Table 1
The four quality paradigms.
| The Empirical paradigm likes to measure, develop measuring instruments, key performance indicators or to develop standards. Its values are accountability and accuracy. In research it embraces positivism as scientific philosophy. The Reference paradigm likes to develop models, protocols, pathways to show how to achieve quality. Its values are success and improvement. It embraces constructivism as scientific philosophy. The Reflective paradigm has the adage that quality cannot be defined, just discussed. The reflective paradigm likes to reflect professionally and between professionals on what good quality is. In the quality event people, their interactions, conceptions and worldviews are the objects of the study, and these are reflected upon. In this paradigm the research method is often the expert opinion, viewpoint, or the perspective of a (group of) researcher(s) on a theory or topic. Its values are wisdom and professionalism. It embraces subjectivism as scientific philosophy. The Emergence Paradigm states that radical innovation emerges out of the interaction and co-creation of a diverse group of people, including professionals, patients, and experts by experience. Its values are willingness to change and flexibility. It embraces complexity theory as scientific philosophy. |
Figure 1
Paradigms and context.
Figure 2
Percentage of articles in each paradigm (total n = 255).