Basic Definitions and Criteria for the Management and Assurance of Quality in Health Care

  • Thomas T. H. Wan
  • Alastair M. Connell


Although health care quality has been defined in many different ways, it is probably fair to say that none has clearly captured all the elements involved. One of the more comprehensive definitions, developed for the Department of Veterans’ Affairs, states that “quality health care is care that is needed and delivered in a manner that is competent, caring, cost effective and timely and that minimizes risk and achieves achievable benefits” (Barbour, 1996). This definition, though adequate, has all the grace usually found in the products of committees, of which it clearly is an example. Translated from committee jargon, the definition can be summed up as “quality health care is doing the right thing, at the right time, and in the right way.” To provide health care of high quality, then, we have to know what is the right action, seize the right time, and single-mindedly pursue the right way—a tall order, indeed.


Cost Containment Quality Health Care Quality Assurance System Milbank Memorial Fund Tall Order 
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  1. Aday, L.A., Begley, G.E. and Larson, D.R. et al. (1993). Evaluating the Medical Care System: Efficiency and Equity. Ann Arbor, MI: Health Administration Press.Google Scholar
  2. Agency for Healthcare Research and Quality (2001). Five Steps to Safer Health Care. Patient Fact Sheet. AHRQ. Quality Interagency Coordination Task Force. Scholar
  3. Barbour, G.L. (1996). How the Veterans Health Administration Improved Quality Management. San Francisco: Jossey-Bass.Google Scholar
  4. Cohen, J. (2000). Outcomes: are they a good thing? Nurs. Health Care Perspect., 21 (2): 100.Google Scholar
  5. Donabedian, A. (1996). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 166–203.Google Scholar
  6. Eddy, D.M. (1989). Selecting technologies for assessment. International Journal of Technology Assessment in Health Care, 5, 485–501.CrossRefGoogle Scholar
  7. Enthoven, A.C. and Vorhaus, C.B. (1997). A vision of quality in health care delivery. Health Affairs, 16, 44–57.CrossRefGoogle Scholar
  8. Gray, B.H. and Field, MJ. (eds). (1989). Controlling costs and changing patient care? The role of utilization management. Washington, DC: National Academy Press.Google Scholar
  9. Institute of Medicine (1974). Advancing the Quality of Healthcare. Washington, DC: National Academy of Sciences.Google Scholar
  10. Institute of Medicine (1990). In a Strategy for Quality Assurance. Vol I, ed. Lohr, K.N. Washington, DC: National Academy of Sciences.Google Scholar
  11. Institute of Medicine (1994). America: Health in Transition. Washington, DC, National Academy of Sciences.Google Scholar
  12. Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System fo r the 21st Century. Washington, DC: National Academy of Sciences.Google Scholar
  13. Medicare Payment Advisory Commission (2002). Report to the Congress: Applying Quality Improvement Standards in Medicare. Washington, DC: Medicare Payment Advisory Commission.Google Scholar
  14. Wan, T.T.H. (1995). Analysis and Evaluation of Health Care Systems: An Integrated Managerial Decision Making Approach. Baltimore: Health Professions Press.Google Scholar

Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Thomas T. H. Wan
    • 1
  • Alastair M. Connell
    • 1
  1. 1.Virginia Commonwealth UniversityUSA

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