Table 6 Key themes in Leatherman and Sutherland
• Clinicians work in the NHS as members of clinical teams, not as isolated individuals |
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• Work of these teams is, in turn, strongly influenced by the (local) organisational culture |
• Importance of professional bodies in supporting quality initiatives in the NHS |
• Huge difficulties in measuring cultural change, especially when there are multiple cultures and sub-cultures, hence the inadequacy of the current evidence base and the need for rigorous evaluation |
• Importance of user involvement in quality improvement |
• Importance of sustaining quality improvements and, hence, of participative rather than top-down approaches. |