Leadership, a key element of quality improvement in healthcare. Results from a literature review of “Lean Healthcare” and the Productive Ward

Mark White, John Wells, Tony Butterworth
  • The International Journal of Leadership in Public Services, December 2013, Emerald
  • DOI: 10.1108/ijlps-08-2013-0021

Key enablers for quality improvement

What is it about?

Leadership is regularly cited as a pre-requiste for improving quality in healthcare. This literature review identifies some of the key enabling themes for quality improvement and confirms leadership as a key element.

Why is it important?

Improving healthcare quality has become the number one goal of modern society. Many healthcare quality improvement interventions have been offered as 'silver bullets'. 'Lean healthcare', and a closely associated improvement programme 'Productive Ward' are marketed as tailor-made solutions for hospitals and healthcare organisations. Identifying the many enabling contextual factors enabling elements serves to enhance implementation. Leadership is often cited as a key ingredient. Understanding the mechanics of why is of great interest to quality improvement practitioners and researchers.


Dr Mark White
Royal College of Surgeons in Ireland

Many healthcare organisations are looking for the 'quick win' or 'silver bullet' solution when it comes to improving healthcare quality. This paper provides the reader with a synthesis of enabling themes, that are represented in the emerging Lean Healthcare and Productive Ward literature, which are reported to influence and impact implementation efforts. The evidence suggest that there is no one aspect or contextual element of implementation that is the 'secret ingredient'. However, the presence of leadership at the micro, meso and macro levels of healthcare organisations appears to be a critical success factor for the initiating, adopting and sustaining quality improvement interventions in healthcare.

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The following have contributed to this page: Professor John Stephen Wells and Dr Mark White