Creating and leading a quality improvement culture at scale

Current models of health and social care in Highland are not sustainable. The combined impacts of our ageing population, reducing workforce, problems with recruitment and financial pressures mean that the way we provide health and social care has to change. Despite the best efforts of staff, the current ways of working are not matched to future requirements; our models of care are also not as safe as they could be and are no longer sustainable or affordable. Better quality care is safer, more person-centred and can also cost less. By reducing harm, waste and unwarranted variation across the health and social care systems, it is possible to increase quality, and at the same time reduce costs. Embedding new ways of working with front-line staff to make such changes in their practice, however, has been challenging. In this article we explore some of our approaches and learning around delivering and embedding quality improvement at scale during times of significant financial pressures. Maintaining a consistency of leadership to support coaching, as well as rigorous adherence to a chosen improvement methodology we believe are important elements of success.