Quality Of Care
Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. It is multidimensional, traditionally defined by the Institute of Medicine’s six aims: safe, effective, patient-centered, timely, efficient, and equitable.
Core Dimensions
- Safety: Avoiding harm to patients from the care that is intended to help them.
- Effectiveness: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit.
- Patient-Centeredness: Providing care that is respectful of and responsive to individual patient preferences, needs, and values. This includes active Patient Engagement.
- Timeliness: Reducing waits and sometimes harmful delays for those who receive and those who give care.
- Efficiency: Avoiding waste, including waste of equipment, supplies, ideas, and energy.
- Equity: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
Frameworks and Engagement
A critical component of patient-centered care is the active involvement of patients and families. Recent frameworks emphasize that engagement is not merely satisfaction or participation, but a specific interaction that influences outcomes.
- Carman Framework: Highlights that patient and family engagement is distinct from participation or satisfaction, focusing on mutually effective interactions between patients, families, and providers to improve health care and health.
- See: Carman - Patient And Family Engagement for details on the elements of engagement and policy implications.
- Shared Decision Making: A collaborative process where patients and clinicians work together to make health care decisions.
Metrics and Measurement
Quality is often measured through structured reports and public data releases (e.g., HCAHPS in the US). Key indicators include:
- Readmission rates
- Hospital-acquired conditions
- Patient-reported experience measures (PREMs)
- Clinical outcome indicators
Related Concepts
- Patient Safety
- Healthcare Systems
- Clinical Governance
- Evidence-Based Medicine