![]() Instead, effective interventions need to be complex and multi-faceted 8–11 and developed iteratively to adapt to the local context and respond to unforeseen obstacles and unintended effects. 5 Research findings highlight the influential effect that local context can have on the success of an intervention 6, 7 and, as such, ‘single-bullet’ interventions are not anticipated to deliver consistent improvements. ![]() 1–4 To make sense of these findings, it is necessary to understand that delivering improvements in healthcare requires the alteration of processes within complex social systems that change over time in predictable and unpredictable ways. Despite increased investment in research into the improvement of healthcare, evidence of effective QI interventions remains mixed, with many systematic reviews concluding that such interventions are only effective in specific settings. ![]()
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