TY - JOUR T1 - Doctors as institutional entrepreneurs – leading quality improvement in clinical contexts JF - Future Healthcare Journal JO - Future Healthc J SP - 56 LP - 56 DO - 10.7861/futurehealth.6-2-s56 VL - 6 IS - Suppl 2 AU - Michael Page AU - Michael Smets Y1 - 2019/06/01 UR - http://www.rcpjournals.org/content/6/Suppl_2/56.abstract N2 - Implementing quality improvement (QI) in clinical contexts is notoriously challenging, with many initiatives delivering little or no improvement in practice.1,2 While the reasons for this are likely to be complex, Easton highlights the role of established organisational culture in frustrating clinicians’ efforts to improve healthcare processes.3 Thus, unlike in manufacturing contexts, where process improvement typically involves operating more efficiently within ‘the rules of the game’,4 QI in healthcare is typically a countercultural activity, which challenges existing rules, norms and beliefs. We were interested, therefore, in how doctors function in … ER -