Intended for healthcare professionals

Letters Building effective quality improvement

Building effective quality improvement: start with joy in work

BMJ 2019; 367 doi: (Published 21 November 2019) Cite this as: BMJ 2019;367:l6596
  1. Rachel Pilling, consultant ophthalmologist1,
  2. Dan Wadsworth, transformation manager2
  1. 1Ophthalmology, Bradford Royal Infirmary, Bradford BD9 6RJ, UK
  2. 2TeleTracking International, London W1W 7AF, UK
  1. rachel.pilling{at}

For quality improvement (QI) to have the impact at the pace and scale required, we cannot solely rely on formal programmes, disseminated from the top down.1 We need to mobilise informal power in organisations to help staff to create their own short change cycles.

QI has three main elements; patient safety, cost effectiveness, and joy in work.2 The beauty …

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