Table 1

Health system improvement continuum

Activity characteristicsHealth system improvement activities
Quality improvement (QI) projectHealth management researchTranslational health management research
Purpose
  • To assess or promptly improve a process, programme, or system; or improve performance as judged by an accepted set of standards.

  • Apply known solutions to a problem or process, typically related to quality, safety, cost or productivity.38

  • Test concepts, theories or frameworks28; establish clinical practice standards where none are accepted.

  • Investigate issues important to organisations through stakeholder involvement.28

  • Develop and apply evidence for ongoing improved practice.7

  • Contribute to the evidence base through academic outputs.

Design
  • Uses established QI methodology, such as a Plan–Do–Study–Act model of change implementation.38

  • Single method research, applied in a single setting or context.38

  • Researcher driven using a systematic process of data collection, analysis and reporting to improve evidence base.

  • Single, multi or mixed methods research in single or multiple settings.38

  • Health organisation and university representatives’ partner in research topic selection, design and implementation processes.21 28

  • Systematic process of data collection and analysis. Single, multi or mixed methods research in single or multiple settings.

  • Dissemination of findings includes a plan for translation of findings into practice and academic outputs.7

Ethical review
  • Ethical review and informed consent are not typically required.38

  • May be required if consumers participate, or if staff act outside their usual scope of practice.

  • Review conducted by organisation where project is conducted, specific to the setting.

  • Required as may place subjects at negligible, low or high-level risk.

  • Required as may place subjects at negligible, low or high-level risk.

Benefits and outcomes
  • Designed to directly benefit the participating organisation, service or team. Normally, focused on improving patient care.

  • Findings are not easily translatable to other settings.38

  • Promptly improve an organisation’s programme, process or system linked to patient care.

  • Designed to benefit organisation, service or team participating.

  • Informs the broader research community and health sector.

  • Findings may be applicable to improving other contexts or organisations.

  • Research questions or hypotheses are addressed.

  • Strategically designed to enable the organisation, service or team to make changes in an informed and systematic way.7 28

  • Findings contribute to research literature and organisational/health management practice and inform policy.40

  • Research questions are addressed.

  • Translation/implementation is conducted and evaluated.7 28

Dissemination plan
  • Reporting to organisation, via internal forums or processes.

  • Potential publication in QI-focused journal.

  • May report to organisation, via internal forums or processes.

  • Dissemination through peer-reviewed research platforms.

  • Reporting to organisation, via internal forums or processes.

  • Dissemination through peer-reviewed research platforms, including publishing recommendations and implementation evaluation.