The Vin McLoughlin Symposium on the Epistemology of Improving Quality

In April 2010 we co-hosted The Vin McLouglin Symposium on the Epistemology of Improving Quality. Why?

Improving the quality of healthcare is a meeting ground for many academic disciplines.

Each has a different language, sets of assumptions, methods and sources of data. We wanted to explore whether different disciplines could learn from one another to generate new perspectives and stimulate further thinking about how to define the science of improving the quality of healthcare.

We brought together 30 leading scholars from a diverse range of disciplines. Some of the key themes to emerge were:

• Quality improvement theory and key approaches such as the Collaborative model need further development. There can be a tendency to ‘rush into’ interventions before being clear on the theory and expectations of success that should underpin its design and implementation. Interventions can sometimes fail because the failure of the underlying theory.
• We need to describe well the implementation of interventions and the process of adapting proven interventions to help us understand why there is often a ‘voltage drop’ between programme ambition and implementation.
• We need theories about healthcare system behaviour and not just theories about individual clinician behaviour. Can we achieve macro system change with just micro level interventions and what can be learn from social movements about how to catalyse large-scale change?

The findings were published in a special supplement of Quality and Safety in Health Care in 2011. It's a substantial statement about the coherence of the underlying science of improvement and asks the question ‘do we already have all the scholarly building blocks in place or do we need a paradigm shift in our view of how best to improve care?’.