Quality is critical in health and social care. However, what is considered as high-quality care depends on who you are talking to. Care users, care providers and care managers all have a different perspective on what constitutes good quality care.
This article explores what high-quality care means to three different types of people: the user, the provider and the manager.
The most commonly used quality domains come from the Institute of Medicine (now called National Academy of Medicine) and endorsed by the WHO. They are: safety, effectiveness, person-centeredness, timeliness, equity and efficiency.
For more on the dimensions of quality, read the article on the six domains of quality.
Better informed and empowered, patients will be able to work more efficiently and manage their health. This is possible with appropriate support from health professionals and health managers working in a well-funded and structured health system.
The perspectives of good-quality care:
- Care users’ perspective
- Care providers’ views
- Care managers’ views
High-quality care – From the user’s point of view
Continuous quality improvement and patient safety is an integral part of everyday health professionals, health associates, managers, and all other employees in the health system. The main goal is to achieve higher levels of efficiency in work. It also helps to get greater satisfaction of users and providers of health services.
New knowledge and technologies require new specialisations of healthcare professionals and associates. This leads to excessive fragmentation of knowledge and practises and increase alienation from care users in the health system.
User requirements are changing and becoming greater. Thus, the perspectives of quality of care change. The availability of modern information technologies enables better information for users. It leads to higher expectations in the health care system.
The modern care user expects to receive such health care with minimum risks and maximum benefits. The care users do not get satisfaction by only solving a health problem. They expect and demand a pleasant experience. This includes ambience, kindly staff, information about their health and any procedures. Also, the user wants to take part in decisions about their health.
For care users, high-quality care includes:
- Focus on the user/patient. The protection provided is tailored to the specifics the needs of the patient involved in the planning, analysis, and implementation of treatment.
- Safety. This implies a health system in which it is patient safety primary and potential hazard during diagnostic and therapeutic procedures minimise.
- Efficacy. The provided health care is appropriate for the patient, therapeutic intervention is achieved desired health outcome.
- Timeliness – health care is provided when the need for it is recognised, without unnecessary waiting.
- Fairness. This means that there is equal access to services for all users regardless of gender, ethnicity, religion, socio-economic characteristics, and place of residence.
Good quality care – Care professionals‘ perspective
Improving the care quality system is a demanding process. It involves teamwork with defined responsibilities, measuring the care processes and results. It also involves applying best practises and identifying and learning from them.
Moreover, it means introducing safety systems, rational use of health technologies, better patient information. Better communication between patients and healthcare workers is crucial. Importantly, it involves patient satisfaction with healthcare provided and healthcare workers’ job satisfaction.
Thus, the perspectives of quality of care from the point of view of care providers is complex.
Care providers commonly consider care to be of high quality when it matches these criteria:
- Continuous medical education, constant professional development, acquisition of new skills, availability of the latest trends and information. Also, seminars, courses, and other continuing education programmes are key perspectives of healthcare quality.
- Improving the safety and sense of security of employees and care users. This involves constant monitoring and control of applied measures for their implementation.
- Formation and creation of spatial, technical, and human resources for professional work.
- Open communication between health professionals and care users. This promotes mutual trust and respect for the individual. For unhindered communication between the health professional, the patient, and his family members, the dialogue is crucial. Each person in the dialogue brings their assumptions, expectations, and behaviour, which affects their interpretation of the dialogue and thus its outcome.
- State participation, its political, social, and financial responsibility, and support.
- Quality, multidisciplinary teamwork – raising the quality of treatment significantly depends on a well-made medical team, and therefore on its efficiency. The cooperation of several doctors from different specialists is often necessary. The active role of other professionals, such as nurses staff, lab scientists, etc, is equally important.
- Media support and cooperation, timely, truthful and professional information to citizens about possible risks and ways to preserve their health.
- Wide application of available and appropriate technology in the promotion and rescue of life.
- Healthcare professionals should be provided with a pleasant and inspiring work environment as a prerequisite for high-quality healthcare.
High-quality care – Managers’ view
The perspectives of quality of care from care managers includes several things, mostly high level outcomes.
Thus, a high-quality care from the managers’ point of view is characterised by:
- developed network and capacity of health care institutions,
- many institutions of different profiles and purposes,
- good coverage of the population with health care,
- many profiles of health staff,
- widespread use of health care,
- implementation of all necessary health care measures,
- increased involvement of people and the community in the implementation of health care,
- increased involvement of other sectors in the implementation of health care,
- implementing measures of promotion, health improvement, behaviour change,
- the growing need to use appropriate and relevant information,
- greater need for coordination of different health care institutions, levels of protection, sectors and other entities relevant to health care,
- high-quality health care enables an uninterrupted organisation, planning, communication, coordination, and evaluation of activities.
Taking different perspectives of quality into account
Bearing in mind that the health care system is getting bigger and more complex, it is necessary to try to make it as efficient as possible with the appropriate management and leadership. To achieve this, it is necessary to develop an information system at all levels of health care.
Gradually, the health information system grows into a health information management system.
In planning, programming, and implementing various activities of the health system special attention should pay to the efficient use of all resources and the application of evaluation methods.
It is necessary to strengthen the application of management and leadership at all levels of the health system. This could be done through appropriate education and training of managerial staff. This is perhaps why the Care Quality Commission has a dedicated domain for assessing leadership.
Implementation of all this in practise is neither simple nor easy. Health management is gaining in importance to achieve more efficient implementation of programmes and activities. Everyone is interested in its application: individuals, organisations, institutions, associations, narrower and wider communities.
The characteristics of a successful health manager include knowledge, innovation, flexibility and leadership. Others are vision of potential progress organisations, as well as encouraging and rewarding individuals and groups for quality work are
High-quality care is not what is achieved at any cost, but the one that meets the needs of patients. Professional staff achieve set goals and uses available resources most efficiently.