In healthcare we often focus on errors in an effort to learn from our mistakes and avoid further harm.

Unfortunately this fails to recognise that the vast majority of what we do on a daily basis is not only good but is practice that improves outcomes and should be shared. Our focus on error means sadly a lot of this excellent practice is missed.

“Learning From Excellence”, is a growing movement in healthcare aiming to redress the balance and recognise these examples. It is in response to this we developed GREATix. http://learningfromexcellence.com/ 

Staff may nominate another staff member or team for a GREATix via a bespoke online tool, when they observe excellence in the workplace.

While excellence is perceived differently for everyone it is important all but all interpretations count. Being inclusive to all staff allows us to learn lessons across all aspects of the patient experience. This may be how efficiently they are dealt with at reception, how compassionate a nurse was or the excellence of physiotherapy and occupational therapy in assisting beyond discharge.

Ultimately we want to be able to feedback to these nominated individuals to recognise greatness but also to share and learn from these examples.

In our own hospital we have seen the word of GREATix spread from an original starting point in the paediatric emergence department.

In the six months the initiative has been operating locally not only have numbers of nomination increased; we have observed it being taken on and embedded into regular practice by other teams and departments throughout the wider hospital. We have also become aware of areas of excellent innovation which we are now championing as service improvement projects in their own right.

A positive reporting system may produce benefits in patient safety without creating a potentially toxic reporting system.

While GREATix is not a substitute for incident reporting it adds value in a system that is frequently under-resourced. The real benefits on moral and culture still have yet to be realised.

It shows real promise as an improvement tool. It is our hope that others can follow our example and develop their own or utilise our system. This can only be beneficial in improving all aspects of the service we offer.

In many ways GREATix is like The Academy of Fab Stuff by allowing a platform to recognise the efforts of others and learn lessons from these as able.

About the Author:

Paediatric Emergency Medicine Trainee in Leicester Royal Infirmary. Interested in what lessons we can learn from the times when things go well. Striving to redress the balance of the NHS negative culture in an effort to improve care, learn lessons and support staff.


  1. SarahNeil 22 July 2016 at 12:40 pm

    Hello, I am really interested in this idea and wondering whether it would be possible to have a look at the bespoke online tool that you use – perhaps some screen grabs so that I can see what it looks like? My email address if you want to get in touch is [email protected]. Many thanks for sharing this, Sarah

  2. Jules135 28 July 2016 at 4:55 pm

    What a fab idea. any chance you could send a link of the online tool
    [email protected]

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