Table 2

 Characteristics of five knowledge systems involved in improvement

Knowledge systemIllustrative features
1. Generalisable scientific evidenceControls and limits context as a variable; tests hypotheses
2. Particular context awarenessCharacterises the particular physical, social and cultural identity of local care settings (eg, their processes, habits and traditions)
3. Performance measurementAssesses the effect of changes by using study methods that preserve time as a variable, use balanced measures (range of perspectives, dimensions), analyse for patterns
4. Plans for changeDescribes the variety of methods available for connecting evidence to particular contexts
5. Execution of planned changesProvides insight into the strategic, operational and human resource realities of particular settings (drivers) that will make changes happen