Addressing unwarranted clinical variation in healthcare as a quality improvement process

Abstract

The reduction of unwarranted clinical variation is a common goal of healthcare systems worldwide. However, the process of developing and implementing variation reducing interventions as a quality improvement process is often overlooked and performed sub-optimally within healthcare organizations. This gap in practice is mirrored by a gap in existing research. The development of a clinical variation specific prescriptive model will assist with the identification, development and application of healthcare specific variation reducing initiatives. Such a model should complement the existing plan, do, study, act quality (PDSA) improvement methodology and respect the learning health systems (LHS) learning cycle. Development through the lens of the quadruple aim of healthcare will ensure that the focus remains true to the core values of clinical organizations. Addressing unwarranted clinical variation is a complex task, however. With organizational support, the utilization of collaborative methodologies and the leveraging of available digital health technologies, healthcare organizations are provided the greatest opportunity for the reduction of unwarranted clinical variation and the optimization of healthcare outcomes.