Defining quality in health care was really
challenging as different parties has different view of standard towards.
Clinical professionals tend to define quality in terms of clinical outcomes
that is achieved as a result of a treatment process (Sullivan & Garland, 2010). Since healthcare was a service-oriented industry, patients
were our main customers and their feedbacks and opinions were essential. Patients
often define quality variously and expect effective treatments and good
outcomes. With the progress of the times and the continuous breakthrough of
modern science and technology, people nowadays demand a higher and higher
quality of life and services. Patients would likely to be treated with respect,
empathy and caring. They also want to have a position to suggest and monitor
the services they received.
There were three standards to measure the quality of care which were
outcome standards, process standards and structure standards (Donaldson, 1999;
Morris & Bailey, 2014).
Outcome standards focus on whether or not the goals of care have been
accomplished. For example, it might measure surgical mortality rates,
hospital-acquired infections, complications from disease, successful repair of
wound and rehabilitation. The critique of this standard is that outcome is the
result of numerous factors requires detailed information. Therefore, it is
difficult and expensive to obtain the data.
Process standards focus on whether or not nurses continuously provide client-centered
care that are compatible to hospital guidelines of care. For example, it might
measure preventive care such as percentage of women received screening for
human papillomavirus (HPV) infection and management of chronic conditions such
as percentage of people with diabetes who had their blood sugar tested and
controlled. The critique of this standard is that nurse will just follow
guidelines and may neglect whether the care provided was appropriate and it may
fail to measure the quality of teamwork.
Structure standards focus on whether or not health care organization had
resources to deliver care. For example, it might measure the ratio of nurse to
patient, the number of consultation liaison nurse and whether the hospital use
an electronic system to order prescribed medication. The critique of this
standard is that it may fail to measure the actual quality of the care received
or whether the care improved health directly.
Take infection control as an example,
structure standards will ensure that there are alcohol gel dispensers in
all entrances to wards; process standards will ensure that visitors use the
alcohol gel on entering and leaving ward; and outcome standards will ensure
Methicillin-resistant Staphylococcus aureus (MRSA) rates are reduced (Sullivan & Garland, 2010).