Lean quality improvement methodology is widely used in healthcare. However, there is a lack of published evaluations of the effectiveness of rapid improvement (RI) methodology. This research uses a RI event to understand the ability of Lean to improve clinical systems and understand the qualitative and quantitative aspects that contribute to improvement.

Method The RI event focussed on improving patient experience during supper times on an elderly care ward to improve the health and wellbeing of patients.

Quantitative metrics were collected at baseline and during the RPIW. COVID-19 prevented follow-up data collection. Qualitative data was collected through semi-structured interviews with participants and subsequently analysed using thematic analysis.

Results Quantitative metrics showed improvement from the baseline state. All data should be used for continuous improvement using Plan-Do-Study-Act cycles. The sustainability of the improvements could not be assessed given the lack of follow-up.

Thematic analysis identified three key themes. For successful QI initiatives, staff needed to be engaged with improvements from an early stage. Staff must also be empowered by leaders to create change, through support and education about QI. Finally, committed and engaged leaders must ensure that QI is prioritised, to ensure that improvement becomes a daily activity in the workplace and staff are supported and encouraged to improve continuously. Ultimately these features result in successful improvement work and initiate culture change for sustainable improvement.

Conclusion QI research often focuses on quantitative data. This research provides a strong argument for including qualitative data collection to further understand how improvement occurs. Qualitative evaluation provided an insight into staff experience of improvement work, which can subsequently be used to guide future quality initiatives.