Williamson's ABNA revisited

Abstract

Purpose

The purpose of this viewpoint article is to acquaint those engaged in health care quality improvement and patient safety programs with an effective, well‐documented but overlooked method. As described in a 1978 article, “Achievable Benefit Not Achieved” (ABNA) is a formal, efficient, transdisciplinary, evidence‐based method to identify and prioritize quality improvement project topics.

Design/methodology/approach

Narrative review of personal experience and pertinent literature.

Findings

While the ABNA method succeeds in serving its purpose when applied, and no evidence could be found to discredit it, ABNA appears to have been abandoned and forgotten for reasons of political expediency.

Research limitations/implications

A strength and weakness of this research is its reliance upon personal narratives from the limited number of individuals still available who have first‐hand knowledge of past events. Convergence of those narratives along common themes, and their consistency with published records, is reassuring; however, age, memory, and some reluctance to broach political barriers limit one's ability to examine key events of past decades. A structured interview format conducted by a trained and experienced interviewer who had no vested interests in the topic, plus independent analysis of transcripts by researchers who have experience in qualitative methods, protects internal validity of the work.

Practical implications

Today's emphasis on continuously improving the quality and safety of health care requires appropriately focused, effective programs. ABNA arose and was suppressed in an era when health service deficiencies characteristically remained hidden as potential embarrassments rather than sought out as opportunities for improvement. ABNA, that era's under‐appreciated tool, should be reconsidered for its unique merits to guide today's programs.

Originality/value

This work, one of the first efforts to trace the entire history of ABNA, confirms that the method remains practical, effective and has not been discredited.

Citation

Birnbaum, D., Konieczna, M. and Ratner, P. (2006), "Williamson's ABNA revisited", Clinical Governance: An International Journal, Vol. 11 No. 4, pp. 326-334. https://doi.org/10.1108/14777270610708869