The WHO Fact Sheet on Quality health services defines quality as 'the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with evidence-based professional knowledge'.
'This definition of quality of care spans promotion, prevention, treatment, rehabilitation and palliation, and implies that quality of care can be measured and continuously improved through the provision of evidence-based care that takes into consideration the needs and preferences of service users – patients, families and communities.
'Multiple quality elements have been described over the past decades. There is now clear consensus that quality health services should be:
- effective by providing evidence-based health care services to those who need them;
- safe by avoiding harm to the people for whom the care is intended;
- people-centred by providing care that responds to individual preferences, needs and values, within health services that are organized around the needs of people;
- timely by reducing waiting times and sometimes harmful delays for both those who receive and those who give care;
- equitable by providing the same quality of care regardless of age, sex, gender, race, ethnicity, geographic location, religion, socio-economic status, linguistic or political affiliation;
- integrated by providing care that is coordinated across levels and providers and makes available the full range of health services throughout the life course; and
- efficient by maximizing the benefit of available resources and avoiding waste.'
Our discussion on HIFA has suggested further elelments such as affordability (Tomislav Mestrovic, Croatia), cost-effectiveness (Joseph Ana, Nigeria), dynamic improvement (Marion Lynch, UK), resilience (Venus Mushininga, Zimbabwe).
The WHO definition above implies the 'bottom line' to the definition of quality is health outcomes. The primary measure of quality would be improvement in health outcomes, including morbidity and mortality. Many of the contributors to our discussion have emphasised the perspective of patients and the patient experience. Would anyone like to comment on the links between improvement in health outcomes and patient experience?
Best wishes, Neil
Coordinator, WHO-HIFA Collaboration: HIFA project on Learning for Quality Health Services
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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG email@example.com