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Introducing healthcare improvement
Introducing healthcare improvement

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2 Six aims of quality in healthcare

One of the most important definitions of high quality care was established in 2001 in the USA. The Institute of Medicine released a report entitled Crossing the Quality Chasm: A New Health System for the 21st Century (2001). This report outlined six dimensions of high quality care that should inform the development of quality improvement initiatives. As a result, these six dimensions of quality are sometimes also referred to as aims for improvement. The Institute of Medicine also stated in their report (2001) that healthcare providers should measure and monitor the quality of the care they offer in relation to these aims so that this information can help target quality improvements at the right aim. The six aims are that healthcare should be:

  • safe
  • effective
  • patient-centred
  • timely
  • efficient
  • equitable.

These aims have also been adopted as a framework by the World Health Organization (2006) and by healthcare providers around the world. For example, the Healthcare Quality Strategy for NHS Scotland [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]  (Scottish Government, 2010) is explicitly based on these aims for improvement.

The Institute of Medicine also stated in their report (2001) that healthcare providers should measure and monitor the quality of the care they offer in relation to these aims. Monitoring healthcare quality allows any quality improvement initiatives to focus on specific aims for improvement. We shall now consider each aim in turn and reflect on what they mean for quality improvement in practice.