Making an Impact? The Emergence of Improvement Science in Healthcare

By Julie E. Reed and Derek Bell.

Published by The International Journal of Science in Society

Format Price
Article: Print $US10.00
Article: Electronic Free Download

At an international level, public, political and economic pressures are increasing awareness of the high level of variation in the quality of health care provision. This knowledge has brought with it the realisation that a translational gap exists between the production of evidence-based scientific knowledge and the application of this evidence into everyday practice to improve patient experience, clinical outcomes and quality of care at a population level. Improvement science has emerged as a transdisciplinary effort to address this challenge. Evidence-based care recommendations typically stem from research that is conducted in controlled and artificial settings with additional resource and highly qualified staff. In comparison, real world frontline healthcare settings are complex adaptive social systems, and research from a wide range of academic disciplines suggests that it is a leap of faith to assume that outputs from research will simply translate to improvements in practice. The philosophy of improvement science questions the value of science to society. This paper considers the challenges that the philosophy of improvement science brings to traditional models for thinking about the value of science. The paper uses healthcare and healthcare research as an example to explore these concepts in detail and propose a new model, the Cycle for Improvement, to help reframe the relationship between science and society.

Keywords: Improvement Science, Translational Research, Implementation, Healthcare, Philosophy

The International Journal of Science in Society, Volume 4, Issue 4, pp.77-92. Article: Print (Spiral Bound). Article: Electronic (PDF File; 746.047KB).

Dr. Julie E. Reed

Health Foundation Improvement Science Fellow, Head of Research Strategy, National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London, Imperial College, London, UK

Julie Reed is a Health Foundation Improvement Science Fellow based at Imperial College London, United Kingdom. Her fellowship focuses on developing the scientific principles of improvement science and the challenges of acting scientifically in complex environments. She is also the head of research strategy for the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for northwest London (population ~ 2 million). The CLAHRC program promotes collaborative working between academics and practitioners to drive improvements in patient care across northwest London using a systematic and scientific evidence-based implementation approach.

Derek Bell

Imperial College, UK