Front Line Ownership

Front Line Ownership (FLO) is a quality improvement approach which deeply engages with staff to empower and encourage staff to creatively develop solutions to challenges they face daily. FLO encourages front-line staff to acknowledge their own capacity and potential.

FLO focuses on positive deviants and the use of liberating structures. For more information on liberating structures see Liberating Structures or join our Liberating Structures user group - contact us through twitter on @LSUsers for more information or through our contact details on the main staff engagement page.

The benefits of using a front line ownership ethos is widely recognised in international literature to improve not only staff engagement but patient outcomes and experience.  If you want to improve service delivery, consider how you might use this approach in your work.  The principles are simple and easy to use.  We hope you find them helpful.  You can also read about our work in University Hospital Kerry as an example of front line ownership by clicking on the case study below.

Principles of Front Line Ownership

The principles of Front Line Ownership are:

  1. Go slow to go fast
  2. Invite the unusual suspects
  3. Work with those who want to work with you
  4. Participation is voluntary
  5. Nothing about me without me
  6. Change can spread bottom up, top down, and sideways
  7. Make the invisible visible
  8. Act your way into a new way of thinking

Case Study

In 2015, in partnership with the Quality Improvement Division (QID), University Hospital Kerry (UHK) commenced a programme seeking to value staff voices through Staff Listening Sessions and encourage creative problem solving through a quality improvement approach based on Front Line Ownership (FLO). 

Case study poster

Hear the experience of Majella Daly

We also organised workshops led by Dr. Michael Gardam and Leah Gitterman for managers, clinical directors and staff to spread the message about front line ownership and the benefits of working with staff to find solutions to challenges.

We’re now using this approach in other services and to support the Lead Non-Consultant Hospital Doctor (NCHD) Programme.

Useful info

  • Gardam M, Gitterman L. If you don’t succeed the first 20 times, please try something different… Accreditation Canada Qmentum Quarterly 2013; 6(2):6-11.
  • Zimmerman B, Reason P, Rykert L, Gitterman L, Christian J, Gardam M. Front-line ownership: generating a cure mindset for patient safety. Healthc Pap. 2013;13(1):6-22
  • Liberating Structures

Follow us on twitter for more ideas: 

 #engaginghealthstaff    #SchwartzRounds    #LiberatingStructures   #culturalchange