Health Care Quality

There are 5 main components of health care quality.

1. Access to care

2. Adequate scientific knowledge

3. Competent health care providers

4. Separation of financial and clinical decisions

5. Organization of health care institutions to maximize quality

There are also quality aims from the Institute of Medicine (IOM).

• Safe—avoiding injuries to patients from the care that is intended to help them

• Effective—providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse, respectively)

• Patient-centered—providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions

• Timely—reducing waits and sometimes harmful delays for both those who receive and those who give care

• Efficient—avoiding waste, including waste of equipment, supplies, ideas, and energy

• Equitable—providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status

Proposals for improving quality

1. Licensure, accreditation, peer review

2.Clinical practice guidelines

3. Measuring practice patterns

4. Continuous quality improvement

5. Computerized information systems

6. Public reporting of quality

7. Pay for performance

8. Financially neutral clinical decision making

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