Quality, Definition

The WSMA supports the following definition of quality in health care:

Defining, continually assessing and improving quality is a proper role of the medical profession.

Quality in health care is defined as the extent to which there is continual improvement in meeting or exceeding professionally established, measurable criteria of health care while balancing the patients' goals and values with established ethical guidelines.

Quality of care may be assessed by:

• Clinical Outcomes
  Acceptable outcomes should be derived from "evidence-based" processes (i.e. confirmed by the peer review literature) where possible and based on peer consensus as an alternative.
• Health Status
  The health status of both patients and populations should be compared using concise, validated instruments to measure peer practices.
• Patient Satisfaction
  Satisfaction with process of care including access should be measured using concise, validated instruments to assess peer practices.
• Value
  Value varies directly with the degree of quality, and inversely to the cost of care (value = Q/C). Value is important to patients and payers, and its determination is an expression of professionalism.

Continuous Quality Improvement is the preferred method for improving quality. There are no absolute values for quality; rather, practitioners should strive continuously to improve outcomes within the resources available. This process requires the institutional and administrative commitment of the organization with which the practitioner is affiliated.

All available sources of expertise for parameters or guidelines for care should be utilized, and should be accessible to all practitioners in multiple, optimally usable forms. Practitioners, payers (including federal and state governments), and health care organizations share the responsibility for dissemination of validated practice parameters, so that all patients may benefit.

The organizational and practitioner specificity of performance data should be disseminated on the basis of "need to know," and should be risk/severity adjusted. This information should be used to improve the quality of medical care and not for the purpose of regulation or marketing.

The WSMA promotes this definition as a national model for defining quality in health care.

(CPA Rpt D, A-96) (Reaffirmed A-23)

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Abbreviations for House of Delegates report origination:

EC – Executive Committee; BT – Board of Trustees; CPA – Council on Professional Affairs; JC – Judicial Council; CHS – Community and Health Services