Management, leadership, and QI are discussed as distinct but overlapping. Some leaders are not managers, and vice versa. Some, but not all, leaders and managers will undertake QI, which can be performed in isolation from leadership and management. But integrating all three is likely to optimise outcomes.

The essay discusses how a new narrative from regulators and boards, strategic intent, investment in training leaders and staff, and a more distributed leadership model that empowers frontline teams is required in order to embed QI in any organisation.