ArticleHealth care analysis : HCA : journal of health philosophy and policy2018
"Don't Mind the Gap!" Reflections on Improvement Science as a Paradigm.
Article in Health care analysis : HCA : journal of health philosophy and policy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Bridging the Silos: A Comparative Analysis of Implementation Science and Improvement Science.Frontiers in health services · 2021Pooled it
- Interprofessional Learning and Improving at the Paediatric Ward: A Participatory Action Research Practising Safety-II Theory.Journal of evaluation in clinical practice · 2025Article
- What is improvement science, and what makes it different? An outline of the field and its frontiers.Frontiers in health services · 2024Article
- Pushing poverty off limits: quality improvement and the architecture of healthcare values.BMC medical ethics · 2021Article
- Making way for a clinical feedback system in the narrow space between sessions: navigating competing demands in complex healthcare settings.International journal of mental health systems · 2019Article
- Defining What is Good: Pluralism and Healthcare Quality.Kennedy Institute of Ethics journal · 2019Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Responding to this issue's invitation to bring new disciplinary insights to the field of improvement science, this article takes as its starting point one of the field's guiding metaphors: the imperative to "mind the gap". Drawing on insights from anthropology, history, and philosophy, the article reflects on the origins and implications of this metaphoric imperative, and suggests some ways in which it might be in tension with the means and ends of improvement. If the industrial origins of improvement science in the twentieth century inform a metaphor of gaps, chasms, and spaces of misalignment as invariably imperfect and potentially dangerous, and therefore requiring bridging or closure, other currents that feed the discipline of improvement science suggest the potential value and uses of spaces of openness and ambiguity. These currents include the science of complex adaptive systems, and certain precepts of philosophical pragmatism acknowledged to inform improvement science. Going a step further, I reflect on whether or not these two contrasting approaches within improvement science should be treated as incommensurable paradigms, and what each approach tells us about the very possibility of accommodating seemingly irreconcilable or incommensurable approaches within improvement science.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.