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My Improvement Journey: Thomas Rose

Thomas Rose - Research Fellow, Institute of Applied Health Research, University of Birmingham - shares his improvement journey from electrical engineering to the NHS, and invites new members to join the Process Visualisation SIG. 

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How – and why? –  did you first get involved in improvement; and what has been your journey since then?

As a Chartered Electrical Engineer I was managing a team of engineers designing control systems and our projects usually started with the words ‘how can we do this?’ or ‘how can we do this better?’, i.e. how can we improve what we are currently doing?. That is what engineers do, find answers to questions. When registration to BS5750, the forerunner of ISO9000 the Quality Management standard, became necessary, these questions had to be applied to our own engineering design processes. That was in 1988. Ever since then I’ve always considered improvement as an important part of everything that I do. As I progressed up the management structure, my work emphasis moved from less product design and improvement to more process design and improvement. All I have learnt in engineering improvement, during my career in engineering, is directly applicable to the NHS. So in September 2016 I decided to do something about it and joined Birmingham University as a Research Fellow looking into process management in the NHS.

What most inspires you professionally?

I love the way that developments in information and digital technologies have made it so much easier to share knowledge in a clear and logical way and simplified the full use of visual techniques. The internet and high level languages, like HTML, combined with good web based database applications, like SQL, means that a world wide audience can be readily accessed using these technologies and techniques. I’ve always supported life long learning and encouraged young people to prepare for their chosen career. I hope that encouraging people to use these new technologies helps them to progress. I’m inspired by making the insurmountable surmountable.

Can you share a hard-won lesson you’ve learnt about what makes for a successful (or unsuccessful) improvement project?

KISS, keep it simple, is a very good acronym to use as a guide. It’s as important to understand your starting point as it is your finish point. Establish good teamwork. Communicate – in writing. If it’s a technology based improvement then prove the application before you try to implement it. There is a saying ‘rubbish in rubbish out’ i.e. make sure your inputs are correct before trying to improve your outputs.

What change could we make that would do most to embed continuous improvement in health and care?

Very simply get a clearer understanding of what you are already doing and make sure that everyone involved has ready access to that knowledge. Learn the difference between policy and procedure and make sure these documents are what they say they are.

Learn the difference between policy and procedure and make sure these documents are what they say they are.

Why did you join Q?

It came along at the right time for me. I’d just started at UOB and was looking for a way to get exposure for my research. Q looked like the answer. Q ticks my professional inspiration in that there is lots of opportunity to seek help and also to offer help, hopefully I’m doing both as a member of Q. I think that the more people you can get to comment on an idea then the better the outcome will be, particularly if there is a diverse range of people commenting. I’m sure that Q members will make a difference to the NHS.

What new connections (and collaborations) have you made as a result of joining the Q community – and what have you learnt so far?

I’ve joined the Q Lab which I have enjoyed so far. I’m certain that membership will make a positive contribution to my own Peer Support processes and activities. I have instigated a SIG and I’m a member of six others. Response from members is a bit slower than I had hoped but nevertheless I have benefited from membership. I’m hoping that Q members will become more active online.

I’ve joined the Q Lab which I have enjoyed so far. I’m certain that membership will make a positive contribution to my own Peer Support processes and activities

Can you tell us about something you’re currently working on (that Q members might be able to help with/feed into/learn from/contribute to)?

The SIG I started is interested in Process Visualisation of processes in the NHS. Process Visualization is another name for Process Mapping but it is different in that linked to the Process Map are all the procedures and work instructions relevant to the process also any guidance documents that have been published by interested parties. All this information is visible from links on the process map. I’d love more Q members to join this SIG to help identify best practice in specific processes.

The process visualisations will be used by hospitals to benchmark their own processes and could be a baseline for Clinical Audit.

If you have a process that you would like mapping then please contact me.


  1. Guest

    Read your piece in CQI Journal and recognise your point.  I've recently conducted a study of rework in the NHS.  Shocking really.  Maybe we could talk about this and other findings??  If you'd like to, please get in touch.
    Kindest regards, John Evans

    1. That should have been

  2. John, How can I get in touch with you? My email is

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