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'But why is that better?'

‘But why is that better?’ An investigation of what applied philosophy and ethics can bring to quality improvement work in healthcare is a research project funded by a Wellcome Trust Collaborative Award in Humanities and Social Science. The project runs for five years, from 2018–2023.

Quality improvement (QI) aims to tackle the shortcomings of health services, but QI initiatives do not always work and sometimes create new problems. One of the reasons for these failures is that people do not agree about what counts as good quality, and quality is often interpreted in ways that fail to capture the aspects of healthcare that matter to people.

This project uses the tools of applied philosophy to help deliver on the promise, and avoid the pitfalls, of healthcare QI. We think that applied philosophy can help elucidate and address the conceptual, ethical and practical challenges faced by researchers and quality improvement practitioners, with potentially transformative implications.

Aims

We will work with QI partners from diverse healthcare settings to address debates about quality and to understand how the potential harms and ethical challenges produced by QI can be better managed. We will pioneer a partnership approach to building applied philosophy into QI.

Methods

We will address these goals by integrating our applied philosophical scholarship with literature-based work; interviews with QI leaders; partnership working with QI sites; knowledge exchange events; and methodological innovation and reflection.

Project team

Professor Alan Cribb

Principal Investigator

 School of Education, Communication and Society, King’s College London
Professor Vikki Entwistle

Co-Investigator

 Health Services Research Unit and School of Divinity, History and Philosophy, University of Aberdeen
Dr Polly Mitchell Research Fellow School of Education, Communication and Society, King’s College London

Advisory group

Name Affiliations
Professor Natalie Armstrong

Department of Health Sciences, University of Leicester
Mr Jono Broad Quality Improvement Patient Involvement (QIπ)
Dr Sibylle Erdmann Ei SMART BMJ Patient Panel and parent carer to two children with healthcare needs
Professor Soren Holm Centre for Social Ethics and Policy, University of Manchester; Manchester Institute for Collaborative Research on Ageing, University of Manchester
Professor Christian Munthe Department of Philosophy, Linguistics and Theory of Science, University of Gothenberg
Professor Craig Ramsay

Health Services Research Unit, University of Aberdeen
Professor Rosamund Scott Centre of Medical Law and Ethics, King’s College London
Professor Nick Sevdalis

Centre for Implementation sciences, King’s College London; NHS National Institute for Health Research

Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London
Professor Justin Waring Centre for Health Innovation, Leadership and Learning, Nottingham University Business School
Professor James Wilson Department of Philosophy, University College London; Health Humanities Centre, University College London

Project team

Alan Cribb

Professor of Bioethics and Education

ECS-Polly Mitchell 850px

Polly Mitchell

Post Doctoral Research Fellow in Bioethics and Public Policy

Conferences

  • The ethical implications of improvement science research and practice: developing a research agenda.
    University of Liverpool, London campus. In conjunction with Dr Lucy Frith (University of Liverpool) and Professor Stacy Carter (University of Wollongong). Supported by the Institute of Medical Ethics
    29 April 2019
  • Development of ethical guidance for WHO on person centred approaches to healthcare
    Videoconference hosted by Centre for Biomedical Ethics, National University of Singapore. In conjunction with WHO Health Ethics and Governance Unit and Integrated Health Services Team, and National University of Singapore Centre for Biomedical Ethics
    27 February 2020

Talks

  • 'Applied philosophy and healthcare quality improvement.'
    Alan Cribb, Vikki Entwistle and Polly Mitchell
    Centre for Biomedical Ethics seminar series, National University of Singapore
    30 January 2019
  • 'The conversation between healthcare quality improvement and bioethics: where to begin.'
    Alan Cribb, Vikki Entwistle and Polly Mitchell
    The ethical implications of improvement science research and practice: developing a research agenda, University of Liverpool in London
    29 April 2019
  • 'Equity in healthcare improvement: where and how should it feature?'
    Vikki Entwistle, Alan Cribb and Polly Mitchell.
    The ethical implications of improvement science research and practice: developing a research agenda, University of Liverpool in London
    29 April 2019
  • 'Speaking out in research: ethical and practical challenges of managing disclosure of concerns.'Alan Cribb. THIS Space, THIS Institute, University of Cambridge
    4 September 2019
  • 'Why healthcare improvement needs philosophers'
    Polly Mitchell, Alan Cribb and Vikki Entwistle. Polygeia Annual Conference, King's College London
    9 November 2019
  • 'Equality in healthcare: why socio-relational theorising matters for healthcare improvement.'
    Vikki Entwistle, Alan Cribb and Polly Mitchell. AABHL NZB Conference, University of Otago, Dunedin
    21–23 November 2019

Publications

Media coverage

Project status: Ongoing

Principal investigators

Professor Alan Cribb

Professor of Bioethics and Education

Investigators

ECS-Polly Mitchell 850px

Polly Mitchell

Post Doctoral Research Fellow in Bioethics and Public Policy

Affiliations

Funding

  • Funding body: Wellcome Trust
  • Amount: £721,710
  • Period: December 2018 - December 2023

Contact

Keywords

  • Applied
  • philosophy
  • ethics
  • healthcare