In this example, the aim is to foster a continuous improvement approach to the HCS’s current approach to process improvement, as illustrated in Figure 2. Stage 1: Establish a cross-functional leadership Steering Group or connect to an existing leadership group with responsibility for all goals including WE (Strategy #1). This group will be responsible for coordination between departments and resource allocation issues – which have been shown to be a critical success factor in improvement processes. They are also responsible for ensuring appropriate quantitative key performance indicators are established and used (Strategy #2) and that relevant stakeholders are engaged in the improvement process (strategy #3). Stage 2: Conduct an organizational scan and establish an improvement process blueprint that defines the desired improvement approach to be used. This step is needed to understand the organizational context (Strategy #4 & 7), the stakeholders that need to be engaged (Strategy #3), and the state of the current process improvement approach (Strategy #7). Engineering tools like process mapping can help understand the organisation and actors of the sub-system in question. This blueprint, that describes the proposed change approach, will need periodic updating as the process develops in order to capture lessons learned of what works (or not) in this organisation’s context (Strategy #5 & #6). Stage 3: Form & Launch the Innovation Teams. A cross functional team, that engages HCP patients and managers is formed to tackle process targeted for improvement (Strategy #3 and #4). In this example, the process to be improved will be set by the steering group. The team may use a variety of approaches and tools (Carayon, 2011; Michalsksi & King, 2003; Neumann, 2007; Salvendy, 2001; Stanton et al., 2004) according to the local context and needs (Strategies #1, #2, and #7). Figure 2 illustrates two teams using different improvement processes: The Plan Do Check Act cycle of Shewart (Deming, 2000) and the Define, Measure, Analyze, Implement, Check (DMAIC) approach of 6-Sigma (Chassin, 2008; Harry & Schroeder, 2005; Michalsksi & King, 2003). These can be chosen according to team preference and stakeholder needs (Strategies #3 & #7) and the particular development stage of the team’s organisational learning journey (Strategy #5 & #6). The strategic framework applies regardless of the choice of improvement process method. Crucial here is that teams focus on integrated & measured goals, securing good working environments so care can be delivered with the integrated goals of quality, efficiency, and good patient experience (Strategies #1, #2 and #4). Management support here is critical to ensure that innovations are sustainable from the perspective of staff workloads and WE. Stage 4: Review, revise, adapt and expand the process. As the steering group reviews and refines the improvement blueprint, new teams focused on new priorities can be established. This poses the second loop of the “double-loop” learning element that is central to the organizational learning paradigm (Senge, 1990; Strategies #5 & #6). Taking time to improve processes needs to be seen as part of everyone’s job (strategies #3 & #5). This flexible set of stages – each of which must be adapted to the specific context of the organization - provides an illustration of an adaptable framework in which engineering and human factors methods can be integrated into hospital improvement routines to jointly optimize the system towards the integrated goals of performance, care quality, and HCP wellbeing (Strategy #1). Internal & External Support pose an important issue in this framework (Figure 2). Developing innovation capacity in the HCS implies new roles and tasks for HCS personnel and for patients and families (strategies #3, #4, and #5). Training will be required (strategy #5). New online platforms, aimed at providing on-demand training in process improvement for nurses pose examples as to how this might be done economically (Neumann & Purdy, 2019; Purdy et al., 2017). While temporary support could come externally from researchers or consultants in early stages of studying this type of development, long term solutions will need either internal or reliable external personnel whose primary duty is to help foster and manage improvement efforts. The support needed during initiation of a process in an organization may be considerably more than that required as the improvement process becomes more routinized (strategies #5 and #6).