Guided by the science?

Professor Jan Mainz and Professor Pierre Barker talk to BMJ about how the concept of improvement science offers new methodologies and evaluation design


The field of improvement science is a practical science that focuses on innovation and swift testing in real-life situations. Its expansion within today’s healthcare systems can generate knowledge on which variations and contexts can improve the quality of care. It combines expert knowledge, improvement methods, and tools from various disciplines like clinical science, psychology, statistics, and systems theory. 

Health professionals can use the concept to identify a specific goal for improvement, devise a plan for measuring the progress, and test minor changes to see if they lead to advances over a brief period. Once these tests are refined and successfully implemented in the specific context, it’s time to expand the testing and scale up the changes. 

This approach finds its roots in American engineer W. Edwards Deming’s philosophy, who believed that organisations could enhance quality and reduce costs by adhering to certain management principles. 


This year’s Improvement Science Symposium stream will make waves in the healthcare industry by bringing this unfolding methodology into the main programme for discussion and example by design. It will explore new methods and evaluation processes to facilitate quality improvement in patient outcomes. At the heart of Tuesday and Wednesday’s symposium lies the belief that health professionals have much to learn from other industries, such as aviation and engineering. 


Here we’ll see notable contributions from clinical Professor Pierre Barker and Professor Jan Mainz, both of whom raise essential issues in quality improvement. BMJ asked what improvement science means to these experts and why they believe it is critical in facilitating quality improvement for better patient outcomes. 

They share the belief that methodology is vital in quality improvement and that by learning through shared experiences, health professionals can benefit by bringing systematic scientific methods into their everyday clinical practice. So, let’s delve deeper into improvement science and see how it can positively impact patient care.


Jan Mainz is a key member of the International Forum’s Danish Committee, having been involved with the International Forum Copenhagen for many years. He cites the importance of inspiration and networking and stresses the significance of improvement science in healthcare, stating that it could help to solve problems across different countries. Whilst quality improvement is frequently used to address healthcare problems, evidence of its effectiveness remains mixed. 


Mainz emphasises the importance of adhering to basic tenets of the Plan-Do-Study-Act (PDSA) cycle for testing a change in improvement projects and conducting scientific studies to learn from them. When BMJ asks him to clarify the difference between quality improvement and improvement science, and the benefits of moving more into the latter area, Mainz explains that while a hospital improvement project can improve quality in a particular department, improvement science can potentially solve problems in multiple countries.

Mainz also highlights the ongoing challenges facing healthcare systems worldwide, such as the burden of chronic disease and preventable patient harm. 

“By emphasising the need for improvement science and scientific methods in healthcare, the Science Improvement Symposium and other similar conferences could pave the way for greater collaboration and problem-solving across borders.”


Another leading expert in this field is Professor Pierre Barker, who describes the Science of Improvement as translating clinical evidence into meaningful action in different contexts. Barker believes that the science of improvement helps us adapt evidence to our environment and pay attention to all the dimensions of quality.




“Whilst the concept is not entirely new, it has recently gained much attention. The Science of Improvement is about finding the most effective way to make changes and systematically examining the best methods and factors to facilitate quality improvement.”

Barker emphasises the importance of context when applying the Science of Improvement. He notes that it is essential to adapt evidence to the specific setting and that there must be a focus on equity and patient-centric care. All dimensions of quality must be considered, including safety, effectiveness, and understanding of what matters to patients.

The Science of Improvement is an exciting field that can help healthcare providers improve patient care. By translating clinical evidence into meaningful action in different contexts, healthcare providers can ensure patients receive the best care. 

The International Forum’s science stream is an excellent opportunity to learn more about the Science of Improvement and how it can be applied to healthcare. 


The Science Symposium runs Tuesday and Wednesday from 11 AM each day. Check the programme for details and specific times.   








Pierre Barker MD, MB ChB 

Pierre Barker, Institute for Healthcare Improvement, USA

Chief Scientific Officer

Institute for Healthcare Improvement, Boston MA USA

 Clinical Professor, Maternal and Child Health

Gillings School of Global Public Health

University of North Carolina at Chapel Hill, NC, USA


Jan Mainz

Jan Mainz, Professor, MD., Ph.D., MPA,

Danish Center for Health Services Research,

Department of Clinical Medicine, Aalborg University