Momentum – why it matters in improvement and how we can build it.

By Dominique Bird, Deputy Director and Head of Quality Improvement, Improvement Cymru

Dominique Bird

In the journey of healthcare improvement there is one essential ingredient that often determines our success – momentum. 

It’s the driving force that propels us forward, enabling us to overcome obstacles and reach our goals. It’s the energy that builds as you take action, learn from your experiences and use that knowledge to propel yourself further. 

Learning Session 3 of the Safe Care Collaborative took place last month, where 220 health and care staff from across Wales shared their improvement experiences. It included ‘spotlight’ and ‘storyboard’ sessions in which teams from across Wales told their stories about their improvement work as part of the collaborative. It was exciting to see that such a lot of momentum has been building in their work.


Momentum matters in improvement for four key reasons:
  • Overcoming inertia – at the start of any improvement journey, there’s often resistance and inertia – this is when momentum is crucial, helping you to break free from the current ways of working and once you begin, it becomes easier to keep going.

Like the Velindre Suspected Metastatic Spinal Cord Compression (MSCC) Pathway Improvement, who shared on their storyboard ‘the team have identified a range of change options which had not previously been considered’.  Showing us that they have  overcome inertia and built momentum around the engagement.

  • Building confidence – every small win and step forward adds to your team’s confidence, fueling the determination to keep improving.

Monmouthshire Integrated Neville Hall Hospital Discharge Model demonstrated wins in their data on reduction in variation of Length of Stay. These early shoots will build the team’s confidence. Similarly, Swansea Bay community workstream is using case studies to illustrate the impact of iStumble app, and stories can be just as powerful as data.

  • Sustaining motivation – consistent progress keeps motivation alive.

Withybush General Hospital are sharing step changes in NEWS scores calculated from triage observations, as well as the full set of physiological observations at triage. Keeping this data visible for all the team helps sustain motivation.

  • Adaptation and resilience – momentum helps you adapt to unexpected challenges – it will help your teams find ways to navigate obstacles and continue on your improvement journey.

Like the Empowering Outpatients Team in Cardiff and Vale University Health Board – they are using the sprint approach to adapt and build resilience as they spread the improvements across specialties.


Scientifically, momentum is determined by two factors: how much stuff and how fast it is moving. These stories at the learning session demonstrated how fast all this ‘stuff’ is moving!  We have gained true momentum on patient safety in Wales, and it is down to the continued commitment from all the teams and the wider colleagues supporting the work in the collaborative.

In the pursuit of improvement, momentum is your greatest ally. It can turn the most challenging journey into a rewarding adventure. By setting clear aims, staying consistent, learning from your experiences and your data, and seeking support from your coaches and sponsors you can cultivate and sustain the momentum needed to achieve continuous improvement.

Remember, it’s not about perfection, it’s about progress. Keep moving forward and you’ll be amazed at what we can achieve together to deliver safe care in Wales.