RT Journal Article
SR Electronic
T1 The next phase of healthcare improvement: what can we learn from social movements?
JF Quality and Safety in Health Care
JO Qual Saf Health Care
FD BMJ Publishing Group Ltd
SP 62
OP 66
DO 10.1136/qshc.2003.006965
VO 13
IS 1
A1 P Bate
A1 G Robert
A1 H Bevan
YR 2004
UL http://qualitysafety.bmj.com/content/13/1/62.abstract
AB 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.