How to improve healthcare improvement-an essay by Mary Dixon-Woods.

Abstract

In the NHS, as in health systems worldwide, patients are exposed to risks of avoidable harm 1 and unwarranted variations in quality.2-4 But too often, problems in the quality and safety of healthcare are merely described, even “admired,”5 rather than fixed; the effort invested in collecting information (which is essential) is not matched by effort in making improvement. The National Confidential Enquiry into Patient Outcome and Death, for example, has raised many of the same concerns in report after report.6 Catastrophic degradations of organisations and units have recurred throughout the history of the NHS, with depressingly similar features each time.7-9