Defining Quality of Healthcare Revised

Defining Quality of Healthcare
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The abstract nature of the term quality occurs to be quite ambiguous. However, personally, I find Donabedian’s model quite lucrative and ultimately presenting the most real sense of quality for the healthcare provider and the patient as well. As such, quality does not only rely on the framework and hospital setting but also the willingness of the health provider to conceptualize quality and interact appropriately with the patient to achieve the intended outcomes. Donabedian summarizes quality in three broad perspectives, that is, structure, process, and outcomes (Berwick & Fox, 2016). In his definition, he identifies structure to encompass the physical facility, medical equipment, and the staffing/human resources training characteristics. Process constitutes the diagnostic, treatment, or technical approaches to delivering care. The concept of outcome captures the efficacy and effect of healthcare interventions on patients or populations.
Although outcome provides the ultimate measure of the quality of healthcare, it has some limitations, since, there are other factors such as culture and patient attitude that might influence the nature of outcomes. Therefore, my definition of quality of health care encompasses both the processes of delivering care and the outcomes of a clinical intervention. To provide the best care, then, the health provider should act in the best interest of the patient. As such, the healthcare provider should assess the issue of patient safety through application of the Route Cause Analysis, application of logic and adherence to scientific inquiry (the evidence-based practice) (Berwick & Fox, 2016).

Also, to improve patient satisfaction, the healthcare provider should seek informed consent, and utilize efficient procedures in the aftercare follow-up, hence, obtain valuable feedback. As Donabedian noted, a nurse should view the patient as a companion, show love, and consult for the best decision of care (Berwick & Fox, 2016). Therefore, the process of care should be the basis to build quality while the outcomes offer the results or the efficiency of the care process.
June last year, I had an opportunity to get the story of a female patient who was attending her annual mammography screening in my current hospital. She narrated to me on how she had to pass through three unnecessary diagnostic screening. She complains that the first physician recommended two mammography screening and then the second physician ordered for an ultrasound. She notes that in all this visits the doctor did not communicate anything to her, and only found a minor cyst on her breast through closer physical examination. She recounts that she was only lucky having undergone three weeks of different ultrasound-guided biopsy. This patient further notes that she wasted a lot of funds on the screenings and her condition was only treated with a minor needle impact.
Indeed, this shows the need for improving the healthcare process for better outcomes. The patient should not be treated as a ‘bystander’ who is only at the mercy of the system, but through proper communication, better clinical interventions can be established.
References
Berwick, D., & Fox, D. M. (2016). “Evaluating the quality of medical care”: Donabedian’s classic article 50 years later. The Milbank Quarterly, 94(2), 237-241.