Why This Episode Matters
Healthcare organizations often treat improvement as a set of projects, tools, or training programs. Amar Shah’s work at East London NHS Foundation Trust (ELFT) and NHS England points to something larger: the long-term work of building belief, capability, infrastructure, and leadership routines so improvement becomes part of how a health system thinks and operates. This conversation explores what it takes to move from local improvement activity to organization-wide and national-scale improvement strategy.
Key Ideas Explored
Building belief as a core design challenge in improvement
Moving from centralized QI support to distributed improvement capability
Why storytelling is essential improvement infrastructure
Co-design as both an ethical commitment and a driver of better results
Scaling improvement from ELFT to NHS England’s national improvement work
Takeaways for Quality Leaders
Treat belief in improvement as something you must deliberately build, not something you can mandate.
Invest in stories that make improvement visible, credible, and emotionally meaningful.
Build distributed coaching capability so improvement support lives closer to the work.
Help boards learn improvement through better questions, better data, and better routines.
Use co-design early and seriously, especially when tackling complex system problems.
Continue the Conversation with Dr. Amar Shah
Resources & Frameworks Referenced
Leading Quality is a podcast for healthcare leaders committed to improving systems, culture, and outcomes.
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New episodes published every other Thursday at 7AM Eastern Time.
Credits:
Host, Writer, and Executive Producer
Jason Meadows, MD
Produced by
Thrive Healthcare Improvement
Edited by
Milan Milosavljevic
