"But why is that better?" An investigation of what applied philosophy and ethics can bring to quality improvement work in healthcare.

Quality improvement (QI) aims to tackle the shortcomings of health services, but improvement initiatives do not always work and sometimes create new problems. One reason for these failures is that people have different ideas about what counts as good quality, and quality is often interpreted in ways that fail to capture aspects of healthcare (including healthcare experiences) that matter to people.

The “But why is that better?” project uses the tools of applied philosophy to help deliver on the promise, and avoid the pitfalls of quality improvement in healthcare. It is funded by a Wellcome Trust Collaborative Award to Professor Alan Cribb (King’s College London) and Professor Vikki Entwistle. The project includes interviews with QI leaders, collaborative working with QI partners, knowledge exchange events, and reflection on the methodological challenges of building applied philosophy into QI.

For more information please visit https://www.kcl.ac.uk/research/but-why-is-that-better-project or Twitter @phil4hcq.

Contacts

Vikki Entwistle; vikki.entwistle@abdn.ac.uk

Status

Ongoing - In analysis

Publications

Entwistle VA, McCann S, Loh VWK, Tai ES, Tan WH, Yew TW. Implementing and evaluating care and support planning: a qualitative study of health professionals’ experiences in public polyclinics in Singapore. BMC Primary Care, 2023, 24: 212. https://doi.org/10.1186/s12875-023-02168-5

Mitchell P, Cribb C, Entwistle V. Truth and consequences. MetaPhilosophy, 2023, https://doi.org/10.1111/meta.12644

Entwistle VA, Cribb A, Mitchell P. Tackling disrespect: the importance of relational understandings of equality. Journal of Health Services Research and Policy, 2023, https://journals.sagepub.com/doi/10.1177/13558196231187961

Cribb A, Mitchell P, Entwistle V. Varieties of improvement expertise: knowledge and contestation in healthcare improvement. Sociology of Health and Illness 2023 https://onlinelibrary.wiley.com/doi/epdf/10.1111/1467-9566.13616

Mitchell P, Cribb A, Entwistle V. A wide vocabulary for person-centred care. Future Healthcare Journal, 2023; 10(1): 82-84.

Mitchell P, Cribb A, Entwistle V. Patient safety and the question of dignitary harms. Journal of Medicine and Philosophy, 2023; 48(1): 33-49 https://doi.org/10.1093/jmp/jhac035

Entwistle VA, Cribb A, Mitchell P, Walter S. Unifying and universalising Personalised Care? An analysis of a national curriculum with implications for policy and education relating to person-centredcare. Patient Education and Counseling 2022; 105(12): 3422-3428 https://pubmed.ncbi.nlm.nih.gov/35965218/

Mitchell P, Cribb A, Entwistle V. Vagueness and variety in person-centred care [version 1; peer review: 2 approved]. Wellcome Open Research 2022;7:170. DOI: 10.12688/wellcomeopenres.17970.1

Cribb A, Entwistle V, Mitchell P. Talking it better: conversations and normative complexity in healthcare improvement. Medical Humanities, 2022; 48: 85-93. http://dx.doi.org/10.1136/medhum-2020-012129

Mitchell P, Cribb A, Entwistle V. Made to measure: the ethics of routine measurement for healthcare improvement. Health Care Analysis 2021; 29: 39-58. https://link.springer.com/article/10.1007/s10728-020-00421-x

Mitchell P, Cribb A, Entwistle V, Singh G. Pushing poverty off limits: quality improvement and the architecture of healthcare values. BMC Medical Ethics, 2021; 22: 91. https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-021-00655-x

Walker MJ, Rogers WA, Entwistle VA. The ethical and epistemic roles of narrative in person-centred healthcare. European Journal for Person Centred Healthcare. 2020; 8(3)

Cribb A, Mitchell P, Entwistle VA. What does ‘quality’ add? Towards an ethics of healthcare improvement. Journal of Medical Ethics, 2020; 46(2):118-120. doi:10.1136/medethics-2019-105635

Mitchell P, Cribb A, Entwistle VA. Defining what is good: pluralism and healthcare quality. Kennedy Institute of Ethics Journal, 2019; 29(4): 367-388.