A Question of Quality
As Bill sat in his office pondering this issue, he wished he knew more about how to measure the quality of healthcare services. He remembered reading that Donabedian said that quality consisted of both a technical component and an interpersonal component. Dr. Able never had the proper technical training, and a review of his staff file revealed that he rarely attended obstetrical continuing education seminars. However, his interpersonal skills with his patients and the nursing staff were outstanding.
How important is patient satisfaction to quality outcomes? Bill knew that his hospital didn’t handle deliveries like the larger facilities (process), but Dr. Able’s record (outcome) was outstanding. No one could remember a single case when Dr. Able had complications with a normal delivery. Was outcome more important in the measurement of quality than process?
Bill also had to consider the role of his hospital in the healthcare system. Lower-cost, high-quality, and increased access to care are everyone’s objectives. Does enhanced access to care justify a different standard for quality?