Current state and future directions for improvement science: reflections from the 2024 International Forum on Quality and Safety in Healthcare (Shah, 2024)

Shah A; Hoffman JM; Twum-Danso N; Burlison J; Barker P;

BMJ leader [BMJ Lead] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.

Quality improvement (QI) is increasingly used as a mechanism to improve care and outcomes in healthcare. It is defined as the application of a systematic approach to solve a complex issue, involving those closest to the issue in discovering new solutions, testing these in practice and learning from the use of data.1 However, despite everyone’s best intentions, QI efforts often fail. Just like the way the holes in James Reason’s Swiss Cheese align when patient safety events occur, the reasons QI projects fail are multifactorial.2 Improving the rigour of our application of QI can ultimately make our efforts to improve care more successful. This field of study is known as improvement science.3 At the 2024 International Forum on Quality and Safety in Healthcare in London, convened by BMJ and the Institute for Healthcare Improvement (IHI), improvement science was included in the conference as one of six main content streams. Attendees of the forum included an international mix of clinicians, academics, professionals and even patients—all of whom have had some degree of involvement in healthcare improvement work. While the majority of participants were from Europe, approximately 50 different countries were represented at the conference. The goal was to highlight the latest thinking and learning in improvement science to enable us to advance the field. The improvement science sessions used didactic and interactive formats, including both commentary on published work and work in progress. Areas of interest to clinical, operational and improvement leaders were covered. The value of adopting practices more commonly used in other fields (ie, implementation science), largely novel uses of technology, and tactics to more consistently practice rigorous improvement science were highlighted throughout the stream.