ArticleBMJ quality & safety2012
Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature.
Article in BMJ quality & safety, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 264 papers, 12 of them syntheses that pooled it.
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Who cites it
264 citing papers in PubMed, 12 syntheses or guidelines pooled it.
- How Have Quality Improvement Strategies Been Adopted and How Has Impact Been Assessed in Care Homes for Older People? A Systematic Search and Narrative Review.International journal of older people nursing · 2025Pooled it
- What are the mechanisms of effect of group antenatal care? A systematic realist review and synthesis of the literature.BMC pregnancy and childbirth · 2024Pooled it
- Impact of hospital accreditation on quality improvement in healthcare: A systematic review.PloS one · 2023Pooled it
- A meta-review of methods of measuring and monitoring safety in primary care.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2021Pooled it
- Measurement and monitoring patient safety in prehospital care: a systematic review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2021Pooled it
- Systems approach to health service design, delivery and improvement: a systematic review and meta-analysis.BMJ open · 2021Pooled it
- Does team reflexivity impact teamwork and communication in interprofessional hospital-based healthcare teams? A systematic review and narrative synthesis.BMJ quality & safety · 2020Pooled it
- Patient feedback to improve quality of patient-centred care in public hospitals: a systematic review of the evidence.BMC health services research · 2020Pooled it
- Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Realist synthesis of intentional rounding in hospital wards: exploring the evidence of what works, for whom, in what circumstances and why.BMJ quality & safety · 2018Pooled it
- Comprehensive process model of clinical information interaction in primary care: results of a "best-fit" framework synthesis.Journal of the American Medical Informatics Association : JAMIA · 2018Pooled it
- The effects of care bundles on patient outcomes: a systematic review and meta-analysis.Implementation science : IS · 2017Pooled it
- Understanding the challenges and successes of implementing 'hybrid' interventions in healthcare settings: findings from a process evaluation of a patient involvement trial.BMJ quality & safety · 2025Trial
- Effect of hands-on interprofessional simulation training for local emergencies in Scotland: the THISTLE stepped-wedge design randomised controlled trial.BMJ quality & safety · 2020Trial
- Improving care at scale: process evaluation of a multi-component quality improvement intervention to reduce mortality after emergency abdominal surgery (EPOCH trial).Implementation science : IS · 2018Trial
- THISTLE: trial of hands-on Interprofessional simulation training for local emergencies: a research protocol for a stepped-wedge clustered randomised controlled trial.BMC pregnancy and childbirth · 2017Trial
- Development of the Learning Health Systems Toolkit: A Collaborative Effort to Bridge Concept and Practice.Learning health systems · 2026Article
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- UK-Africa Leadership Fellowship for Antimicrobial Stewardship (UK-ALF-A): A Bilateral Learning Approach to Advancing AMS Expertise Among Pharmacists.Antibiotics (Basel, Switzerland) · 2026Article
- Welcome to the jungle: collection and evaluation of quality indicators with the QUALICATOR instrument.BMJ quality & safety · 2026Article
204 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFormal evaluations of programmes are an important source of learning about the challenges faced in improving quality in healthcare and how they can be addressed. The authors aimed to integrate lessons from evaluations of the Health Foundation's improvement programmes with relevant literature.
methodsThe authors analysed evaluation reports relating to five Health Foundation improvement programmes using a form of 'best fit' synthesis, where a pre-existing framework was used for initial coding and then updated in response to the emerging analysis. A rapid narrative review of relevant literature was also undertaken.
resultsThe authors identified ten key challenges: convincing people that there is a problem that is relevant to them; convincing them that the solution chosen is the right one; getting data collection and monitoring systems right; excess ambitions and 'projectness'; organisational cultures, capacities and contexts; tribalism and lack of staff engagement; leadership; incentivising participation and 'hard edges'; securing sustainability; and risk of unintended consequences. The authors identified a range of tactics that may be used to respond to these challenges. DISCUSSION: Securing improvement may be hard and slow and faces many challenges. Formal evaluations assist in recognising the nature of these challenges and help in addressing them.
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