6 Dimensions of Healthcare Quality

6 Dimensions of Healthcare Quality

health care providers and institutions seek to continually improve the care they provide research describes a process healthcare systems and providers use to improve the quality of their care the institute of medicine's 2001 report crossing the quality chasm defines six dimensions of healthcare quality this report and subsequent work highlights the complex nature of quality and also underscores the notion that quality can be defined measured and improved upon each of the six dimensions is distinct and none is more important than the others given these characteristics any course on the foundations of healthcare quality should focus on specific topics and scholarly fields within each of the six dimensions rather than quality is a composite measure so let's go over each of our six dimensions first safety safety is the first thing most people think of when they hear about quality improvement and for good reason safety is fundamental for providing healthcare safety refers to making sure that the treatment given in a healthcare setting does not harm patients safety is easy to spots if the patient has an adverse reaction because they were given the wrong dosage of medication that's a safety issue while it's easy to see once harm has occurred addressing the root cause of safety issues is not always straightforward safety highlights the system's nature of health care quality when we take the systems perspective in regards to safety we can catch the near misses potential gaps in safety notice before an adverse event occurs quality improvement and a culture of safety arise only when we all use systems thinking effectiveness is how well treatments are carried out compared to how they were designed effectiveness looks at the potential gap between how things were intended to happen and how they're actually being done for example if researchers conduct a clinical trial and find out that drug B works statistically better at treating diabetes than eh they might publish their findings and help physicians everywhere start using drug B but some health care providers might not have read the publication's or they might start giving drug B to all their diabetes patients even when the published research focused on a narrow population of diabetes patients this is an effectiveness issue effectiveness is also related to the development and implementation of evidence-based guidelines as well as the recent advent of performance measures these innovations of evidence-based guidelines and performance measures can improve effectiveness but sometimes to the detriment of the other quality dimensions equity is all about fairness although everyone should be treated the same historically we know that some groups systematically receive better healthcare than others research that explores the dimension of equity might compare how treatments and outcomes differ among groups of patients national data can be used to compare the rates of treatments and outcomes by race or gender such as how quickly a patient in the emergency department is treated for heart attack symptoms sometimes these differences among groups may be warranted or even advantageous one area of scholarship on equity relates to the heterogeneity of treatment effects among different groups of patients for example some types of blood pressure medications are more effective for certain racial or ethnic groups compared with the general population scholarship and efficiency explores the sources of waste waste arises when resources are used without having added benefits waste is a driving factor in excessive healthcare costs research in this area tries to discover when expensive procedures create better health outcomes and when outcomes are the same regardless of whether the expensive procedure is done does a patient with X disease do better with a two day inpatient hospital stay then an outpatient procedure efficiency is all about getting the best outcome with the fewest amounts of inputs but as Rob and him fill a head of the VA National Center for patient safety recently described at the 2015 VA quality scholars Summer Institute there could be a tension between safety and efficiency timeliness is made up of two parts access and system responsiveness first can the patient access the care she needs at the moment she needs that care are there financial social or other barriers to her accessing care second does the hospital or medical system get the treatment to the patients fast enough if long waits in the emergency department cause an unnecessary delay in an urgent surgery this would be a timeliness gap neither problems accessing care nor time delays in receiving treatment should result in a negative patient outcome these are timeliness concerns timeliness is a dimension that can be evaluated using objective and subjective assessments these two types of measures are likely to generate different but equally valuable types of information related to timeliness patient centeredness health care should be centered on the patient more often than not treatment plans involve options allowing the patient to explore the options available and choose a treatment plan that works best for them is essential ultimately all care must be aligned to the values and goals of patients and their family members in a terminal cancer patient quality of life may be more important than the length of life or vice versa putting the patient at the center of care is a vital dimension of quality attention to the people's experiences of receiving healthcare and of being a patient ie the patient experience is another key facet of patient centeredness in modern healthcare the ends do not always justify the means if patients experiences involve excessive pain suffering and alienation subjectively reported measures are often the best way of measuring and defining patient centeredness so there you have it the six dimensions of quality safety effectiveness equity efficiency timeliness and patient centeredness together these dimensions help ensure that the care we provide keeps our nation healthy

7 thoughts on “6 Dimensions of Healthcare Quality

  1. Good afternoon, I work for Texas Woman's University in the Disability Services for Students office. One of our professors is using the following video as a part of their curriculum. Can you either upload accurate captions to this video to make them accessible to Deaf and Hard of Hearing people viewing the video, or will you give me permission to caption the video so that we can get this video captioned before the start of the spring semester? We are not able to use the auto-generated captions as they are not ADA-compliant. Thank you

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