Perspectives: Quality Care as a Driver for Health System Change

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Quality measurement in health care has always been difficult and expensive. In my 30 years in medicine, the focus has been geared more towards measuring outcomes from an acute care perspective rather than quality from the point of view of the individual. For example, documenting hemoglobin A1C levels or body mass index scores may measure clinical quality, yet these markers reveal little about a person’s daily living needs and how decisions about their care are made.

Date Updated: 03/11/2014

Over the years, quality has been limited to three distinct buckets:

  • Is the environment where care is delivered safe and staffed appropriately?
  • Are the technical aspects of care consistent with data driven guidelines?
  • Are patients satisfied with the service they receive?

The problem is that these measures too often do not reflect the totality of the experience of the person receiving care. While these elements are important and necessary, they do not provide a complete look at quality, particularly for those who have serious chronic illness or functional limitations.

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