
AID  - 10.1136/bmjoq-2017-000008
DP  - 2017 Oct 01
TA  - BMJ Open Quality
PG  - e000008
VI  - 6
IP  - 2
4099  - http://bmjopenquality.bmj.com/content/6/2/e000008.short
4100  - http://bmjopenquality.bmj.com/content/6/2/e000008.full
SO  - BMJ Open Qual2017 Oct 01; 6
AB  - 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.