Theory

Becoming Science : Science of Becoming.

Improvement science as a science of practice is not about ‘getting things done’ but about ‘doing things’. Batalden characterized the moral engagement required for professional ‘becoming’ as not only ‘doing ones work’ but also ‘improving ones work’. It is not … Continue reading

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Improvement DNA : Triple Aim from Double Helix.

Geometries have always played a predominant ‘regulative’ role in human reasoning. The triangle was justifiably considered the most stable of geometric shapes by the ancients. The Egyptians chose it as the basis for their pyramids.The Buddhists found the circle to … Continue reading

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Doctor, don’t kill me with Improvement.

Artificial sciences are in-separable from human interests. One can speak  of purpose of an event only because we are [ or someone is ]    involved in the beginning, middle and end of the event. Natural events are usually understood as … Continue reading

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Communities of Care: From Systems to Lifeworlds

From Systems to Lifeworlds. “The ‘art of Improvement’ is the radical notion that patients are  people “. Improvement is not a disinterested science. But, humanism per se, as embodied in the individualistic notion of ‘care’, though necessary, is not a … Continue reading

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Before Method: The Capability Manifesto

The Capability Manifesto:  Quality as Capability. Improvement is a capability science. Aristotle in his ‘Metaphysics’  made the distinction between the potential and actual. Improvement Science exists because of the gap between efficacy and effectiveness; between fact and value; between the general … Continue reading

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Improvement Studies: The two cultures.

Improvement Science has arrived in practice.But its theory and pedagogy lag behind. It works in practice , but does it work in theory. This ontological anxiety spills over into epistemology and pedagogy. We need to identify two categories of pedagogy: … Continue reading

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Creative Research : Discovery in Practice.

Improvement  Science is the adoption of profound knowledge to healthcare practice.Profound Knowledge as a theory of Improvement is concerned with both performance and transformation. However, the knowledge , the ethos and substrate of performance and transformation are different. While mechanical … Continue reading

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The Uses and Limitations of Pragmatism.

An action is judged by the result. Research as an activity provides a warrant only for efficacy. Efficacy is not the same as effectiveness. Evidence is not the same as ‘Effect’. This is the central problem of the epistemology of … Continue reading

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Scientific Practice : The Missing Epistemology.

The strength of medicine as a profession is that it values knowledge. It is a learned profession. It admires expertise and experience. While true, this characterization can also be understood as a weakness: To know is to act.Knowledge is virtue. … Continue reading

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Room for Improvement: Local Action.

Global Quality and Ground Realities: A Look at Healthcare Global Quality Systemically-Global, Inter-national, Trans-cultural. Change efforts fail often due to one of two reasons. When they are implemented with passion but without systems or with systems without passion– Tom Peters … Continue reading

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Meta-Effectiveness: A Meta-Theory of Improvement.

Capability for Improvement  is dependent on the opportunity-ie the rationale and right to engage with the system. It is the awareness of the ‘freedoms’ and ‘unfreedoms’ that  support or prevent the participation of individuals in changing the system. Thus system … Continue reading

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Quality as Moral Progress: Science and Conscience.

“Quality is nothing but care writ large and sure”  with abject apologies to Rudolf Virchow. There are two defining characteristics of human beings: The need to know and the need to improve. The foundational question in any science including medicine … Continue reading

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Quality at the Bottom of the Pyramid

Not only must a future be imagined, it must be built. … – C. K. Prahalad and Gary Hamel This entry is to mark my respects for Prof.C.K.Prahalad who unexpectedly passed away today  in the US. Even though his work … Continue reading

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The Logical Structure of Improvement Science.

  Improvement science may be defined as the study of the cumulative effectiveness of system change under bounded Predictability[Uncertainty and Complexity]. It is my contention that the various components of this definition are sufficient to characterize the essence of the … Continue reading

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Defining Improvement Science: a means to a beginning.

” Nothing new can ever be learned by analyzing definitions. Nevertheless, our existing beliefs can be set in order by the process and order is an essential element of intellectual economy , as of every other ‘ – Charles. S. … Continue reading

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Improvement as Freedom : Learning from Development.

This entry was earlier posted as ‘System as Praxis’ but has been revised and expanded under the present title, to emphasize the ‘opportunistic’ nature and the ‘liberalizing moment’ in improvement. A Prolegomena to a Metaphysics of Improvement: ‘Quality is the … Continue reading

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Safety by Design

Safety is implicit in the medical professional’s social contract. To begin with it was seen as social attitude and individual intention. Yet harm remained inevitable due to the uncertainty of the knowledge base However, while greater certainty has been achieved … Continue reading

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Road Ahead Map

‘Quality is the relentless pursuit of the basics’ -Peter Drucker. Conceptual building blocks. Coming Soon! For the time being here is something for you to contemplate . i am sure you will add more categories.

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Action at a Academic Distance.

Welcome to the base-camp of Improvement Methodology ! ‘There is nothing so practical as a good theory.’ – Kurt Lewin The word Improvement Science is a declaration of the maturity of field and an independence from its ‘translational’ adolescence . The development … Continue reading

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