ABSTRACT
This chapter examines the evidence on outcomes relating to influential service improvement initiatives in healthcare and focuses on the breakthrough series (BTS) collaborative model which is currently the most widely adopted approach in the National Health Service (NHS). The BTS model is a key element of the NHS strategy to roll out service improvement activity. In seeking dramatic improvement in organisational performance within two years, the intention was to realise the classic business process re-engineering (BPR) model. The concepts of continuous quality improvement, BPR and the BTS collaborative model share a range of common process-oriented service improvement characteristics. The Northern New England Cardiovascular Disease Study Group illustrates the latter point, while also being one of the most influential examples of process-oriented service improvement initiatives recorded in the literature. National Patients’ Access Team's first programmes were the National Booked Admissions Programme and the Cancer Services Collaborative, the first phases of which were subject to evaluation.
