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Making many small changes can result in quality improvement

BMJ 2002; 324 doi: (Published 11 May 2002) Cite this as: BMJ 2002;324:1159
  1. Tim Wilson (, director, St Paul RCGP Quality Unit,
  2. Sarah Fraser, professor
  1. Royal College of General Practitioners, London SW7 1PU
  2. Dinton, Buckinghamshire HP18 0AB

    EDITOR—David Fillingham, the chief executive of the Modernisation Agency, comments that the staff in the NHS want to change but are too busy to do so.1 We would draw attention to that expert on management and quality improvement, A A Milne.

    Predating the work of Deming,2 Berwick,3 and others, …

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