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• W2034167834 abstract "The field of improvement science in health care is broad, including all areas of research that investigate improvement strategies in care, systems, safety, and policy. Improvement of quality, value, and safety are imperatives across health services, supported by policy, patient advocacy, and health-care professionals, yet research to establish which interventions are effective has been insufficient at best. Although the need for evidence is high, corresponding capacity among health services researchers to conduct rigorous, well designed studies focused on implementation is lacking. Attempts to use research evidence to inform practice have included translational research targets, evidence-based care, evidence-based quality standards, risk management, error prevention, organisational development, leadership and front-line enhancement, and complex adaptive systems frameworks.1Grol R Baker R Moss F Quality improvement research: understanding the science of change in health care. BMJ Books, London2004Google Scholar Nevertheless, most improvement interventions are insufficiently evaluated. Well designed investigations and sufficient sample sizes and follow-up are needed to understand cause and effect and produce robust findings. The over-riding goal of improvement science is to ensure that quality improvement efforts are based as much on evidence as the best practices they seek to implement.2Shojania KG Grimshaw JM Evidence-based quality improvement: the state of the science.Health Aff (Millwood). 2005; 24: 138-150Crossref PubMed Scopus (472) Google Scholar Simply put, strategies for implementing evidence-based quality improvement need an evidence base of their own. The Health Foundation is aiming to build research capacity across the UK to develop this area of research and to counter the deficits that contribute to patchy implementation, with mixed results in replication of interventions that have shown improvement in specific contexts. Methodological shortcomings include problems with design and analysis of interventions and poor reporting of results. We aim to support leading researchers to develop a sound theoretical, empirical, and experiential evidence base and to adopt a more scientifically rigorous approach to development, evaluation, and dissemination of quality improvement methods. We have developed a 3-year post-doctoral fellowship in applied improvement science research, funding applicants whose work looks likely to have greatest effect for improved care. An intensive leadership and personal development component is core to the fellowship, with the aim of strengthening the skills of the future leaders of the field. Fellows are supported by a collaborating group drawing in theory from a range of disciplines. Wider opportunities are needed in improvement science. Fellowship applicants tend to be deeply entrenched within one discipline, so we now offer PhD funding to help to make improvement science a credible and inviting area for a research career. The programme encourages senior academics to collaborate across disciplines to create centres for improvement science research, building links between academia and front-line services to implement scientifically rigorous improvement interventions. Research in this field is improving understanding not only of which interventions can improve quality of care, but also how and where they work, to enable the spread of successful approaches through deeper understanding of the context in which they have worked. What is clear is that we cannot eliminate context and therefore we must understand how context affects an improvement intervention in the complex setting of a health-care service. Through better reporting and robust evaluation we can replicate success and avoid continuing with interventions that are ineffective. Helen Crisp is Assistant Director of Research at The Health Foundation, London, UK." @default.
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• W2034167834 title "Building the field of improvement science" @default.
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• W2034167834 doi "https://doi.org/10.1016/s0140-6736(15)60320-8" @default.
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