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Rediscovering the importance of 'context' in health systems innovation

Updated: Jul 29, 2023


(This short introductory piece is adapted from a Linkedin article I wrote a few years ago).


There's a common saying which goes 'If it looks like a duck and walks like a duck, then it is probably a duck.'

It's a useful heuristic that works in many situations. Except of course if you decide to visit Australia: where you will find all manner of things that look, walk, and behave like familiar old-world creatures (mice, cats, moles, squirrels, wolverines to name a few) but all of which are marsupials. The theory is that marsupials have 'adaptively radiated' to occupy ecological niches normally held by other mammals; and despite any morphological and behavioural similarities, they are more removed from to their old-world cousins (at least in a biological sense) than the above logic would imply. With this in mind, it might be more accurate to say, 'If it looks like a duck & walks like a duck, it might live near a pond'.


The role of 'context' in shaping a system's evolution is well appreciated in many fields but especially in ecological research, so much so that nearly everything in that field is studied in, and only in, its ecological context. In the arena of health systems improvement, a proper appreciation of context is much rarer. Fundamentally, context is never a confounder - its entirely point. If your a healthcare leader or QI practitioner and serious about following the science - I commend this excellent article by Prof Mary Dixon-Woods that covers a lot of the relevant teritorry from causation to correlation & cargo cult improvement to a balanced understanding of context!


https://www.health.org.uk/sites/default/files/PerspectivesOnContextDixonWoodsTheProblemOfContextInQualityImprovement.pdf



Happy improving!


Despite what the manual might say, quality improvement in health and social care settings is never easy - that is, unless you have the right team in your corner! We can help diagnose, design and execute complex quality improvement and systems innovation programs for you and with you - reach out to us using the link below. We would love to connect.









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