TitleDemystifying theory and its use in improvement
AuthorsFrank Davidoff, Mary Dixon-Woods, Laura Leviton, Susan Michie
Published journalBMJ Quality & Safety
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.
You might also like...
Invitation to tender
The deadline for responses is 12.00 on Tuesday 5 November 2019.
Dr Nicola Burgess on the practical value of creating formal spaces to spread informal knowledge within organisations.
OnlyWan response to NHS England monthly performance stats for September.
We explore five challenges that need to be addressed if we're to harness the full potential of data and technology…
Work with us
We look for talented and passionate individuals as everyone at the OnlyWan has an important role to play.View current vacancies
The Q Community
Q is an initiative connecting people with improvement expertise across the UK.Find out more