3 How do I determine improvement and identify progress?
Having explored the notion of ‘service’, you are ready to reflect on the terms improvement and progress. The two terms are not quite the same thing. Improvement implies a direction, working towards stated aims, and a new state of affairs. Progress is more about the monitoring of events, experiences, behaviour or outcomes to gauge whether a service is going in the right direction.
It is notable that key aspects of healthcare quality and quality improvement do not include cost (The Health Foundation, 2013). In other words, we should work towards an ideal. However, quality is a slippery concept and relates to that which is valued in any given context. In medicine, this focuses upon the best possible health outcome in the light of current medical knowledge. You are left to debate what constitutes an outcome. Quality improvement may focus on some or all of the following:
- patient experience
- effectiveness of the intervention
It can be valuable to first clarify your own understanding of improvement associated with the service with which you are most familiar.
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