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What is Quality Health Care?

There are two alternative definitions of "Quality Health Care":

the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (The Institute of Medicine)
the achievement of optimal physical and mental health through accessible, cost-effective care that is based on best evidence, is responsive to the needs and preferences of patients and populations, and is respectful of patients' families, personal values and beliefs (The American Association of Family Physicians)

The Institute of Medicine (IOM) led the movement for Quality Health Care. Initially, it identified three types of Quality Health Care problems: overuse, underuse and misuse. In their 2001 report Crossing the Quality Chasm: A New Health System for the 21st Century, the IOM provided guidance for improving the health care system as set forth below:

Six Aims of Quality Health Care

Safe – avoiding injuries to patients from care that is intended to help them
Effective - providing services based on scientific knowledge
Patient-centered – providing care that is responsive to individual patient preferences, needs and values and assuring that patient values guide all clinical decisions
Timely - reducing waits and sometimes harmful delays for both those who receive care and those who give care
Efficient – avoiding waste, including waste of equipment, supplies, ideas, and energy
Equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location or socio-economic status.

Simple Rules for the 21st Century Health Care System
Current Approach	New Rule
Care is based primarily on visits.	Care is based on continuous healing relationships.
Professional autonomy drives variability.	Care is customized according to patient needs and values.
Professionals control care.	The patient is the source of control.
Information is a record.	Knowledge is shared and information flows freely.
Decision making is based on training and experience.	Decision making is evidence-based.
Do no harm is an individual responsibility.	Safety is a system property.
Secrecy is necessary.	Transparency is necessary.
The system reacts to needs.	Needs are anticipated.
Cost reduction is sought.	Waste is continuously decreased.
Preference is given to professional roles over the system.	Cooperation among clinicians is a priority.
Institute of Medicine. 2001. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington D.C.: National Academy Press.

What is Quality Health Care?

Simple Rules for the 21st Century Health Care System