Health care, quality

Definition

High quality health care services are appropriate to situations and timely and efficiently delivered to satisfied patients and their families.

Description

There are two elements in the appropriateness of care: proper technical care and the sensitive, empathetic and compassionate manner in which it is delivered.

Timeliness of care refers to its being delivered when needed.

There are two elements in the efficiency of care: not wasting either patient or care provider resources of time and materials.

The satisfactoriness of care relates to how patients and families evaluate the care they received. For them, quality includes understanding what to expect while receiving and as a result of the care, the extent to which their expectations match their experience, how they feel about the personal treatment they received, and whether their questions were adequately addressed.

Measuring health care quality

There are two ways of measuring health-care quality. One is by auditing delivered health care services using standards of prevention, health maintenance, diagnostic, curative, restorative and palliative care developed from research and established by expert, peer panels. The other is by auditing patient satisfaction with the health care they received.

Reporting quality of health care

Patients and their families need and should have usable, understandable and readily available information about the quality of health care provided by their doctors and health-care institutions, similar to the format in Consumers Reports Magazine and online service.

Viewpoint

While the American health care system provides some of the finest, most sophisticated services and treatment available anywhere, they are unevenly delivered, spottily available, and fraught with mistakes and adverse outcomes.

Caregiver concerns

The quality of health care has not been systematically addressed in our price and cost-obsessed health care system. Like all other goods and services, it's up to patients and their families to do as much personal research as they can on the quality of their doctors and health care institutions.

Resources

BOOKS

Lee, Philip R., and Carroll L. Estes. The Nation's Health. 5th ed. Boston: Jones and Bartlett Publishers, 1997.

PERIODICALS

Blumenthal, David. “Quality of Care—What Is It?” New England Journal of Medicine 335 (September 19, 1996): 891–894.

Perkins, Sherry B., et al. “Outcomes Management: From Concept to Application.” Advanced Practice in Acute & Critical Care 11 (August 2000): 339–350.

Young, Wendy B., et al. “How Wide Is the Gap in Defining Quality Care?: Comparison of Patient and Nurse Perceptions of Important Aspects of Patient Care.” The Journal of Nursing Administration 26 (May 1996): 14–20.

ORGANIZATIONS

Agency for Healthcare Research and Quality. 2101 E. Jefferson Street, Suite 501, Rockville, MD 20852. (301) 594-1364. http://http://www.achpr.gov/.

American Healthcare Quality Association. 1140 Connecticut Avenue, Suite 105, Washington, DC 20036. (202) 331 5790. http://www.ahqa.org/.

Barbara Wexler MPH