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Increasing the generalisability of improvement research with an improvement replication programme
  1. John Øvretveit1,
  2. Laura Leviton2,
  3. Gareth Parry3,4
  1. 1Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
  2. 2The Robert Wood Johnson Foundation, New Jersey, USA
  3. 3Institute for Healthcare Improvement, Cambridge, Massachusetts, USA
  4. 4Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Gareth J Parry, Research Scientist, Institute for Healthcare Improvement, 20 University Road, 7th Floor, Cambridge, MA 02138, USA; gparry{at}


If a quality improvement is found effective in one setting, would the same effects be found elsewhere? Could the same change be implemented in another setting? These are just two of the ‘generalisation questions’ which decision-makers face in considering whether to act on reported improvement. In this paper, some of the issues are considered and a programme of research for testing improvements in different settings is proposed to build theory and practical guidance about implementation and results in different settings.

  • Generalisation
  • quality and safety improvement
  • research methods
  • effectiveness
  • healthcare quality
  • outcome
  • research

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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  • Funding The Health Foundation.

  • Competing interests None declared.

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