Frontiers of Improvement Science in Health Services

Improvement science involves the study and practice of improving complex systems. Within health services, improvement science can address all aspects of quality to ensure timely, safe, equitable, patient-centered, effective, and efficient care, whilst improving patient and population outcomes and staff wellbeing.

As a relatively young field, improvement science is still defining its scope and its differentiation from other fields of enquiry and practice. There is no doubt that improvement science has been influenced by and draws heavily upon more established fields including patient safety, quality improvement, implementation science, innovation and intervention research, health service research, health economics, complex systems thinking, sociology, psychology, operational research, engineering, design, organizational and management sciences.

Given the extensive contributions from and overlap with interests of other fields it can be questioned what is actually new in the field of improvement science, and how is it different from what has gone before?

This special issue aims to provide a space to debate and delineate the field of improvement science, both defining and advancing the frontiers of this emergent field.

As a platform to stimulate debate, the launch of this special issue is accompanied by the publication of an article outlining a conceptual map of what matters to the improvement community, along with a series of questions that help illustrate the scope of interest of improvement science, and that represent the frontiers of current knowledge and practice.

Areas of the conceptual map of improvement science – and topics of interest for this special issue include:

• Improvement in practice:

o Achieving improvements (impact, sustainability and spread)
o Approaches to achieving improvements (value and limitations of different approaches, fidelity of use, developing supportive organizational cultures)
o Integrating improvement in context (improvement alongside business as usual, competing agendas and priorities, adapting and responding to real work pressures)
o Measurement and evaluation to inform improvement

• Aligning improvement efforts

o The interdependence of system levels (navigating and managing multiple improvement initiatives across macro, meso and micro levels)
o The interactional work of improvement (relationships, power dynamics, motivations, facilitation)
o Enhancing the value of improvement practice and research (costs, benefits, resource allocation)

• Advancing the contribution of the improvement community

o Seeking synergies between knowledge, research, and practice to achieve improvement
o Ways of knowing and doing (making sense of diverse theoretical and philosophical perspectives)
o Building the community (education, leadership, collaborative working)

Submissions are invited to explore issues within the conceptual map of improvement science, or indeed to debate, refine or object to the contents of the map itself.

Exploration of how other fields of enquiry or practice can inform or be built on by the field of improvement science are welcome, as are examples of the challenges or approaches to make sense of multiple different perspectives – theoretically or practically.

Empirical, conceptual and theoretical explorations of the frontiers of improvement science are invited, including identifying key challenges and examples of how understanding and practice can be advanced. Descriptions or evaluations of improvement initiatives that do not engage with the wider issues of improvement science as a field are out of scope for this special issue.

We ask that authors specify how they are responding to the issues outlined in this call in the letter to editor during the submission process.

We invite authors to submit a manuscript summary or a short outline of their manuscript by the 15th September 2025. While this is not mandatory, it will allow the editorial team to provide early feedback on your manuscript's suitability.

Researchers interested in submitting their work spontaneously to this project are kindly requested to first send a cover letter and/or abstract to healthservices@frontiersin.org for preliminary consideration.

This special issue is dedicated in memory of Dr Johan Thor

Dr Johan Thor was an internationally renowned leader of the improvement science community, based at Jonkoping University and the Karolinska Institute in Sweden. Johan made a significant impact in the lives of many members of the improvement community through his love of teaching and supervision, and his desire to bring people together and build on learning from diverse disciplines and perspectives. His enthusiasm for the subject and his generosity in supporting and encouraging others will long be remembered.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Improvement science, Quality improvement, Complex systems, Implementation, Transdisciplinary, Interdisciplinary, Health service research, Knowledge mobilisation, Knowledge translation, Coproduction, Codesign

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.