Fundamentals of quality

"Quality is not a given. It takes vision, planning, investment, compassion, meticulous execution, and rigorous monitoring, from the national level to the smallest, remotest clinic."

Tedros Adhanom Ghebreyesus, WHO Director General

There is growing acknowledgment that quality health services across the world should be:

• effective: providing evidence-based health care services to those who need them;

• safe: avoiding harm to people for whom the care is intended; and

• people-centred: providing care that responds to individual preferences, needs and values.

   

 

In addition, to realize the benefits of quality health care, health services must be:

• timely: reducing waiting times and sometimes harmful delays for both those who receive and those who give care;

• equitable: providing care that does not vary in quality on account of age, sex, gender, race, ethnicity, geographic location, religion, socioeconomic status, linguistic or political affiliation;

• integrated: providing care that is coordinated across levels and providers, and makes available the full range of health services throughout the life course; and

• efficient: maximizing the benefit of available resources and avoiding waste.

Unsafe health care causes a significant amount of avoidable patient harm, human suffering and negatively affects the quality of health services provided. Patient safety is a fundamental aspect of quality of care and it is often used as a key entry point to improve the quality of health services.

In addition, quality health services span promotion, prevention, treatment, rehabilitation and palliation, implying that quality of care can be measured and continuously improved through provision of evidence-based care that reflects the needs and preferences of service users

Foundational requirements

Five foundational requirements for quality health services are proposed, all of which are relevant to national, district and facility levels.

Culture of quality

Planning for improvements in the quality of health services requires special attention to developing and institutionalizing a culture of quality – in organizations and across the health system – as a means to sustainable and meaningful change.