This review analyses evaluation reports from five Health Foundation improvement programmes. It identifies ten key challenges:
- Convincing people there is a problem of relevance to them.
- Convincing people that the solution chosen is the right one.
- Getting data collection and monitoring systems right.
- Excessive ambition and “projectness” (project orientation).
- Organisational cultures.
- Capacities and contexts.
- Tribalism and lack of staff engagement.
- Incentivising participation and “hard edges”.
- Securing sustainability.
- Unintended consequences.
This article identifies important considerations when working to improve the quality of health services and discusses the risks and downsides. The authors suggest a range of tactics to respond to these challenges.
Dixon-Woods, M. McNicol, S. [and] Martin, G. (2012). Ten challenges in improving quality in healthcare: lessons from the Health Foundation’s programme evaluations and relevant literature. BMJ Quality and Safety, October 2012, Vol.21(10), pp.876-84. (Click here to view the PubMed abstract).