Beyond evidence: the micropolitics of improvement.

Abstract:

:This paper aims to draw attention to the social and micropolitical dimensions of attempting to implement improvements within healthcare organisations. It is argued that quality improvement initiatives, like other forms of organisational innovation, will fail unless they are conceived and implemented in such a way as to take into account the pattern of interests, values and power relationships that surround them. Drawing on examples, it is suggested that innovators can intervene more successfully if they understand how the benefits and costs of interventions are likely to be distributed among stakeholders within their setting, how different but equally legitimate value sets may structure peoples' understanding of them and how the nature of the interventions themselves (and, in particular, the shape of their hard core and soft periphery) might provide scope for redesigning or adapting interventions in ways that are likely to make them both more effective and politically feasible.

journal_name

BMJ Qual Saf

journal_title

BMJ quality & safety

authors

Langley A,Denis JL

doi

10.1136/bmjqs.2010.046482

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

i43-6

eissn

2044-5415

issn

2044-5423

pii

20/Suppl_1/i43

journal_volume

20 Suppl 1

pub_type

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