Engaging with improvement

Nursing leadership can feel challenging, with the constant drive for improved performance in health and social care, and a top-down performance management culture in which we typically operate. Having recently visited an acute trust, the leadership and feedback from teams felt more upbeat, with colleagues’ commitment to embedding a change and continuous improvement model coupled with a set of behaviours and actions to set the culture. Their approach to all that they did was: ‘Does it make our patients and our staff lives better?’

This inspired me to refresh my knowledge of continuous improvement models. I revisited at Kotter's 8-Step Model, continuous improvement using the Toyota Production System (TPS) – often called ‘lean’ – and the NHS England Change Model Guide. What I saw in common across these models were the key themes for success:

According to Kotter (2018), the change process starts by identifying critical opportunities or risks that demand immediate action, then progressing through the next steps: