It is easy to become very focused on one method of quality improvement, and to overlook others. Health care staff who find that an improvement method works in one situation may, understandably, use that approach again in other contexts. Sometimes this works, but the approach that was effective in one ward, or with a particular problem, may fail to deliver the desired outcome in another situation.
Improvement science tries to work out which improvement methods work, and why. Researchers also try to understand in what context particular approaches are of most value.
Some of the research can be esoteric, and too abstruse to be of much value to practitioners. The best work, however, can be useful in practice, and can give you an idea about a different approach to a problem.
Quite a few websites have appeared with information on improvement science. Some of them are described below, and I will cover others in future posts.
The Health Foundation is a UK Charity set up after a large grant from the sale of a private health care group. They work in several areas, including service quality. There is a general description of their improvement science work at this link. Their site includes a survey of quality improvement research, available as a downloadable pdf.
The Improvement Science Research Network is a US programme that aims to improve the quality of research in health care quality improvement, by linking researchers, supporting multi-site projects and agreeing US priorities for research and evaluation. The website has details of US projects that are either in progress, or are being planned. They have a blog and a newsletter, but some of the resources are restricted to network members.
This US Government agency covers a wide range of topics, and has useful resources on quality measurement. While their work has a US context, many of the reports are relevant to work in other countries as well, including advice on high reliability organisations, and surveys on safety culture.
This English NHS site covers many quality improvement programmes, including those concentrating on patient safety. Some of the resources are only available for NHS staff in England, or by agreement with the providers. Some material can be accessed, however, including the archived pages from the NHS Institute for Innovation and Improvement. Although these pages are no longer updated, they include a wealth of useful material, most based on improvement science. The materials are archived on the National Archives site and, while not all the links continue to work, there is so much useful material that it is worth persevering. The decision to put some of the Improving Quality material behind a firewall does make the English NHS material much less accessible than it was in the past.
This is a useful American site. Resources include a workbook by DuncanNeuhauser and colleagues to help teach quality improvement methods, including PDSA cycles, and other materials including teaching materials on Lean produced by Earll Murman.
The Robert Wood Johnson Foundation is a large US funder. They have supported numerous quality improvement programmes in health care over the years. The programmes are archived. Many of the programme results can be downloaded from links at the site, including evaluations of training programmes on quality improvement methods, and details of a large programme of funded research.
The US Department of Veterans Affairs has useful material on improvement. Their work is centred around specific health care topics. Examples of material include resource guides on evaluation, toolkits on care in specific conditions, and archived copies of presentations.
Improvement Science London focus, as their name suggests, on improvement work across the capital. The most useful part of their website for a wider audience are their videos with an introduction to improvement science, and their occasional blog posts and videos, including a lecture from Martin Marshall.
King’s Improvement Science brings together an academic institution, King’s College London, with three NHS services. This website describes the initiative and describes how it will link with specific projects. There are examples of two current projects, but limited detail of what is actually being done. As this project develops, it should have useful information, but at present it is one for the future, rather than having great current value.
This site describes improvement science work at the University of Cardiff. It includes slides from a 2013 event. The presentations give a feel for the range of approaches that can be used for improvement work, from the mathematical to a focus on people and their behaviour.
Are there other websites that I should have included?
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