Much Ado About Change


After starting out as a registrar in Geriatrics in a district hospital and working under stressful situations with poor rotas and staffing levels, I found myself at a crossroads of my career: whether to give up hospital medicine and pursue an alternative profession. The only way I thought I would go back to clinical medicine would be if things changed. Change is the gamble we all too frequently are reluctant to take but how would I affect this?

Having been successful at securing a Leadership Fellowship at the Improvement Academy, this opportunity paved a way for me to realise my ambition of improving patient safety. The last 12 months have seen me develop skills in quality improvement, behaviour change, leadership and many more; skills I would have never otherwise gained by just being on the ward.

The main things I have discovered through this journey have been developing my passion for patient safety and putting into practice basic principles of improvement through some of the projects I have been working on. Involving patients in their care and the changes that have been made has been extremely rewarding. I feel that we do not engage patients often enough in the changes that we make which are often aimed at improving their care and wellbeing. Patients have a lot of the answers we seek and the scope for successful improvement work needs to focus on this invaluable yet underutilised resource.

This year has also taught me about leadership skills and being assertive as I have progressed through some of the projects that have been challenging to say the least. Most importantly, it has developed my negotiation skills and confidence and it has made me understand better the complex interactions within the NHS and how to engage stakeholders in helping them see why patient safety needs to be at the forefront of everything we do. Targets need to be met – but I would put patient safety above all else.

As I return to clinical practice in a few weeks, I am well aware that there are people out there who see this ‘movement of change’ as something ‘airy fairy’ and there will be resistance to some of the work I hope to do in the future. To be honest, I am slightly anxious about this – being surrounded by improvers gives you energy to make things happen, and going back to where you may be in the minority will be testing.

However, I shall draw strength from this network and family of quality improvement who have continued to support and inspire me. These are the people who influence change in their own environment, until this positivity becomes infectious and cascades across wards, clinical settings and directorates. Change is possible without further cuts in resources or compromising care, and change is possible simply because a group of people who are passionate about safety have come together to do something differently. One bay, one shift, one day at a time.

Be the change you wish to see in the world – Mahatma Gandhi