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Demystifying theory and its use in improvement

BMJ quality & safety, 2015-03, Vol.24 (3), p.228-238 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. ;Copyright: 2015 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2015 ;ISSN: 2044-5415 ;EISSN: 2044-5423 ;DOI: 10.1136/bmjqs-2014-003627 ;PMID: 25616279

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  • Title:
    Demystifying theory and its use in improvement
  • Author: Davidoff, Frank ; Dixon-Woods, Mary ; Leviton, Laura ; Michie, Susan
  • Subjects: Health Services Research - organization & administration ; Humans ; Models, Theoretical ; Quality Improvement - organization & administration ; Research and Reporting Methodology ; Researchers ; Science ; Studies ; Theory
  • Is Part Of: BMJ quality & safety, 2015-03, Vol.24 (3), p.228-238
  • Description: The role and value of theory in improvement work in healthcare has been seriously underrecognised. We join others in proposing that more informed use of theory can strengthen improvement programmes and facilitate the evaluation of their effectiveness. Many professionals, including improvement practitioners, are unfortunately mystified—and alienated—by theory, which discourages them from using it in their work. In an effort to demystify theory we make the point in this paper that, far from being discretionary or superfluous, theory (‘reason-giving’), both informal and formal, is intimately woven into virtually all human endeavour. We explore the special characteristics of grand, mid-range and programme theory; consider the consequences of misusing theory or failing to use it; review the process of developing and applying programme theory; examine some emerging criteria of ‘good’ theory; and emphasise the value, as well as the challenge, of combining informal experience-based theory with formal, publicly developed theory. We conclude that although informal theory is always at work in improvement, practitioners are often not aware of it or do not make it explicit. The germane issue for improvement practitioners, therefore, is not whether they use theory but whether they make explicit the particular theory or theories, informal and formal, they actually use.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 2044-5415
    EISSN: 2044-5423
    DOI: 10.1136/bmjqs-2014-003627
    PMID: 25616279
  • Source: BMJ Open Access Journals
    MEDLINE
    Alma/SFX Local Collection
    ProQuest Central
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