Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives

Milbank Quarterly - Tập 85 Số 1 - Trang 93-138 - 2007
Richard Grol1,2, Marije Bosch2, Marlies Hulscher2, Martin Eccles3, Michel Wensing2
1Maastricht University
2Radboud University Nijmegen
3Newcastle University

Tóm tắt

A consistent finding in articles on quality improvement in health care is that change is difficult to achieve. According to the research literature, the majority of interventions are targeted at health care professionals. But success in achieving change may be influenced by factors other than those relating to individual professionals, and theories may help explain whether change is possible. This article argues for a more systematic use of theories in planning and evaluating quality‐improvement interventions in clinical practice. It demonstrates how different theories can be used to generate testable hypotheses regarding factors that influence the implementation of change, and it shows how different theoretical assumptions lead to different quality‐improvement strategies.

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