{
  "abstract": "Quality improvement (QI) is increasingly used as a mechanism to improve care and outcomes in healthcare. It is defined as the application of a systematic approach to solve a complex issue, involving those closest to the issue in discovering new solutions, testing these in practice and learning from the use of data.1 However, despite everyone’s best intentions, QI efforts often fail. Just like the way the holes in James Reason’s Swiss Cheese align when patient safety events occur, the reasons QI projects fail are multifactorial.2",
  "authors": [
    {
      "affiliations": [
        "East London NHS Foundation Trust, London, UK",
        "NHS England, Redditch, UK"
      ],
      "name": "Amar Shah"
    },
    {
      "affiliations": [
        "St Jude Children's Research Hospital, Memphis, Tennessee, USA"
      ],
      "name": "James M Hoffman"
    },
    {
      "affiliations": [
        "Institute for Healthcare Improvement, Boston, Massachusetts, USA"
      ],
      "name": "Nana Twum-Danso"
    },
    {
      "affiliations": [
        "St Jude Children's Research Hospital, Memphis, Tennessee, USA"
      ],
      "name": "Jonathan Burlison"
    },
    {
      "affiliations": [
        "Institute for Healthcare Improvement, Boston, Massachusetts, USA"
      ],
      "name": "Pierre Barker"
    }
  ],
  "title": "Current state and future directions for improvement science: reflections from the 2024 International Forum on Quality and Safety in Healthcare",
  "uid": "540e27c9-b3d3-5bf3-958b-8af7e65f717e"
}