Marginal Gains

Last week I was fortunate to attend a Q&A with Sir Dave Brailsford, Team Principle for Team Sky and previously Head of British Cycling, for the charity Bloodwise.  Having very little interest in cycling, I was there to hear about the principles of ‘marginal gains’, ‘continuous improvement’ and ‘winning behaviours’* that Dave Brailsford has advanced in the last few years.

The principle of ‘marginal gains’ was created and applied by the British Cycling team with great success and you can read more about that here; but the same principles are applicable to other industries, including education, and quality improvement (QI) in healthcare too.

The principle of marginal gains is based on two ideas:

1. A large number of small changes, when combined, can have a significant impact

2. Everyone can contribute and it is everyone’s responsibility to be open to improvements that can be made, no matter how small

As well as these two simple ideas, the principle has much in common with the approach to QI that we use at ASPH and we talk about more on this site:

  • Use a simple and repeatable approach
  • However, this simple idea must be constantly and relentlessly applied over time to ensure we continue to improve
  • This takes an attitude as well as some skills
  • But mostly this takes an outlook of being curious to spot the opportunities for, and then make, the ‘marginal gains’

If you have a few minutes, you can hear Sir Dave Brailsford talk about the marginal gains theory below:

“Improving everything by a marginal amount, when combined together will make a big improvement”– Sir Dave Brailsford, Team Principle, Team Sky

Hope this provides some food for thought and we would really welcome your feedback in the comments section below.



(*The principle of ‘winning behaviours’ is really interesting but a subject for another day)

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