What does quality mean to me? The word itself (“quality”) brings to mind an
aspect that a person or thing exhibits.
For example, one of Ahab’s qualities was megalomania, or the one quality
of that lampshade is that it is red. So,
it is helpful if the quality is observable and even better if it is
measurable. However, what value do those
qualities have? The answer could vary
widely from person to person.
In the case of health care
delivery, quality is not easily defined or uniformly measured. The very nature of observing and measuring
quality can affect the behavior of those being observed, too, if they are aware
of the fact that they are being evaluated.
When considering the measurement of quality, arguably most think of a
continuum ranging from poor to excellent such as a scale of zero to ten. This is consistent with Donabedian’s concept
of quality as a “balance of health benefits and harm” as “the essential core of
a definition of quality (Ransom et al., 2008, p. 3).”
The six dimensions of quality
offered by the Institute of Medicine are excellent guidelines for judging
quality in the delivery of health care, judging it on the following
criteria: safe, effective, efficient,
timely, patient centered, and equitable (Ransom et al., 2008, p. 5). When I seek medical care, I personally judge
its quality on those six factors, especially timeliness, patient centeredness,
and efficiency. The level of skill that
the provider exhibits is important, especially if the nature of the medical
problem is complex. I prefer that a
practitioner show a concern for economic matters, too, such as a willingness to
prescribe cheaper alternatives to medications and provide multiple refills in
order to prevent unnecessary office visits in the future.
Ultimately, quality is similar to beauty
in that it is in the eye of the beholder.
What is important to me may not be important to you. However, there is common ground of limited
criteria that most can agree upon:
properly accredited and educated physicians to provide care, for
example. Obviously quality is an
important idea to the American people.
Its role in cost-benefit analyses utilizing Quality Adjusted Life Years
is evidence of how quality is paramount to not just the care we receive, but
also what we expect health care to provide us.
Ransom, E.R., Joshi, M.S., Nash, D.B, & Ransom, S.B. (2008). The
Healthcare Quality Book; 2nd Ed. Chicago, IL: Health Administration
Press.
