The Complicated World of Health Care Quality
By Jim Judson, Director of Quality
Over the last forty years, there has been much discussion on the
definition related to the quality of health care. There have been
multiple attempts by various governing bodies to define quality
succinctly. Many healthcare quality and safety experts utilize the
definition developed by the Agency for Research and Healthcare Quality
(AHRQ), a federal agency of the Department of Human and Health
Services. AHRQ defines quality as “doing the right thing, at the right time, for the right person, and having the best possible result.”
Even with the above definition of healthcare quality, the concept is
much more complicated than it appears. Each member of the healthcare
team, including the patient, has a different perception of quality. If
you asked a physician, a nurse, a patient or a quality healthcare
professional what he or she would define as “good quality health care”,
the answers might vary and may include “assuring I am providing care
that is safe and effective”, “the staff being friendly” or “achieving
care that is three standard deviations above the expected mean.”.
Whether it is in a hospital or at a vacation resort, the definition of
quality is always based on an individual’s perception.
So with such individuality, what can a healthcare organization do?
What may be quality care and services to one recipient may not meet the
definition of another consumer. It is virtually impossible to meet
everyone’s expectation of quality when the expectations are so diverse.
Although members of the healthcare team do try to meet those
expectations, providers often project our own definitions of quality
Healthcare organizations can demonstrate quality to all those who
are part of the care and services provided. This includes patients,
residents, clients, direct and indirect care providers, vendors and
regulatory agencies. Healthcare organizations need to have quantifiable
measures to demonstrate the quality of care to those we serve. Currently every affiliate of Masonicare has quantifiable quality
measures that they have defined and track. Some of these indicators are
mandated by the Center for Medicare/Medicaid Services (CMS) in order to
receive federal funds and are publically reported on CMS
websites to assist the public in making decisions as to where to seek
their care. Other Masonicare indicators are unique quality issues
identified by each affiliate. Current quality indicators include levels
of client’s satisfaction, appropriate use of medications, rates of
readmission and transfer, adherence to evidence based medical practices
and tracking patient outcomes.
When any quality indicator does not meet
the affiliate’s expectations, corrective actions should be taken to
improve the results. Even if expectations are met, plans should be in
place to sustain or improve compliance.
It is important to provide quality care to those we serve. Providing care that is patient-centered, safe and effective is a
continuous process. The frequent monitoring of quality indicators and
associated measures allows us to be sure we are on target and allows us
the opportunity to improve when the target is missed. The mission of
Masonicare is to enhance the quality of life thru an exceptional
continuum of person-centered care. To assure that we live up to this
mission takes commitment to our work, to the population we serve and to
We do this, to paraphrase the Agency for Healthcare
Research and Quality, because “it is the right thing to do” for our
future and present patients, resident and clients and to quantify that
Masonicare provides the highest caliber of quality care and services.