The Scottish Improvement Journey: a nationwide approach to improvement

This paper shares the story of the Scottish Improvement Journey encompassing 50 years of clinical audit and improvement programmes.

9. Conclusion

The Scottish improvement story shows a long journey of commitment to quality improvement. It took years to arrive at the point where Scotland finds itself now. This commitment did not start 9 years ago with Patient Safety; however, the SPSP programme played a key part in igniting a national movement. All emerging national quality improvement programmes are building on the learning of the forerunners who prepared a fertile ground. The way Scotland thinks about improvement has now changed.

Consistent improvements in outcomes are being achieved across the range of programmes introduced in Scotland and a deserved sense of pride is felt amongst those involved. The SPSP is recording significant reductions in avoidable harm across Scottish healthcare. Other countries are learning from Scotland when designing and implementing their own safety programmes. Scotland has led the way in demonstrating the transferability and applicability of the improvement methodology beyond health and into the wider public services, creating unique collaborations among very different sectors and areas of work. Over time, IHI has become a critical friend to Scottish public services, adding value from their expertise rather than doing the work for them. Niñon Lewis, Executive Director at IHI, summarises the journey: “Scotland has really paved the way in the safety space and now in terms of community wide improvement, has really opened doors to show what is possible when you use QI as your execution method”.


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