Defining Care Quality
By Jane A Malkoff MSN RN NP
The definition of “quality” as either objective or subjective is a matter of much debate. I consider “care quality” objective because there are standards by which to measure it. However, I do see dimensions in those standards which can be subjective, such as enjoying or not enjoying the personality of a person involved in delivering a component of one’s care.
How is care quality defined? Several years ago the Institute of Medicine (IOM) took on the task of seeking an answer to that very question. Here is the answer the IOM came up with; care quality is “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”. The IOM went further and identified care quality as having the following six domains:
- Effectiveness
- Efficiency
- Equity
- Patient-centeredness
- Safety
- Timeliness
It is complex to create specific standards to measure the quality of these six domains. There are many compounding variables such as co-morbidities and patient perceptions. Nevertheless, the definition and the six domain categories from the IOM has created huge advancements over the past 25 years. There are more hospitals and care organizations than ever before focused on measuring care quality.
Why does this matter? It matters because consumers who understand the measurable features of quality care can more likely obtain quality care. It also matters because as the number of consumers seeking quality care goes up the standards by which quality care is measured will improve and become more accurate.
As consumers of care, we can understand the definition of care quality as stated above, i.e. gaining our desired health outcomes in a health care system expected to be up to date on options and services. Through this consumer role we have an opportunity to advance care quality. We can be hopeful in the midst of our care needs because we can use our voices to speak to the effectiveness of, the efficiency of, the equity of, the patient centeredness of, the safety of and timeliness of the experiences we have.