Improving Medical Practice: A Conceptual Framework

Dr. Leif Solberg has long been a pioneer in improving medical practice through research-based interventions. In this article, Dr. Solberg has achieved his purpose stated in the abstract, "to produce a relatively simple conceptual framework for guiding and studying practice improvement." However, he has done much more than that with this article. He has summarized multiple theories that relate to the change process, to leading quality improvement in medical and other systems, and summarized larger systems theory that applies to improving medical practice. He has also shared his hard-earned wisdom achieved by his efforts to champion and study practice improvement and change processes over many years.

While briefly reviewing the literature and the multiple dimensions of creating positive and productive changes in medical practice, Dr. Solberg has outlined a ‘relatively simple’ over-arching model for improving practices. The three key components are worth stating again here:

1. Setting as a top priority a practice improvement process and applying enough resources to the task to make a measurable difference.

2. Understanding and managing the change process and creating the capability of creating changes within a practice as a parallel activity to any care improvement.

3. Establishing clear and measurable care process improvements with enough detailed content to know when the goals are achieved and/or what barriers are inhibiting such achievements.

In this brief paper, Dr. Solberg has outlined the core content that all practice leaders must know and interpret for their own environment in order to improve significantly any medical practice. As (or if) the reward systems embedded in our current medical-industrial complex shift toward supporting primary care services, then practices, both large and small, will want to refer to the concepts outlined by Dr. Solberg as they direct energy and resources to improve medical practice. This paper is only one aspect of Dr. Solberg’s many contributions to improved health care services but clarifying these concepts is among his most durable achievements.

Competing interests:   None declared