Update from RCP Quality Improvement: Improving improvement through practice, learning and research

Abstract

The most cited article from Future Healthcare Journal is Mary Dixon Woods’ paper ‘Does quality improvement improve quality’.1 The conclusion of this article, her Harveian lecture and the recent BMJ paper is that it depends how it's done, and we need better research.2,3 So we need to improve how we do improvement, both now and in the future. What do we mean by quality improvement (QI)? There is no single definition. The Health Foundation states that quality improvement ‘aim[s] to bring about a measurable improvement by applying specific methods within a healthcare setting ... [with] common approaches used to improve quality’.4 Batalden and Davidoff describe the key elements of quality improvement as understanding systems, processes, variation and context, and then developing new knowledge by testing and adapting planned changes, while measuring the effect over time.5 This needs to happen in a culture of learning as teams and organisations. Many individuals make valiant efforts to improve quality by changing processes of care, but without applying a ‘method’. If we look at the parallel with clinical …