Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries

Abstract

With the aim to explore how improvement science is understood, taught, practiced, and its impact on quality healthcare across Europe, the Improvement Science Training for European Healthcare Workers (ISTEW) project “Improvement Science Training for European Healthcare Workers” was funded by the European Commission and integrated by 7 teams from different European countries. As part of the project, a narrative literature review was conducted between 2008 and 2019, including documents in all partners’ languages from 26 databases. Data collection and analysis involved a common database. Validation took place through partners’ discussions. Referring to healthcare improvement science (HIS), a variety of terms, tools, and techniques were reported with no baseline definition or specific framework. All partner teams were informed about the non-existence of a specific term equivalent to HIS in their mother languages, except for the English-speaking countries. A lack of consensus, regarding the understanding and implementation of HIS into the healthcare and educational contexts was found. Our findings have brought to light the gap existing in HIS within Europe, far from other nations, such as the US, where there is a clearer HIS picture. As a consequence, the authors suggest further developing the standardization of HIS understanding and education in Europe.

Qualitative evaluation of an educational intervention about healthcare improvement for nursing students

“…Los resultados demuestran la importancia de Healthcare Improvement Science en todas las etapas profesionales y educativas de la enfermería (12)(13)23), así como la falta de formación al respecto puesto que el 100 % de estudiantes no había tenido contacto con la materia previamente. La implementación de los módulos del proyecto ISTEW contribuyen al objetivo principal del mismo: la diseminación e implantación de la cultura de HIS en toda Europa (8).…”

“…Hay ejemplos de proyectos concretos en España, Suecia, Reino Unido o Irlanda, entre otros (10)(11). Sin embargo, como quedó patente tras el proyecto europeo Improvement Science Training for European Healthcare Workers (ISTEW) de 2013 a 2015, a nivel educativo, HIS en Europa sigue siendo una ciencia emergente ya que no en todos los países existe educación específica en mejoras y, si existe, no se encuentra estandarizada (12). Uno de los resultados principales de este proyecto fue la creación de cuatro módulos universitarios específicos sobre HIS, acreditados por Higher Education Institutions (HEIs) (8).…”

Transforming the Future Healthcare Workforce across Europe through Improvement Science Training: A Qualitative Approach

“…From 2013 to 2015 the Improvement Science Training for European Healthcare Workers (ISTEW) project funded by the European Commission evidenced the gap in the provision of accredited health improvement science (HIS) education across Europe and outlined the need to improve quality of care services and related education. The most representative ISTEW outcomes were (a) the European HIS consensus definition, known as the Bled definition, (b) four HIS training modules, and (c) the Healthcare Improvement Science Evaluation Framework (HISEF) [7][8][9]. The Bled definition defines HIS in the European context as "the generation of knowledge to cultivate change and deliver person-centered care that is safe, effective, efficient, equitable and timely.…”

“…Since the 1980s improvement science has been developed extensively, focusing on health outcomes from an economic and efficiency perspective. In the U.S., the Institute of Health Improvement (IHI) has been focused for decades on the creation of specific improvement education, its implementation in healthcare contexts, and dissemination in their healthcare system [8]. Across the European countries, differences among HIS understanding and practice have been evidenced.…”

“…In the European educational field specifically, the differences are even more evident. For instance, in Slovenia only 4% of the European Quality Assurance Register for Higher Education (EQUAR) courses include HIS contents, a figure similar to that of Italy (7%), followed by Poland (10%), and far behind England (27%) and Romania (25%) [8].…”