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Learning from Quality Improvement
Author Bio
Introduction
The Challenges of Pragmatic Science
The First Element
The Second Element
Currently selected section: The Third Element
The Fourth Element
Self Test
Conclusion

 


Chapter 13: Learning from Quality Improvement in Healthcare Systems: The Third Element: A Trial and Learning Approach to Improvement
 
     

The epistemology of quality improvement is learning through trial and observation of effects. The system evolves as changes are made and new knowledge is gained about what improves performance. Only in very focused improvement efforts can the intervention or change be replicated without modifications in the study units. A framework is needed that allows caregivers to learn what adaptations to make under conditions encountered in the daily care of patients. One example of a framework is the Model for Improvement, illustrated below (Langley et al., 1996; Berwick, 1996). The model consists of three questions that provide the basis for learning and a Plan-Do-Study-Act Cycle for testing and implementing changes. Click on the questions to learn more.

Figure 5.1 Plan-Do-Study-Act Cycle
Graphic depiction of Plan-Do-Study-Act Cycle, described in text.

Source: Langley G, Nolan K, Nolan T, Norman C, Provost L. The Improvement Guide: A Practical Approach to Enhancing Organizational Perfromance. San Francisco, CA: Jossey-Bass; 1996:10. Reprinted with permission from Associates in Process Improvement (API).

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