What We Learned About Improvement in 2025

As the year comes to a close, December is a natural moment to pause and reflect.

Across 2025, we’ve published a wide range of articles on improvement - drawing on conversations with healthcare teams, improvement leads, senior leaders, and system partners. While each article focused on a specific challenge, a few clear themes kept reappearing.

This post brings those themes together. Rather than a “most-read” list, it’s a reflection on what the year taught us about how improvement really works in practice - and what teams heading into 2026 might want to keep in mind.

1. Improvement succeeds or fails on leadership attention

One of the clearest lessons from this year is that improvement is rarely held back by methodology. Teams generally understand PDSA cycles, driver diagrams, and measurement basics.

What makes the difference is leadership attention.

When leaders consistently:

• Ask about improvement work
• Make time for review and learning
• Show curiosity rather than judgement

… improvement efforts tend to gain momentum. Where leadership attention drifts, even technically strong programmes often stall.

Several articles this year explored this from different angles - from executive sponsorship, to how leaders show up in review meetings, to the unintended signals organisations send about what “really matters”.

Key takeaway: Improvement doesn’t need louder endorsement - it needs sustained, visible interest from leaders at every level.

(Related reading: The Crucial Role of Leadership Buy-in in Driving Continuous Improvement from the Bottom Up)

2. Measurement still causes more anxiety than clarity

Measurement remains one of the most emotionally loaded aspects of improvement work.

Throughout the year, we returned again and again to questions like:

• How much data is enough?
• What if the numbers look bad?
• How do we balance rigour with practicality?

A recurring pattern emerged: teams often collect more data than they can meaningfully use, driven by fear of scrutiny rather than a desire to learn.

The most effective improvement work we saw in 2025 used measurement as a learning tool, not a performance weapon. Simple, timely measures, reviewed regularly and discussed openly, consistently proved more useful than complex dashboards reviewed months later.

Key takeaway: Measurement works best when it supports learning, not reassurance or compliance.

(Related reading: Stop Fearing SPC Charts, they're Simpler and Smarter than you think)

3. QI capability is built locally, not rolled out centrally

Another strong theme this year was the tension between central improvement programmes and local ownership.

While organisational frameworks and shared tools are important, lasting improvement capability develops when:

• Teams feel ownership of their work
• Improvement connects directly to local priorities
• Learning is shared sideways, not just reported upwards

Several articles highlighted how over-standardisation can unintentionally drain energy from improvement, even when intentions are good. The most resilient approaches created space for local adaptation while maintaining a shared language and infrastructure.

Key takeaway: Improvement capability grows through participation and practice, not implementation plans alone.

(Related reading: How to Ensure the Spread and Sustainability of Quality Improvement)

4. Time is the constraint everyone underestimates

If there was one constraint mentioned more than any other this year, it was time.

Teams are not resistant to improvement - they are stretched. Articles across the year surfaced a consistent reality: improvement work competes with operational pressure, not indifference.

What stood out was how successful teams approached this challenge. They didn’t “find more time”; they:

• Integrated improvement into existing meetings
• Kept cycles small and realistic
• Made progress visible to maintain motivation

Key takeaway: Sustainable improvement respects the limits of real working lives.

(Related reading: How to Charter an Improvement Project: SMART Aims, Teams & Pitfalls)

5. Reflection and learning are still undervalued - but essential

Finally, a quieter but important theme: reflection.

Across multiple articles, we saw how often teams move quickly from one change to the next without pausing to ask:

• What did we learn?
• What surprised us?
• What would we do differently next time?

Where reflection was built in, even briefly, improvement work became more confident and more adaptive. Learning didn’t slow progress; it strengthened it.

Key takeaway: Improvement accelerates when learning is treated as work, not an optional extra.

(Related reading: Metrics to Measure the Success of a QI Project)

Looking ahead to 2026

If 2025 reinforced anything, it’s that improvement is not a technical challenge waiting to be solved. It’s a human, organisational, and relational endeavour.

As teams look ahead to the coming year, we hope these reflections offer a useful lens, whether you’re starting something new, trying to sustain momentum, or simply making sense of what’s already underway.

Thank you to everyone who has read, shared, and reflected with us this year. We look forward to continuing the conversation in 2026.