An explanation of theories that guide evidence‐based interventions to improve quality

The concept of evidence‐based medicine, or medical practice based on up‐to‐date research about the best available diagnoses and treatments, has been well accepted into mainstream medicine. In contrast, evidence‐based quality improvement, culminating in evidence‐based dissemination or implementation of the latest research, is far from a reality. One of the many reasons for this failure is that all responsible for dissemination and implementation do not understand or apply relevant theories from the social and educational sciences. Rather, many popular approaches to quality improvement have been chosen empirically, unguided by theory. Sometimes these choices have resulted in failure and/or unintended consequences. The purpose of this review is to categorize and explain various theories relevant to quality improvement interventions. Each reviewed theory is connected with approaches the theory suggests would be successful. The review discusses how knowledge of improvement theory can drive not only the choice of techniques to employ but also the choice of contexts for employment. The review offers a critique of some theories and their associated approaches.