Standards and Evaluation of Healthcare Quality, Safety, and Person-Centered Care

Excerpt

Health care encompasses services and products provided to individuals who are both patients in the traditional sense and customers in a modern context. This activity emphasizes the delivery of health care in both capacities. Therefore, the term patient-customers is used throughout to reflect this dual role. Healthcare providers should consider this concept when engaging with this topic and delivering care, ensuring a balanced approach that prioritizes both clinical outcomes and patient experience.

The history of quality delivery in health care dates back to the earliest texts on physician ethical obligations. Please see StatPearls' companion resources, "Medical Ethics" and "Patient Rights and Ethics," for more information. Since the European Enlightenment, the use of objectively measured data to assess and improve healthcare quality has become increasingly common. Another key goal of quality management is the standardization of practices and products once a defined quality threshold has been met. Ernest Codman (1869-1940) is a notable pioneer in both areas. As a surgeon who began practicing medicine in 1895, he initiated record-keeping of surgical outcomes to enable retrospective analysis of processes and their impact on outcomes. To achieve practice standardization, he played a leading role in the American College of Surgeons (ACS) and its Hospital Standardization Program, which eventually became the Joint Commission (TJC) on Accreditation of Healthcare Organizations. Another pioneer in healthcare quality is Ignaz Semmelweis (1818-1865), who established the practice of antisepsis in hospitals. Both Codman and Semmelweis were rejected and harassed by other clinicians for insisting that the status quo was detrimental to patients.

The deliberate study, quantification, and practical application of data to achieve quality in business originated outside of health care and remains a distinct field of study outside of health care. While working in telecommunications engineering, Walter Shewhart (1891-1967) pioneered modern statistical process control. Edwards Deming (1900-1993), a physicist who later became a business consultant and a professor of statistics and business, expanded Shewart's work and has been called the originator of quality management. Deming is most recognized for his impact on quality control in automobile manufacturing, and healthcare professionals later adopted his principles. Quality control measures in modern healthcare are often influenced by the work of one or more of these 4 individuals.