Developing a standard definition of the "science of improvement" can enhance healthcare organizations' improvement efforts, according to a commentary in Quality Management in Health Care.
The term "science of improvement" refers to a scientific approach to improvement that can be applied to a diverse range of settings. However, a lack of standard definitions and principles creates confusion, the authors argue. They present seven propositions to form the basis of the science of improvement, which healthcare organizations can use to improve the delivery of care:
1. The science of improvement is grounded in testing and learning cycles. The Plan, Do, Study, Act cycles align with the scientific method, according to the report.
2. The philosophical foundation of the science of improvement is conceptualistic pragmatism. Theories or predictions of changes should be informed by prior knowledge and experience, a principle similar to conceptualistic pragmatism, which states that all observations are informed by past experiences, according to the report.
3. The science of improvement embraces a combination of psychology and logic. This proposition supports multidisciplinary collaboration and the value of multiple perspectives on a problem.
4. The science of improvement considers the contexts of justification and discovery. Improvement efforts should balance discovery and creativity with a form of justification such as data.
5. The science of improvement requires the use of operational definitions. Everyone involved in the improvement effort needs to understand the stated definition of terms.
6. The science of improvement employs Shewhart's theory of cause systems. Walter Shewhart developed the idea of a control chart — a tool to help people distinguish between common or special cause variation, which affects decision-making, according to the report.
7. Systems theory directly informs the science of improvement. The science of improvement requires people to think of an organization as a collection of interdependent people and processes, called systems thinking, according to the report.
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