Article Text

Download PDFPDF
Developing a common language for evaluation questions in quality and safety improvement
  1. Mark F Lambert,
  2. Heather Shearer
  1. NHS Institute for Innovation and Improvement, University of Warwick Campus, Coventry, UK
  1. Correspondence to Dr Mark F Lambert, NHS Institute for Innovation and Improvement, Coventry House, University of Warwick Campus, Coventry CV4 7AL, UK; mark.lambert{at}


Evaluation is an important component of service improvement but is not undertaken often enough. Many evaluation guides are available, and the language describing approaches is complex and varied. This variation is a potential barrier to evaluation, particularly in communication between practitioners. A structured literature review of development and evaluation frameworks for healthcare quality improvement was carried out. Four frameworks with diverse methodological perspectives were identified. Partial mapping was possible against an existing structure for health promotion research. When the questions in this framework were adapted for healthcare evaluation, it provided a common structure for the four frameworks. There is significant common ground underpinning these terminological differences between descriptions of evaluation techniques. The common language developed here has potential to ease communication in healthcare evaluation and improvements in quality and safety. It is an aid for practitioners in framing pragmatic evaluation of improvement projects.

  • Quality assurance
  • healthcare (standards
  • methods)
  • total quality management (standards
  • methods)
  • research design (standards
  • methods)
  • quality improvement
  • evaluation studies as topic
  • continuous quality improvement
  • quality of care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding NHS Institute for Innovation and Improvement.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • Quality lines
    David P Stevens