Lecture Case 3 Quality Management in Health Care IQM
It is important to improve the quality and safety of care; for example: how can a similar incident be
prevented in the future (so basically how will we do better in the future?)
It happens a lot that wrong decisions are made (wrong leg amputated or nurses using a different
drug due to similar packages)
Innovation and Quality Management are important due to and for:
Challenges in healthcare
Demands by patients and family
Prevention of unnecessary harm
Improvement
1.What is quality of care?
Quality of care: there are two types of influential definitions about this
Donabedian, 1980: the kind of care which is expected to maximize an inclusive measure of
patient welfare, after one has taken account of the balance of expected gains and losses that
attend the process of care in all its parts.
Institute of medicine, 1990: the degree to which health services for individuals and
populations increase the likelihood of desired health outcomes and are consistent with
current professional knowledge.
Differences in these definitions:
Institute of medicine described outcomes narrower (health outcomes instead of patient
welfare)
Why a definition for quality of care?
Common understanding
Guides the operationalization (you know what to focus on) and measurement
Influence the choice of interventions and policies
2. Which dimensions of quality of care can be distinguished?
Dimensions of quality of care: (in order to measure quality) -> in total 6
o Safety: makes sure that the treatment given to patients does not harm them. Easy to spot
when a person has an adverse reaction (due to wrong dosing from example). This is an
example of a safety issue. However it is easy to see when harm is done but not to address
the roots of it.
o Effectiveness: how well treatments are carried out versus how they were designed (potential
gap between intension and outcome). From design to implementation basically.
o Equity: about fairness, how treatments/outcomes differ between groups of patients (based
on race/ gender). Some medications are also more appropriate for certain patients
compared to the larger group
It is important to improve the quality and safety of care; for example: how can a similar incident be
prevented in the future (so basically how will we do better in the future?)
It happens a lot that wrong decisions are made (wrong leg amputated or nurses using a different
drug due to similar packages)
Innovation and Quality Management are important due to and for:
Challenges in healthcare
Demands by patients and family
Prevention of unnecessary harm
Improvement
1.What is quality of care?
Quality of care: there are two types of influential definitions about this
Donabedian, 1980: the kind of care which is expected to maximize an inclusive measure of
patient welfare, after one has taken account of the balance of expected gains and losses that
attend the process of care in all its parts.
Institute of medicine, 1990: the degree to which health services for individuals and
populations increase the likelihood of desired health outcomes and are consistent with
current professional knowledge.
Differences in these definitions:
Institute of medicine described outcomes narrower (health outcomes instead of patient
welfare)
Why a definition for quality of care?
Common understanding
Guides the operationalization (you know what to focus on) and measurement
Influence the choice of interventions and policies
2. Which dimensions of quality of care can be distinguished?
Dimensions of quality of care: (in order to measure quality) -> in total 6
o Safety: makes sure that the treatment given to patients does not harm them. Easy to spot
when a person has an adverse reaction (due to wrong dosing from example). This is an
example of a safety issue. However it is easy to see when harm is done but not to address
the roots of it.
o Effectiveness: how well treatments are carried out versus how they were designed (potential
gap between intension and outcome). From design to implementation basically.
o Equity: about fairness, how treatments/outcomes differ between groups of patients (based
on race/ gender). Some medications are also more appropriate for certain patients
compared to the larger group
