Defining quality in healthcare is not straightforward.  There are a variety of views on its meaning and some debate as to whether quality has to be measurable.  The World Health Organisation (WHO) suggests: "Quality is a process of meeting the needs and expectations of patients and health service staff".

Patient perceptions of quality in healthcare also influence the public expectations and confidence placed in the NHS. Clinical errors, patient suffering and hospital closures always attract media attention while development of new services, changes to treatments and good news stories are hard to publicise.
Crossing the Quality Chasm (Institute of Medicine 2001) proposes an agenda for improving the quality of health care made up of six components:

  • Safe: avoiding injuries to patients from the care that is intended to help them
  • Effective: providing services based on scientific knowledge to all those who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse, respectively
  • Patient-centred: providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions
  • Timely: reducing waits and sometimes harmful delays for bother those who receive and those who give care
  • Efficient: avoiding waste, including waste of equipment, supplies, ideas and energy
  • Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location and socio-economic status.
These six aims for improvement need to be underpinned by quality improvement systems and processes that support a learning and improvement culture. 



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Quality is more observed in service providing institutions most especially in the healthcare industry. Patients look for a healthcare facility known for the qualities they have like equipments, doctors, and specialist when a hospital or clinic does not have at least one of these they end up looking for another healthcare service provider. Over the years there have been issues regarding the qualities of hospitals like the nurses slacking and unpleasant facilities to cite examples so this is what should be improved. The six components of improving the quality of health care are the areas that really need improvement. These qualities should always improve no matter what the situation is in order to provide the best services.

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    Krishnakumar Nair

    Lean Healthcare Practitioner
    QI & I Expert
    Lean Champion of the Year 2013, United Kingdom

    View my profile on LinkedIn


    March 2013