Why is it that in spite of all the health policy reforms, clinical practice innovations, increasing intersectoral interdependencies and new medical and informationtechnologies, so little has changed in the way we research and evaluate health care?Don’t these changes cry out for new ways of being studied and appraised? Anddon’t our approaches to clinical practice innovation cry out for being reinventedtoo? Surely, we cannot continue to wheel out research and evaluation paradigms, improvement approaches and methods that were designed for 20th centuryproblems and 20th century health care, and assume they will be able to make senseof the problems we experience and the care we provide in the 21st century?These changes necessitate a new paradigm of health service research, evaluationand improvement and this new model adopts approaches and methods thatembrace complexity. The approaches and methods can account for the vicissitudesof front-line care, the activities of front-line staff and the experiences of patients andfamilies – where care happens. Visualising Health Care Practice Improvement draws on years of video feedbackresearch shaping an approach that enables not only a retrospective understandingbut also a view into the future, of what might be possible. It presents the argumentthat change is not principally about adopting solutions from elsewhere but thatit is conditional on people exploring whether proposed solutions suit existinghabituations. It involves a process of exploration, discovery, secession and renewal. Health care managers, policy makers and shapers will find this book enlightening. It will also be empowering to all health care professionals and front-line staff.
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