Building a Culture of Improvement at East London NHS Foundation Trust

Building a Culture of Improvement at East London NHS Foundation Trust. Cambridge, Massachusetts: Institute for Healthcare Improvement; November 2016. (Available at

East London NHS Foundation Trust (ELFT) in the UK provides mental health and community services to a diverse and largely low-income population. Approximately 65,000 individuals come into contact with ELFT’s services each year at more than 100 community and inpatient sites.

In the past few years, ELFT has significantly reduced incidents of inpatient violence, medication errors, waiting times for treatment in the community, and improved staff satisfaction and engagement, among other improvements.

What made these achievements possible? Leaders and staff made a concerted effort to entrench a culture of continuous improvement in the organization, and they integrated quality improvement methodology and training into every level of work. To support their efforts, ELFT has been working closely with IHI since 2014 and became an IHI Strategic Partner in 2015.

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​Using QI to Reduce Violence in an Inpatient Mental Health Setting

In this video clip, ELFT's Andrew Cruickshank describes how openly and proactively discussing violence has helped prevent violent incidents and increase staff morale.

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