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

Int J Environ Res Public Health. 2019 Nov 14;16(22):4480. doi: 10.3390/ijerph16224480.


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.

Keywords: consensus statement; health education; healthcare improvement science; narrative review; patient-centered care; quality improvement.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Delivery of Health Care / organization & administration*
  • Delivery of Health Care / statistics & numerical data*
  • Europe
  • Female
  • Health Personnel / education*
  • Humans
  • Male
  • Middle Aged
  • Patient-Centered Care / organization & administration*
  • Patient-Centered Care / statistics & numerical data*
  • Quality Improvement / organization & administration*
  • Quality Improvement / statistics & numerical data*