MANUSCRIPT: Ten challenges in improving quality in healthcare: lessons from the Health Foundation’s programme evaluations and relevant literature.
BACKGROUND:Formal evaluations of programmes are an important source of learning about the challenges faced in improving quality in healthcare and how they can be addressed. The authors aimed to integrate lessons from evaluations of the Health Foundations improvement programmes with relevant literature.METHODS:The authors analysed evaluation reports relating to five Health Foundation improvement programmes using a form of best fit synthesis, where a pre-existing framework was used for initial coding and then updated in response to the emerging analysis. A rapid narrative review of relevant literature was also undertaken.RESULTS:The authors identified ten key challenges: convincing people that there is a problem that is relevant to them; convincing them that the solution chosen is the right one; getting data collection and monitoring systems right; excess ambitions and projectness; organisational cultures, capacities and contexts; tribalism and lack of staff engagement; leadership; incentivising participation and hard edges; securing sustainability; and risk of unintended consequences. The authors identified a range of tactics that may be used to respond to these challenges.DISCUSSION:Securing improvement may be hard and slow and faces many challenges. Formal evaluations assist in recognising the nature of these challenges and help in addressing them.
via Ten challenges in improving quality in healthca… [BMJ Qual Saf. 2012] – PubMed – NCBI.
Written by Brian S McGowan, PhD
Brian is a research scientist and educational technologist. He helped transform Pfizer’s Medical Education Group and previously served in educational leadership roles at HealthAnswers, Inc.; Acumentis, LLC.; Cephalon; and Wyeth. He taught graduate medical education programs at Arcadia University for 10 years. Dr. McGowan recently authored the book "#socialQI: Simple Solutions for Improving Your Healthcare" and has been invited to speak internationally on the subject of information flow, technology, and learning in healthcare.
