How often to people understand "Quality".  People deal with this every day of their life yet one cannot adequately define quality. Be it a service or a product, the perception of quality depends on how either of these influences an individual’s judgment of the attribute. Moreover,'quality' may differ from person to person.

Whilst there is no universal definition of quality, some of the characteristics of quality would be:

• Meeting or exceeding consumer anticipations
• It is dynamic (good today but average or below tomorrow)
• It can undergo a transformation for the better

Important Factor for Quality in Healthcare:

The cost factor

Unlike most other industries, the relation between cost and quality in healthcare is more difficult to gauge. Whilst healthcare services are expensive, the essence of quality varies based on the payer (self or insurance). Moreover, the healthcare seeker cannot afford to wait till either the quality improves or the costs come down.

Whilst insurers track overuse and overcharging of services, a 'fee for service' payer has little option but to pay. At that time, the cost of services factor overbears the quality factor. Yet there are those affording patients who are willing to pay more for quality of healthcare.

Quality in healthcare

As a rule, patients look forward to correcting diagnosis and treatment. They expect the quality of the hospital to be clean, hygienic and patient friendly; have humane and courteous staff, employ good level of medical technology.

Insurers, on the other hand, may value good quality and yet cost-effectiveness of healthcare services is paramount to them.

Yet another angle of quality in healthcare is that of the service provider viz. doctors, nurses, technicians and administrative staff who offer services to get the desired health outcomes.

The important facets of quality healthcare delivery encompass safety of patients and providers; efficiency of care without defensive or excessive practices; being patient-centric; efficient, impartial and timely services.

Managing quality

Quality is dynamic and hence it need to be measured, evaluated and improved at predetermined intervals.

There is no room for 'overuse' or 'underuse' of services leave alone 'misuse'.

Principles of Performance Excellence for Quality Healthcare

• Senior managers need to create strategies, systems and processes for achieving excellence in healthcare and direct and motivate the caregivers to excel in healthcare practices.
• The delivery of health care services must be patient focused. Patient satisfaction takes into account both medical and non-medical factors.
• Upgradation of knowledge and continuing education for all caregivers is essential in order to achieve new goals in healthcare delivery mechanisms.
• All staff must receive their due credence so as to motivate them to excel in their patient care activities. The organization must practice `Change Management’ such that all care givers are responsive to change in the healthcare services and by anticipating stakeholder expectations; technological advancements and innovations; changing regulatory norms; community expectations and new initiatives by competition
• Faster and more adaptable response to patients and other clients is crucial as is the organisations responsibility towards community health
• Monitoring and assessing the institutions practices and outcomes

Conclusion

Quality in healthcare services (NABH Hospital Accreditation) and delivery cannot be defined simplistically nor measured by applying a formula. It is an amalgamation of multiple factors that encompass the practices, policies, processes, etc. of the caregiver and the outcomes of these on multiple elements involved in this process. The final gradation is the level of satisfaction, which yet again is a volatile matter, subject to varying grades given by the care receiver. The effort by an institution is mainly to strive to deliver the best of all.