Before you start

The HSCPs that participated in the pilot programme have developed a summary of their “models for implementation”. These documents provide a very quick summation highlighting the differences in approach that each HSCP took and their recommendations for colleagues and peers just starting off their improvement journeys.

Argyll and Bute Implementation Model
Perth and Kinross Model for Implementation

Start Small

Pick smaller, quieter areas within your care home or partnership to test your improvements and then spread to others.

Find enthusiastic colleagues to help you. One passionate person (a nurse/doctor/student) in just one area can be all you need to get going. We have provided you with short presentations in the resource section that you can use to inform other team members and key stakeholders about your planned improvement activity and why the changes are important to resident’s care.

Check the Resources page for other tools that were developed by your peers that you might choose to use within your area.

Once you have identified your staff member to lead change in your area and champion pressure ulcer care, invite colleagues to assess their readiness to adopt the proposed change and help them to prepare. Promote the free NES Pressure Ulcer Prevention and Management Workbook and encourage them to complete these as a team.

Where Are You Now?

You can only demonstrate improvement with a measurement of where you started. Check out the measurement page for guidance on doing some very simple baseline auditing.

Ask for help. Don’t forget to call on the expertise of teams around you. Tissue viability networks, quality improvement leads, clinical governance teams and residents can all support your work. Nursing and medical students need to undertake projects as part of their studies – involve them in data collection and analysis for their university work if you can.

Being able to demonstrate measurable improvement is invaluable in demonstrating your successes and securing future collaboration.

Where Are You Going?

Work with your team to develop a vision of your aspirations for the service across your care home or partnership and how the resources that are shared on this website can help you get there.

Hand out some post-it notes to your team and each write down what you imagine the pressure ulcer prevention and care looking like in the future.

Group similar ideas together. Focus on the ones that most of the team consider important.

Develop a plan to reach your shared goals, showing who, how, and by when each goal will be achieved.

Learn from failure. When things don’t go the way you think they should, reflect on the experience, learn from the experience and use it to plan forward. Use plan do study act methodology for your improvement – this helps keep a log of what you are doing and a reflective account of success and failures.


  • Take your time! Improvements won’t happen overnight so take your time to plan and embed each tool successfully. The more you do, the easier and quicker it gets. Choose with staff/teams/which changes will be easiest to implement and are likely to have the biggest impact.
  • Learn who to talk to. Don’t try to do everything yourself, other teams and individuals will have skills to share and experience with improvement programmes.
  • Don’t reinvent the wheel. If a process already works well, leave it alone and target something else. Keep your changes small, simple, and build on existing foundations. Consider whether you need to adapt some of the resources already developed for your own care home needs. Many of the tools have elements that can be customised – allowing you to add your own text and logos. Involve staff and residents in making the changes so that they need local needs.
  • Set regular check-ins. Put regular dates in the diary to meet as a team to feedback how your improvement activity is going, what needs changing, and your next steps. Think about what you have learned. Be honest with yourselves – was there anything you could have done better? Make a note of this for your next tool or further roll-out. Share your lessons and achievements with other care homes across Scotland whenever possible.
  • Report your findings – be brief but informative – make data relevant and interesting. Communicate to wider staff networks. Your clear improvements will encourage buy-in from peers and senior management. It will also highlight the achievements of the staff who have piloted your improvement activity with you.