Defining Healthcare Quality 

A standardized definition for healthcare quality has been elusive; though most will agree that the term “quality” in healthcare refers to the patient’s overall experience, or, encounter with the healthcare system.

More formally, healthcare quality can be defined as “the extent to which services provided to individuals and patient populations improve desired health outcomes.” (NIH). In this context, health outcomes might be reducing high utilization of emergency room services, reducing admissions and seeing better management of chronically ill patient’s across the board.

More broadly, we could define healthcare quality in terms of the health professionals involved in addition to the patients as the way that these services are delivered: not only in relation to their efficacy, but the attitude of those delivering them.

Breaking Healthcare Quality Down

On the whole, a healthcare system’s attitude will determine the overall patient experience, perhaps even more so than the procedures or treatments themselves. If everyone within a healthcare system is dedicated to quality improvement, they will reap the benefits of this attitude.

Healthcare quality is made up of several sub-topics:

Safety

Efficacy

Patient-Centeredness

Efficiency

Timeliness

Equity

Healthcare Quality | Safety

Safety in the context of healthcare quality might be defined as the reduction of medical errors, which might include injury to the patient, incorrect medication dosing, unwanted surgical outcomes, or in grave cases, death.  A healthcare organization must meet several standards of safety in order to operate, but when a patient interacts with the healthcare system those safety measures are on a smaller, microcosmic plane. Safety is of utmost importance to the entire health of the organization, but also, when finely tuned, protects the individual.

Healthcare Quality | Efficacy

In order for healthcare treatments to be effective, the physicians and allied health professionals involved in providing the treatments to patients must have the highest level of education and be working to the top of their licensure at all times. The knowledge of a treatment extends beyond it’s delivery to the question of relevance: just because the treatment will work, is it the best option for this patient? Would something else work better?

Healthcare Quality | Patient-Centered Care

The concept of patient-centeredness isn’t completely new, but it is newly in focus for healthcare providers. The mindset allows patients to feel involved in their care. They can have choices about their treatment and instead of the physician giving one or two options and dictating his medical preference, he can supply the alternatives to the patient and educate them on the risk-benefit breakdown of each option. When a patient is informed, they can then participate in the decision-making.

Healthcare Quality | Efficiency 

Defining efficiency in healthcare is reminiscent of how we define efficiency in any other business: avoid wasting time and resources. In healthcare, expenses and budget are often the highlight of many administrative conversations, but a physician or nurse doesn’t have time to think about the cost of each glove she uses in the office. The struggle to be efficient is real, and it has the potential to adversely affect patient care if the patient feels as though they are being “short changed.”

Healthcare Quality |Timeliness

For the patient anyway, timeliness is a huge quality measure. Waiting rooms are notorious for griping patients- sometimes, if a physician is running behind, a patient can sit in the waiting room for an hour. This is sometimes unavoidable, but often, it can be traced back to an issue with the workflow of the practice. Refining these operations can decrease the wait times even in the case of unforeseen circumstances, which keeps stress down for the physicians, the office staff and the patients.

Healthcare Quality |Equitable

In an ideal world, every patient would experience the same level of care regardless of their socioeconomic situation, background or demographics- but we’re finding more and more that there are some patients who seem to consistently “fall through the cracks.” Addressing these issues is touchy, because no one wants to be accused of prejudice. But the reality is, there is a delicate balance between keeping a patient’s socioeconomic situation in mind to let it inform your medical decision making and making assumptions about their needs based on their lifestyle, or economic situation.

As you can see, quality is a multi-faceted but sometimes vaguely defined entity in healthcare. While these measure speak to the definition as it applies to patients and sometimes their doctors, what about on a healthcare organization or administrative level? What about on a national level? The higher up the administrative ladder you climb, the foggier these definitions get. But mastering what quality means “in the trenches” of healthcare is the first step to understanding their wider applications.

BHM is a healthcare management consulting firm whose specialty is optimizing profitability while improving care in a variety of health care settings. BHM has worked both nationally and internationally with managed care organizations, providers, hospitals, and insurers. In addition to this BHM offers a wide breadth of services including healthcare transformation assistance, strategic planning and organizational analysis, accreditation consulting, healthcare financial analysis, physician advisor/peer review, and organizational development.