This book is for anyone who is interested in improving quality in healthcare. It will appeal to those who are traditionally responsible for quality matters, as well as practicing clinicians and leaders. Unusually, it will also be as relevant to those who have the keenest interest in the quality of care - interested citizens. It is a deliberate antidote to the anti-intellectual, QI tool driven, mechanistic approach that still dominates much of healthcare quality improvement work. The authors - both of whom have extensive experience of working in and around quality issues in healthcare at a national, regional and local level - challenge such approaches, which they believe fail to take account of patient and organisational context and invite reductionism, cherry picking, atomisation of complex issues, leading ultimately to simplistic and unsustainable outcomes. Key features of the book: • An exploration of some of the often-overlooked and misunderstood core concepts of quality; their history and meaning in a contemporary context. • A framework to “question the work" using four interconnected conceptual domains as a valuable framework to consider improving quality and reducing failure demand. • Critical re-examination of the dominant approaches to change that are frequently adopted in “quality” work, many of which have been rooted in scientific management that have failed to live up to their promise – particularly transformational. • Exploring how an inter-disciplinary perspective can reframe aspects of quality thinking.

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