Question

What policy initiatives do you perceive will strengthen nurses’ capabilities to improve upon the six domains of healthcare quality (safe, effective, patient/person-centered, timely, efficient and equitable) as defined by the Institute of Medicine

Answer 1

Ans) A handful of analytic frameworks for quality assessment have guided measure development initiatives in the public and private sectors.

- One of the most influential is the framework put forth by the Institute of Medicine (IOM), which includes the following six aims for the health care system.

Safe: Avoiding harm to patients from the care that is intended to help them.
Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).
Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.
Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.
Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
- Existing measures address some domains more extensively than others. The vast majority of measures address effectiveness and safety, a smaller number examine timeliness and patient-centeredness, and very few assess the efficiency or equity of care.

- Frameworks like the IOM domains also make it easier for consumers to grasp the meaning and relevance of quality measures.

- Studies have shown that providing consumers with a framework for understanding quality helps them value a broader range of quality indicators.

- For example, when consumers are given a brief, understandable explanation of safe, effective, and patient-centered care, they view all three categories as important.

- Further, when measures are grouped into user-friendly versions of those three IOM domains, consumers can see the meaning of the measures more clearly and understand how they relate to their own concerns about their care.