Learning to Improve

Clinical systems are constantly changing. In order to be sure the changes we make are positive, valuable, and sustained, we need to understand and measure the impact of our work. This development programme will give you an understanding of improvement methodology and develop your quality improvement skills.


Levels of development



Bronze level is an introduction to improvement. You'll be introduced to improvement through TURAS QI zone. It is expected that you will be able to use this theory whilst participating in ongoing QI activity, within your clinical department.


Silver builds on your learning and allows you to start leading on some aspects of project delivery. You'll have the opportunity to develop your skills and prepare a project for local presentation.


For Gold you will be expected to lead on an improvement project, with mentorship available from the MED QI team. Your work will be of a quality that culminates in publication or presentation at a national meeting.

Development matrix


Getting started

Starting the Clinician Development Programme is simple.
  1. Using the resources listed below work through the Bronze section
  2. Once you have completed all parts of the Bronze section send an email with your accompanying evidence to CDF@nhslothian.scot.nhs.uk
  3. Your Bronze level certificate will be sent to you with instructions on how to sign up for Silver and Gold levels should you wish to

If you have any questions please contact the team at CDF@nhslothian.scot.nhs.uk




TURAS QI zone:

Developing your aims and change ideas

Testing your change ideas

Understanding your system

Measurement for improvement

Implementation and spread

Local teaching

Attend Foundations of safety and quality (this is integrated into the Foundation Years teaching programme) https://www.med.scot.nhs.uk/trainee-doctors/founda...

Attend a Clinical Change Forum for upcoming dates see https://qilothian.scot.nhs.uk/clinical-change-foru...

Local workshops

Model for improvement (1hrs)

  • This will introduce the learner to change concepts and measurement for improvement.

Understanding your system (1hr)

  • This introduces concepts of systems and how to use tools and data to understand these.

Leading Improvement (1hrs)

  • This course explores behaviours and creating conditions for improvement to succeed

All delivered via MS teams and are bookable via TUBS https://tutorialbooking.com/


Reading list

  • Heath C, Heath D. Switch: how to change things when change is hard. New York: Broadway Books, 2010.
  • Langley GJ, Moen RD, Nolan KM. The Improvement Guide: a practical approach to enhancing organizational performance. San Francisco: Jossey-Bass, 2009.
  • Deming WE. Out of the crisis. Boston: Massachusetts Institute for Technology Center for Advanced Engineering Study, 1982.
  • Michael Bungay-Stanier. The Coaching Habit: say less, ask more & change the way you lead forever. Toronto: Box of Crayons Press, 2016.


Dr Ross Paterson
ADME (Improvement)
Intensive Care Consultant (WGH)