RT Journal Article SR Electronic T1 Ten tips for advancing a culture of improvement in primary care JF BMJ Quality & Safety JO BMJ Qual Saf FD BMJ Publishing Group Ltd SP 582 OP 587 DO 10.1136/bmjqs-2018-008451 VO 28 IS 7 A1 Tara Kiran A1 Noor Ramji A1 Mary Beth Derocher A1 Rajesh Girdhari A1 Samantha Davie A1 Margarita Lam-Antoniades YR 2019 UL http://qualitysafety.bmj.com/content/28/7/582.abstract AB Embracing practice-based quality improvement (QI) represents one way for clinicians to improve the care they provide to patients while also improving their own professional satisfaction. But engaging in care redesign is challenging for clinicians. In this article, we describe our experience over the last 7 years transforming the care delivered in our large primary care practice. We reflect on our journey and offer 10 tips to healthcare leaders seeking to advance a culture of improvement. Our organisation has developed a cadre of QI leaders, tracks a range of performance measures and has demonstrated sustained improvements in important areas of patient care. Success has required deep engagement with both patients and clinicians, a long-term vision, and requisite patience.