Quality improvement: theory and practice

In October 2008, the NHS Institute for Innovation and Improvement published a report which focused on the many quality improvement approaches used in health care (Boaden et al, 2008). It reviewed the Plan-Do-Study-Act (PDSA) cycle, Statistical Process Control (SPC), Six Sigma, Lean thinking, Theory of Constraints (TOC) and Mass Customisation, and drew on academic and empirical sources of information to provide a series of challenges for healthcare managers and leaders. Quality improvement approaches from industry are increasingly applied in health care and this article considers what evidence exists of their effectiveness and applicability.