The quality domains – what’s your druthers?
As was said in the report Crossing the Quality Chasm [blah blah blah]….
Every report and article on the topic “health care quality” starts this way, because the report was groundbreaking, laying out the domains that we should aspire to perfect: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. These domains apply at multiple levels throughout the healthcare system. But as Don Berwick pointed out, our true lodestone should be the patient’s experience.
In that case, why don’t we ask how people (sorry, “patients”) feel about these domains, and what are most important to them? Of course, it’s impossible to achieve all the domains perfectly at once. Everyone could be made perfectly safe if nothing were attempted. Care could be timely if no one ever asked patients’ opinions or double checked that errors weren’t being made. And so on.
How would you make the tradeoff, if you could? Once I get your answers, we can discuss how they compare to past and present literature, and what to do about the balancing act.
