Evaluating Critical Care

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Using Health Services Research to Improve Quality, Update in Intensive Care Medicine

ISBN: 354042606X
ISBN 13: 9783540426066
Herausgeber: William J Sibbald/Julian F Bion
Verlag: Springer Verlag GmbH
Umfang: xiii, 379 S.
Erscheinungsdatum: 21.01.2002
Auflage: 1/2002
Produktform: Kartoniert
Einband: KT

Includes supplementary material: sn.pub/extras

Artikelnummer: 5967651 Kategorie:

Beschreibung

Measuring the quality of a complex service like critical care that combines the highest technology with the most intimate caring is a challenge. Recently, con sumers, clinicians, and payers have requested more formal assessments and comparisons of the quality and costs of medical care [2). Donabedian [1) pro posed a framework for thinking about the quality of medical care that separates quality into three components: structure, process, and outcome. An instructive analogy for understanding this framework is to imagine a food critic evaluating the quality of a restaurant. The critic might comment on the decoration and lighting ofthe restaurant, how close the tables are to each other, the extent ofthe wine list and where the chef trained. These are all evaluations of the restaurant structure. In addition, the critic might comment on whether the service was courteous and timely - measures of process. Finally, the critic might comment on outcomes like customer satisfaction or food poisoning. Similarly, to a health care critic, structure is the physical and human resources used to deliver medi cal care. Processes are the actual treatments offered to patients. Finally,outcomes are what happens to patients, for example, mortality, quality of life,and satisfac tion with care (Table 1). There is a debate about which of these measurements is the most important measure of quality.

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