It is a deliberate antidote to the anti-intellectual, QI tool driven, mechanistic approach that still dominates much of healthcare quality improvement work. The authors - both of whom have extensive experience of working in and around quality issues in healthcare at a national, regional and local level - challenge such approaches, which they believe fail to take account of patient and organisational context and invite reductionism, cherry picking, atomisation of complex issues, leading ultimately to simplistic and unsustainable outcomes.
Key features of the book:
· An exploration of some of the often-overlooked and misunderstood core concepts of quality; their history and meaning in a contemporary context.
· A framework to "question the work" using four interconnected conceptual domains as a valuable framework to consider improving quality and reducing failure demand.
· Critical re-examination of the dominant approaches to change that are frequently adopted in "quality" work, many of which have been rooted in scientific management that have failed to live up to their promise - particularly transformational.
· Exploring how an inter-disciplinary perspective can reframe aspects of quality thinking.
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I was particularly drawn towards the chapters on Cultures of Quality and "Supporting the Human System at Work in which they discuss a wide range of issues that impact on safety. They cite a lot of the great work done by Prof Mary Dixon-Woods (often referred to in this newsletter) and the Harmed Patient Alliance work on "compounded harm . Although the book is unashamedly an academic text, it s also pretty accessible, and offers a thoughtful analysis of how to understand some complex issues with case study examples to illustrate their points.
James Titcome OBE email 20240119