rss
Qual Saf Health Care 13:62-66 doi:10.1136/qshc.2003.006965
  • ORGANISATIONAL MATTER

The next phase of healthcare improvement: what can we learn from social movements?

  1. P Bate1,
  2. G Robert1,
  3. H Bevan2
  1. 1Centre for Health Informatics and Multiprofessional Education, University College London, London, UK
  2. 2NHS Modernisation Agency, London, UK
  1. Correspondence to:
 Professor P Bate
 Chair of Health Services Management, CHIME, Royal Free and University College Medical School, University College London, The Archway Campus, London N19 3UA, UK; s.p.batechime.ucl.ac.uk

    Abstract

    To date, improvement in health care has relied mainly on a “top down” programme by programme approach to service change and development. This has spawned a multitude of different and often impressive improvement schemes and activities. We question whether what has been happening will be sufficient to achieve the desired scale of change within the time scales set. Is it a case of “more of the same” or are there new and different approaches that might now be usefully implemented? Evidence from the social sciences suggests that other perspectives may help to recast large scale organisational change efforts in a new light and offer a different, though complementary, approach to improvement thinking and practice. Particularly prominent is the recognition that such large scale change in organisations relies not only on the “external drivers” but on the ability to connect with and mobilise people’s own “internal” energies and drivers for change, thus creating a “bottom up” locally led “grass roots” movement for improvement and change.

    Free sample

    This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of BMJ Quality & Safety.
    View free sample issue >>

    Email alerts

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

     

    Navigate This Article