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This stage involves rolling out and spreading changes to other areas where appropriate.

The Quality Improvement Journey

Why Spread is important

Spread describes the process by which we take change ideas beyond the initial area of testing to new areas or teams.  Spread normally takes place once a change idea has been succcesfully tested, implemented and sustained under a variety of conditons. If you know the change project and ideas are likely to be spreadable this should be planned for from the beginning of an improvement project.

Watch the animation below for an overview of Spread.

Topics in spread

When to spread, context and adopters

Five questions to help you spread improvement

  • What are you spreading?
  • What is your system?
  • Sensitivity to context?
  • What is your scalable unit?
  • What is your compelling story?


Tools to help you spread improvement