Batalden and Davidoff1 have proposed a framework for sustaining quality improvement (QI) efforts in healthcare: a triad of continual improvement of patient and population outcomes; better system performance; and better professional training and development—all tightly linked. They suggest that several knowledge systems should interact for the deeper understanding of quality improvement. This has deep implications for both the content in healthcare professional education and research methodologies. The two papers by Hoffman et al23(see pages 278 and 283) provide excellent examples of research into the model found in the proposal from Batalden and Davidoff.

Another perspective from which to approach the two Hoffman reports comes from Van de Ven4 in his recent book “Engaged scholarship: Creating knowledge for science and practice,” where he argues that academic research has become less useful for solving practical problems, and as a result organisations are not learning fast enough to keep up with the changing times. Van Ven proposes methods of “engaged scholarship” to address the gap between theory and practice. His focus is primarily on organisation and management studies but can inspire many fields, including QI research. Van de Ven suggests a pluralist view of science and practice as representing distinct kinds of knowledge, which leads him to see the gap …