Introduction: There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and 'change making' should become an intrinsic part of everyone's job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy.
Methods: This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania.
Results: A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: 'Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.'
Conclusions: The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science.
Uvod: Skupno število raziskav na področju znanosti o uvajanju izboljšav vzdravstvu (Healthcare Improvement Science - HIS) je majhno. Vendar pa bi morala izboljševanje kakovosti in vpeljava sprememb postati neločljivo povezana z vsakodnevnim delom zdravstvenih delavcev na vseh področjih zdravstvenega sistema. Pomanjkanje teoreticnih izhodišč bi lahko delno pojasnilo nizko stopnjo prenosa rezultatov raziskav v zdravstveno politiko.
Metode: Namen članka je predstaviti postopek oblikovanja definicije za pojem znanost o uvajanju izboljšav v zdravstvu. Pri pristopu z metodami konsenza smo uporabili metodo Delfi, izvedeno v dveh krogih, panelne skupine strokovnjakov in tehnike konsenzne skupine. V skupini strokovnjakov in konsenzni skupini je sodelovalo 18 oseb, v okviru metode Delfi smo analizirali 153 odgovorov. Sodelujoče osebe so bile raziskovalci, izobraževalci in zdravstveni delavci iz Škotske, Slovenije, Španije, Italije, Anglije, Poljske in Romunije.
Rezultati: V drugem krogu metode Delfi je bila dosežena visoka stopnja konsenza (86-odstotna) za široko definicijo. Konsenzna skupina je oblikovala naslednjo končno definicijo: »Znanost o uvajanju izboljšav omogoca ustvarjanje znanj za izvajanje sprememb ter zagotavljanje v pacienta usmerjene zdravstvene obravnave, ki je varna, zmogljiva, učinkovita, pravična in pravočasna. Izboljšuje pacientove izide zdravstvene obravnave, sistem nudenja zdravstvenih storitev in zdravje populacije.«.
Razprava: Postopek oblikovanja dogovorne definicije je razkril različno razumevanje pojma znanost o uvajanju izboljšav v zdravstvu med sodelujočimi. Oblikovanje skupne dogovorne definicije je pomemben korak naprej, saj pripomore k splošnemu razumevanju tega pojma in s tem tudi k spodbujanju strokovnega izobraževanja in izvajanju znanosti o uvajanju izboljšav v praksi.
Keywords: Europe; consensus methods; definition; healthcare; improvements; science.