An Introduction to Quality Assurance in Health Care by Avedis Donabedian

By Avedis Donabedian

Avedis Donabedian's identify is synonymous with caliber of treatment. He unraveled the secret in the back of the concept that by way of defining it in transparent operational phrases and supplied particular blueprints for either its measurement(known as caliber review) and its improvement(known as caliber assurance). Many prior to him claimed that caliber could not be outlined in concrete goal phrases. He proven that caliber is an attribte of a procedure which he known as structure, a collection of prepared actions whihc he referred to as process, and an consequence which ends from either. during this ebook Donabedian tells the total tale of caliber overview and insurance in uncomplicated, transparent phrases. He defines the that means of caliber, explicates its parts, and gives transparent and systematic courses to its evaluation and enhancement. His variety is lucid, succinct, systematic and but own, nearly conversational.

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And, as their practitioners also do, patients compare the expected improvements in health to the risks associated with care. But, it is also important to recognize that patients may value each of these consequences of care (effects, risks, and 22 AN INTRODUCTION TO QUALITY ASSURANCE IN HEALTH CARE cost) in a way that differs from the valuations of their practitioners. Moreover, patients differ greatly from one another in their valuations. When these differences arise out of ignorance of the consequences of the care contemplated or received, education is the remedy.

To begin with, these attributes are desirable in their own right. They embody cherished values of the health care professions, and include desirable characteristics of every interaction in a civilized society. Moreover, when such attributes are present, patients are not only pleased, but also reassured. They regard their presence as evidence (which they understand) that technical care (which they do not understand so well) will also be good. For these reasons, when patients have a choice, and when competition among providers of care is allowed, the attractiveness of the patient-practitioner relationship becomes a key to success among competing organizations.

It is far from an exhaustive description of how the attributes of quality that are most salient vary from situation to situation. The lesson to be learned is that one must focus on what one is responsible for, what one can improve, and what is most in need of improvement. Steps in Monitoring and Improving Clinical Performance Again, my intent in this little book is to describe briefly how one may assure the quality of health care by monitoring clinical performance and The Components of Quality in Health Care 27 improving it when necessary.

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