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The Hayes, Batalden and Goldmann piece is an important contribution to the debate about what exactly is practice improvement. Most practice improvement thinking is anchored in the ‘innovation’ paradigm, and this paradigm is predominantly ‘gadget thinking’. Others’ solutions are to be adopted here because they produce great outcomes elsewhere. Except now we have to figure out how we can get the gadget to work. Few commentators have been game to shift towards acknowledging that care practices are now too complex for ‘gadget thinking’. Hayes and colleagues are an exception. They propose that frontline professionals themselves need to become smarter at ‘codesigning’ solutions that suit their unique contexts …
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