(5) Efficiency to individual patient. Efficiency to an individual patient is still
another area of concern in maintaining quality health care. Medical staff qualifications,
length of stay, costs of care, timely and effective use of technical services, and infection
control programs are all elements of efficiency to the individual patient.
(6) Satisfaction of health care professionals. Among the factors which have a
bearing on the satisfaction of health professionals are: highly qualified support staff,
adequate or improved physical facilities, effective management, sound fiscal and
administrative organization, and peer review.
(7) Accountability. Accountability is a significant area of concern to providers of
health care. Medical treatment facilities are accountable (answerable) for the quality of
health care to: the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO), PROs, Medicare/Medicaid administrators, consumer advocacy groups, the
Inspector General, and others.
EVALUATION OF QUALITY
a. One of the purposes of the Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) is to conduct survey and accreditation programs which encourage
medical treatment facilities (MTF) to promote high quality care so that patients can derive
the optimum benefits that medicine has to offer. To accomplish this, the JCAHO
establishes standards against which it evaluates MTFs. These standards are in a
continuous process of development. Standards must meet three criteria: They must be
valid, that is, they must relate to the health care or services provided and must encourage
excellence within the limitations of available resources. They must be achievable, that is,
the standards of health care must have been demonstrated in another health care facility.
Finally, standards must be measurable.
b. No single method of health care evaluation is best. Each assessment technique
has strengths that are useful in some situations, and limitations that make it inappropriate
for other applications. Donabedian, whose definition of "quality health care" was provided
earlier, identified three approach methodologies to the assessment of quality care. The
(1) Appraisal of structure.
(2) Assessment of process.
(3) Assessment of outcomes.