THIS Institute (The Healthcare Improvement Studies Institute)

@thisinstitute.cam.ac.uk

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We are The Healthcare Improvement Studies Institute. We're strengthening the evidence base for healthcare improvement. Based at the University of Cambridge and made possible by the Health Foundation. thisinstitute.cam.ac.uk

Sketchnote with six top tips for spreading, scaling, and sustaining healthcare improvement. 1. Starting from scratch isn't always the answer 2. Think about the potential for spread, scale-up, and sustainability early on 3. They tend to be overlapping and interdependent, not a step-by-step process 4. Pay attention to the context and the resources that can support the process 5. Bring in the right people, with the right skills, at the right time 6. Be open to adapting interventions to work in different settings.
Human Factors and Ergonomics Element by Mark Sujan and Laura Pickup
Top Tips for values and ethics. Includes ethical analysis is integral, examine assumptions, create space for debates, divide up tasks, strike a balance and collaborate with specialists.
Two people seated facing each other in conversation, with a central audio waveform and icons for speech bubbles, a document, an envelope, and a microphone showing recorded dialogue and message exchange.
THIS Institute vacancy advert for a research associate/ research assistant in health services research.
NHS signage on side of a building
A young Black woman participating in a discussion in a community centre, with people listening
Six tips for measurement for improvement: use a family of measures, collect data consistently and quality assure it, monitor variation over time, engage stakeholders, make data collection easy, use data to adjust your approach.
Mary Dixon-Woods
The healthcare improvement studies (THIS) Institute event stand at NHS Expo 2026.
Explain THIS. Collaboration-based approaches
Two speakers sit on armchairs on a stage during a Q&A session at 2026 THIS Institute Annual Lecture, seen from the audience. A large screen behind them displays the text “THIS Institute.” A small table between the speakers holds a bottle of water and two glasses.
Two people at a conference stand in front of a red THIS Institute display, looking at a screen showing THIS Institute's Elements series.
Explain THIS. Implementation science
Mary Dixon‑Woods gives a lecture on stage, looking towards a central screen, with an audience seated in front of her.
Explain THIS. Governance and leadership.
Neils Peek speaking and presenting at the THIS Institute’s 2025 annual lecture.
Nurse with medical supplies at hospital
Top tips for collaboration-based approaches: 1 Balance and structure and autonomy, 2 Don't rely on goodwill, 3 Plan for sustainability, 4 Be flexible, 5 Consider the wider context, 6 Be inclusive, 7 Weigh up costs and benefits, 8 Involve a range of voices.
Joanne McPeake, Professor of Nursing at THIS Institute with a quote reading 'The people who get patients better are their families and their social networks. The clinical team must do absolutely everything possible to care for this important group'.
Home caregiver helping a senior woman standing in the bedroom
Two healthcare workers in coversation as they walk along a hospital corridor.
Five top tips for implementation science 1. Select your framework by thinking about the change you want to see, your setting, and what has worked well in the past 2. Don’t ignore challenges that aren’t covered by your chosen theory or framework – think broadly 3. Consider the context where the implementation will happen 4. Be prepared to adapt to change 5. Choose practical strategies to bring about change.
Woman in a hospital bed holding her newborn baby
At macro level (national): 1. Use incentives carefully: Incentives can drive change but may have unintended consequences. Involve people managing, delivering, and using services in developing incentive systems. 2. Consider practical and emotional burdens: Make sure the right resources (people, capacity, time) are in place to deal with the practical and emotional burdens associated with improvement efforts. At meso level (systems and organisations): 3. Prioritise quality and safety: This should be a central priority for boards. Include them on agendas, use data to support understanding of quality and safety, and dedicate resources to building expertise in these areas. 4. Build a case for quality: Leaders should use both hard data (such as performance metrics) and soft data (such as patient stories) to make a compelling case for improving quality and building an improvement culture. 5. Learn from others: Boards should be open to building networks with and learning from external organisations to improve their own approaches to quality and safety. 6. Combine approaches: Making large-scale improvements requires combining both top-down leadership (from the board) and bottom-up approaches (from frontline staff). At micro level (clinical teams): 7. Use person-centred leadership: Leaders should focus on individuals’ needs and aspirations. Constructive feedback enhances team skills, sense of value, and encourages ownership of team priorities. 8. Use task-centred leadership: Establish shared objectives, responsibilities, and ownership for quality within teams. This promotes a culture of collaboration, psychological safety, and innovation.
A senior woman is sitting on a wheelchair, feeling stressed and worried, at home.
Headshot of Clair Le Boutillier and title: Co-designed personalised cancer care: Read the fellowship story
Newborn baby being held and examined immediately after birth, wrapped in a blanket while a parent reaches out to touch them in a clinical setting.
Nnenna Osuji and Graham Martin facing each other in conversation on a red sofa with the text “Why is speaking up so hard?” overlaid in between them.
Woman in a hospital bed holding her newborn baby
Explain THIS by THIS Institute. Hero image
Front cover of the framework to guide early planning of large scale programmes in health and healthcare
Newborn asleep in cot next to a blue hat, holding onto an adult's finger
Young nurse doing blood sugar test for senior lady patient on hospital bed
Arm of a patient in a hospital bed, with lines and cannula in hand.
Headshot of Justin Waring with title Improving perioperative care on national scale: Read the fellowship story
In a collaborative office, engineers deploy AI intelligence.
The Transforming Our Future: Prediction, Prevention & Early Diagnosis in Healthcare conference poster
Graphic illustrating what role operations management can play in shaping how care is designed, planned, and delivered.
THIS Space 2025 logo and the title 'Six perspectives of real-world learning on healthcare improvement' along with 6 headshots of fellows
Healthcare worker in blue trousers runs down a hospital corridor, pushing a trolley
Mother and newborn daughter born by Cesarean section
Giving you more control over your health and care.
Nurse in a hospital ward offering a glass of water to an elderly patient in bed.
Nurse with a patient and his partner by the hospital bed.
A surgeon wearing a blue headcover and a mask is putting on white surgical gloves
Smiling nurse attends to senior patient in hospital bed.
Illustration of a diverse group running together in a relay, passing a red circle to symbolise teamwork and inclusion.
Group of people in a GP surgery. Woman holding a phone.
Woman looking at her phone
GP woman attending to a patient by reviewing the blood pressure.
Nurse wheeling a tray down the corridor.