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Understanding Quality

What do I need to know about quality?

Most people understand quality when they relate it to their car or truck.  Consumer organizations collect information from experts (who are knowledgeable in the field about which they are offering their opinion, but are not themselves rated by anyone else) and other consumers. Consumer organizations can collect information about how products have performed in the past. Products that have needed many repairs or failed to perform as advertised suggest to all of us that products from the same manufacturer in the future are likely to provide the same low level of performance and satisfaction. Consumer organizations do realize that all of us have different needs and different expectations from our cars and trucks. We as individual consumers must decide how each product meets our needs. If we chose a product that meets our needs that are actually impractical, that does not change the fact that we have met our need. When we purchase a car or truck we are usually offered a warranty or guarantee over a certain time period.  We understand that the manufacturer will attempt to fix any problem we might have with the product and its performance.

Health care quality is more challenging to measure.

We have no difficulty measuring service quality in that we can survey satisfaction with such issues as wait times, clean exam rooms and pleasant receptionists. The challenge is in measuring the clinical aspects of quality. If the doctor was kind, friendly, prompt and accessible, but prescribed the wrong antibiotic for our infection because he did not keep up with the recommended choice for our infection, then we did not receive quality. If we go into the hospital for surgery and we suffer a complication because the extent of our cancer required that the surgery in part caused us harm, we may have actually enjoyed the best quality available for that situation.

The Institute of Medicine and The National Quality Forum have both concluded that quality depends on patient centered systems. Systems are the organization behind your care that you rarely see. As a user of health care you should look for evidence of organization and systems.

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