Behaviour Change for Patient Safety

In a Nutshell: Many things we do in healthcare to improve safety, such as the introduction of new guidelines and technologies require NHS staff to change their behaviour. It is often assumed that this is easy – tell people what to do and they will do it. But, behaviour change can be difficult to achieve. In this work we help  healthcare teams to Achieve Behaviour Change by applying tried and tested theories from Psychology.


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The challenge

Patient safety requires healthcare practitioners to adopt best practice but interventions to support practitioners to do this do not consistently lead to change. Research evidence tells us that interventions based on theories of behaviour change are more effective but these theories are often not accessible to healthcare professionals and managers who are responsible for making change happen.

What have we done about it?

Behaviour change theory became accessible to both researchers and health care practitioners alike when a group of psychologists within the British Psychological Society developed the Theoretical Domains Framework (Michie et al.'s 2005). We have taken this framework and used it to develop a five stepped approach to behaviour change. This involves 1) establishing an implementation team supported by the exec team; 2) identifying a target behaviour; 3) understanding the barriers to change; 4) developing intervention strategies that address these barriers and 4) monitoring change. A programme of research has demonstrated the success of this approach (Taylor et al., 2014), and over the past two years the Improvement Academy, in partnership with the Yorkshire Quality and Safety Research group, has helped teams across the region to engage in their own behaviour change project by: 

  • Hosting five one day behaviour change workshops attended by 250 delegates including patient safety leads, improvement specialists, doctors, nurses and mangers
  • Developing an ABC Behaviour Change Toolkit and making it freely available online. The toolkit offers direction and examples for every step of the behaviour change journey
  • Offering post workshop support through the provision of an Academic Improvement Fellow who supports the adoption of this approach for individual patient safety improvement projects

The future

This work will be scaled up to reach other regions through a “train the trainer” package and associated resources;

  • We will continue to deliver workshops and support clinician led patient safety projects
  • We are conducting an on-going evaluation of the package in order to develop it further

Contact for further information

Rebecca Lawton – Academic Advisor to the Improvement Academy
E: r.j.lawton@leeds.ac.uk
T: 0113 3435715

Judith Dyson, Academic Improvement Fellow
E: J.Dyson@hull.ac.uk
T: 01482 464680

Behaviour Change Toolkit

Click here to access our Achieving Behaviour Change Toolkit resource, including information on how to apply it along with a worked example.

Further Information

Yorkshire Quality & Safety Research Group

Rebecca Lawton


0113 3435715