Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Quality Measurement and Improvement
Lecture:Definitions and framework for assessing quality
What is known about health care quality
Slide content:Donabedian Model of Quality (2002) Three categories: Structural: Factors that make it easier or harder to deliver high-quality care (e.g., hospital location, volume, association with teaching hospital) Process: Factors describing health care content and activities (e.g., adherence to screening, guidelines) Outcomes: Changes attributable to care (e.g., mortality, morbidity, functional status) Implemented and measured at different levels at an institution (e.g., individual, department, organization) 5
Slide notes:Donabedian developed a model of quality with three categories of quality measures. The first category is structural measures, which are factors that make it easier or harder to deliver high-quality care. Structural measures are factors such as hospital location, patient volume, whether the hospital is associated with a teaching institution, and so forth. The second category is process measures. These are factors that describe health care content and activities, such as how much screening is done and the degree of adherence to established practice guidelines. Finally, there are outcomes measures, which are changes attributable to care, such as the mortality rate, morbidity, and functional status. These factors are implemented and measured at different levels within an institution, such as the individual practitioner level, the department level, and the organization as a whole. 5