Building an organisational culture of continuous improvement

Key points

• The evaluation of the NHS partnership with Virginia Mason Institute, which examined how
five NHS trusts in England attempted to build a culture of continuous improvement, provides
important lessons about how to plan and implement an organisation-wide approach to
improvement. This long read outlines some of the key learning from the evaluation and offers
recommendations for national policymakers and local systems leaders.
• Crucially, the evaluation finds that a strong culture of peer learning and knowledge sharing is a
critical enabler of organisation-wide improvement. The trusts with the highest CQC ratings
had a much greater levels of social connectedness between staff than those with the lowest
ratings. The evaluation suggests that trusts should prioritise efforts that allow staff to come
together on a regular basis to share ideas and learning in an open and respectful way.
• Another key lesson is that visible and sustained commitment to improvement programmes
from trust leaders is essential if they are to gain organisation-wide traction and support.
Without this, there is a risk that performance gains from improvement programmes will be
restricted to specific care pathways and services, and not generate organisation-wide benefits.
• Finally, the evaluation highlights the importance of ensuring that improvement priorities and
metrics are aligned with organisational and national objectives. This helps to ensure that trust
leaders, managers and local improvement teams are working towards the delivery of shared
improvement goals.