Table 3.

Implemented change initiatives from each case

Case	Team goal	Implementation action	Exemplar quotes
Willow	Improve the number of delayed discharges	Audit and feedback of rounding times	We mentioned about the doctors' rounds, that was one huge issue…we did a study on the times to see if we could improve things. So I think doctors, they're doing their rounds more efficiently now…which helps patient flow (Nurse3W)
	Improve communication	MDT huddle introduced	the huddle really helps…It's more effective communication at an appropriate time when people can actually focus and take it all on board (AHP4W)
	Improve workflow	Team completed a Lean 5S to organise, clean, develop and sustain a productive work environment	I think things are running a bit, the ward runs smoother (Support staff1W)
Brickley	Improve role clarity	Development of poster to distinguish staff uniforms	{patients} might know who the nurse is from the colour of the uniform, but they would not know who anyone else is (Nurse4B)
	Improve communication	MDT huddle introduced	The MDT huddle is a small thing but it's hugely helpful…just allows us to plan a little bit better for our patients… (Medic1B)
	Improve patient satisfaction	Development of a patient information leaflet to improve awareness of the team	A lot of patients they're not really aware of what the {unit} is or anything so a lot of those things {the leaflet} I thought were really positive to kind of come out of it (AHP2B)