Any health care resource’s level of value, as evaluated by some assessment, is known as its quality of care. It is an evaluation of whether something is good enough and appropriate for its function, much as quality in other fields. The purpose of health care is to provide good quality of life, treat illnesses when possible, and increase life expectancy, and other objectives by making high-quality medical resources available to everyone who need them.

Quality matters for health policy:

One of the most commonly cited principles of health policy is quality of care, and policymakers at all levels—national, European, and international—are currently placing a high priority on this issue. Addressing the issue of healthcare quality at the national level may be driven by a variety of factors, from a general commitment to the provision of high-quality healthcare as a public good to the renewed focus on patient outcomes in the context of popular value-based healthcare ideas to the identification of specific healthcare quality problems.

Since the Sustainable Development Goals (SDGs) include the requirement to “achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all,” quality is receiving more attention on a global scale. The World Health Organization (WHO) produced two papers in 2018 that reflect this: a handbook for national quality policies and plans (WHO, 2018) and a guide meant to help people around the world understand quality as it relates to the goal of universal health care.

12th International Nursing, Healthcare & Patient Safety Conference

Initially, health professionals and researchers who studied health services dominated discussions about what constitutes high-quality healthcare. Although it is becoming more widely acknowledged that the tastes and viewpoints of the general public, patients, and other important parties are also very important (Legido-Quigley et al., 2008).

The definition given by Donabedian (1980) and the one offered by WHO’s handbook for national quality policy and strategy, which compiles some of the most significant definitions of healthcare quality from various contexts (WHO, 2018).

In a general sense, Donabedian defined quality as “the capacity to realise desirable goals through proper channels.” The fact that the word “quality” is used by a wide range of people in various spheres of society and is not just a phrase used in the healthcare industry is reflected in this definition.

When referring to a variety of advantages associated with hospitals and doctors, as well as when discussing food or automobiles, people often use the term “quality.” In fact, the term quality is used so frequently by policymakers, researchers, and other stakeholders in the field of healthcare that it helps to clarify some of the misunderstandings around the idea of healthcare quality.

The definition provided by Donabedian is intriguing because it makes clear that the purpose of high-quality care is to maximise patient welfare and that the quality of care is tied to the care process in all of its components. The patient’s health is undoubtedly a part of their welfare (later specified as encompassing physical, physiological and psychological dimensions; see also Donabedian, Wheeler & Wyszewianski, 1982).

However, the idea of patient welfare is equally consistent with a strategy that takes into account what patients value. Donabedian’s concept also acknowledges the limitations of quality and its progress by emphasising that gains and losses are inevitable during the course of providing care.

The last two definitions in are from the WHO and the European Commission (2010). (2018). Both of these definitions of quality, in contrast to those previously addressed, indicate three primary characteristics or attributes: efficacy, safety, and responsiveness, or patient-centeredness. Both definitions were heavily impacted by the work of the OECD’s Health Care Quality Indicators (HCQI) project, therefore it is not by chance that they are similar (Arah et al., 2006; see below).

These last two categories are especially intriguing since they include additional characteristics of healthcare and healthcare systems that are connected to quality of care, such as accessibility, timeliness, equity, and efficiency. However, they expressly differentiate the basic dimensions of quality from other qualities of good healthcare by noting that these additional components are either “part of a wider debate” (EC, 2010) or “essential to enjoy the benefits of quality health care” (WHO, 2018).

In actuality, during the past 40 years, there has been a lot of discussion about the components of care quality. The discussion of the various aspects of healthcare quality is the main topic of the following paragraph.

Qualitative aspects of healthcare:

As was already established, Donabedian said that knowing what quality of care entails and does not include is necessary for assessing and improving it. Numerous elements that are recognised as contributing to quality are frequently listed in relatively long lists in different definitions of quality.

But several definitions—along with those not represented in Table 1.2—include qualities including appropriateness, timeliness, efficiency, access, and equity. This is perplexing and frequently obfuscates the distinction between healthcare quality and total health system effectiveness. The table divides its elements into three categories—core quality dimensions, contributing subdimensions, and other performance aspects of the health system—in an effort to organise these ideas.

Healthcare should strive to achieve six main goals: it should be safe, effective, patient-centered, timely, efficient, and equitable, according to the IOM’s “Crossing the Quality Chasm,” an influential report that was released in 2001.

Although the IOM explicitly defined these six principles as “performance expectations” (“a list of performance characteristics that, if addressed and improved, would lead to better achievement of that overarching purpose“), numerous organisations both inside and outside the United States have adopted them as the six dimensions of quality. Six concrete improvement goals are suggested by the group to this objective. According to IOM (2001), “Healthcare should be.”

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  1. American Assembly for Men in Nursing
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  7. American Association of Diabetes Educators
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  5. JKK Muniraja Institute of Health Sciences
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Sub-tracks of Healthcare Quality:

The importance of quality in evaluating the effectiveness of health systems:

Over the past 20 years, a number of frameworks have been created with the intention of promoting a better knowledge of health systems and enabling health system performance evaluations (Papanicolas, 2013; Fekri, Macarayan & Klazinga, 2018). The majority of these frameworks either directly state or imply that quality is a crucial health system aim, but they vary in how they define quality and how they explain how it fits into the larger objectives of the health system. The WHO (2006a) “building blocks” framework for strengthening health systems is a particularly effective approach. The conceptualization of health systems in the framework takes the form of building blocks, such as service provision, the health workforce, data, medical goods, financing, and leadership/governance.

We therefore suggest saving the phrase “healthcare quality” for the first level, or the level of healthcare services, in order to avoid confusion and establish conceptual clarity. There appears to be a global trend toward utilising the term “health system performance” to characterise the extent to which health systems fulfil their ultimate and intermediate goals with regard to the second level, or the health (care) system level.

For the purposes of this book, we define “strategy” more specifically and sectorally to refer to a course of action designed to accomplish particular quality assurance or improvement objectives by addressing particular targets within the healthcare industry (for example, health professionals, provider organisations or health technologies).

For instance, while the identical ideas would be referred to elsewhere as “quality interventions,” “quality initiatives,” “quality improvement tools,” or “quality improvement activities,” we view clinical practise guidelines and accreditation of healthcare professionals as quality strategies.

To reap the rewards of high-quality healthcare, the following conditions must be met:

Organizations that assess quality include: