The discipline of improvement: Something old, something new?

Charlotte L. Clarke*, Jan Reed, David Wainwright, Siobhan Mcclelland, Veronica Swallow, Jane Harden, Graham Walton, Anna Walsh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


In response to calls to improve the efficacy of health care services, there is an increasing focus on the processes of achieving a continuous improvement of services and practices. One specific response is that of the NHS Modernization Agency and National Health Service University in relation to the Discipline of Improvement in Health and Social Care. This paper draws on a study that explored the underpinning knowledge base of the Discipline of Improvement and focuses on describing the framework that was developed. The two-dimensional framework is composed of five primary categories, which cross-link to 11 competencies. The study concludes that the Discipline of Improvement draws together a group of ideas that together cohere to form a distinctive model to aid the improvement of health care. While some of these ideas are well-established, the way in which the Discipline of Improvement makes connections between them offers something new to our understanding of change in the complex world of health care provision, and to nursing management.

Original languageEnglish
Pages (from-to)85-96
Number of pages12
JournalJournal of Nursing Management
Issue number2
Early online date19 Feb 2004
Publication statusPublished - 1 Mar 2004


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