Embedding quality improvement into routine clinical practice.

Our patients rightly expect quality healthcare, our politicians expect the £100bn funding of the NHS to deliver quality healthcare and we, as clinicians, strive to deliver quality healthcare; so why is quality improvement (QI) so difficult to routinely deliver, and why does it remain a Cinderella function in healthcare? This edition of Future Hospital Journal ( FHJ ) presents a series of articles that offer readers the opportunity to view QI from multiple perspectives covering different aspects of the theory, educational requirement, delivery and intended outcomes of QI within the UK healthcare sector. A number of major challenges are identified that all require addressing if we are to embed a routine quality driven culture within our clinical workspace. Highlighting systemic issues, Leatherman et al 1 give a strategic view from the Health Foundation, highlighting the lack of ownership of the quality agenda within NHS England, the disparate accountability landscape for quality and the lack of national leadership development for QI (as opposed to initiatives for personal development). Along with other contributors, the challenges and tensions that arise from both top-down, policy driven and bottom-up, local approaches to QI are acknowledged and explored. As is so often the way, while setting of standards from the top …