Setting the scene
Chapters 2 and 3 have described the underlying principles of good performance management and the framework within which we are working. This chapter considers the conditions necessary to create tangible, long-lasting performance improvement. Creating an environment and an infrastructure where change can flourish is more important as a predictive factor for success than any specific performance intervention (Ham et al. 2002). Many studies of successful change have highlighted the contributing role of a receptive local context for change. Characteristics of a receptive context include effective clinical and managerial leadership, clear strategic goals, collaboration and teamwork and learning from mistakes (Garside 1998; Pettigrew et al. 1998; Shortell and Kaluzny 1998; Ham et al. 2002; Greenhalgh et al. 2004; Maher and Gustafson 2004).