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Does quality improvement improve quality?

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Martin, Graham P 

Abstract

Although quality improvement (QI) is frequently advocated as a way of addressing the problems with healthcare, evidence of its effectiveness has remained very mixed. The reasons for this are varied but the growing literature highlights particular challenges. Fidelity in the application of QI methods is often variable. QI work is often pursued through time-limited, small-scale projects, led by professionals who may lack the expertise, power or resources to instigate the changes required. There is insufficient attention to rigorous evaluation of improvement and to sharing the lessons of successes and failures. Too many QI interventions are seen as 'magic bullets' that will produce improvement in any situation, regardless of context. Too much improvement work is undertaken in isolation at a local level, failing to pool resources and develop collective solutions, and introducing new hazards in the process. This article considers these challenges and proposes four key ways in which QI might itself be improved.

Description

Keywords

evaluation, healthcare organisation, hospitals, patient safety, quality improvement, research design/methods

Journal Title

Future Hosp J

Conference Name

Journal ISSN

2055-3323
2055-3331

Volume Title

3

Publisher

Elsevier BV
Sponsorship
Wellcome Trust (097899/Z/11/Z)
Mary Dixon-Woods is funded by a Wellcome Trust Investigator award, WT097899