Learning about the conditions for improvement and excellent care from high performing clinical networks

We are learning from high performing professionals why things go right in healthcare. Using a mixed method approach, a combination of six conditions for successful services and improvements were found: (1) Invisible web of interaction. Professionals with defined roles and tasks are working and learning together in multiprofessional teams, with a common desire to make a positive difference together with their patients. (2) Management by trust, knowledge and data collection. Leading and continually improving the system in a climate of empowerment. Developing easily available plans and clearly defined roles and responsibilities. (3) Fostering creative ability. No plan can cover everything that may happen. With a good structure, knowledge and trust, good improvisations are made, allowing the team to do what the situations demands. (4) Minimizing the number of handoffs in the care process to prevent adverse events. (5) Monitoring current practices and change. Reflecting together on the variations in practice using longitudinal control charts and video-recorded training sessions. Making decisions based on findings. (6) Easily available professional and improvement knowledge and guidance