Table 1 Quality of Care frameworks and components
Authors | Definition | Components |
|---|---|---|
Donabedian (1988) | - Using medical science and technology to improve health without compromising risk. - QoC consists of technical care and interpersonal process. | - Structure - Process - Outcomes |
National Academy of Medicine (formally the Institute of Medicine/IOM) (IOM 2001, Lohr 1990) [82] | “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” | - Safety - Effectiveness - Patient-centredness - Timeliness - Efficiency - Equity |
World Health Organization (2006) [83] | - Comprehensive whole-health system perspective that focus on outcomes for individuals and communities. The working definition includes six dimensions. | - Effectiveness - Efficiency - Accessibility - Acceptability - Equity - Safety |
Hanefeld, Powell-Jackson, and Balabanova (2017) | - Quality is a complex concept. - Includes both the demand and supply side of health care. | - Clinical quality - Perceived quality - Process - Responsiveness - Quality as a social construction |
Bruce QoC Framework (1990) | - Consists of six elements outlined in a framework. It is both a subjective and outcomes-based concept. It places an important emphasis on the experience of clients. | - Choice of methods - Information given to users - Technical competence - Interpersonal relations - Continuity mechanisms - Appropriate constellation of services. |
Bruce-Jain framework revised (2018). | - Revision of the Bruce/Jain QoC Framework with modification to five of the elements originally included. Maintains a human-rights base, client-centred focus. | - Focus on safety of contraceptive products, trained HCPs, and resources. - Choice of methods - Information given to users, to be replaced by information exchange that includes follow-up, and switching methods, service provider or outlet - Technical competence, to include safety. - Interpersonal relations, to emphasise dignity, respect, privacy, and confidentiality - Continuity mechanisms – covered under the information element - Appropriate constellation of services. |
NDoH, South Africa National Core Standards for Health Establishments in South Africa (2011). | - The common definition of QoC is to obtain the best possible results with available resources. To attain the goals of health improvement and responsiveness to the expectations of the population. | - Patient Rights - Patient safety, clinical governance, & care - Clinical support services - Public health - Leadership & corporate governance - Operational management - Facilities & Infrastructure |
NDoH, South Africa National Contraception and Fertility Planning Policy and Service Delivery Guidelines (2012) [13] | - Uses the common definition of QoC as set out in the National Core Standards for Health Establishments in South Africa. | - Management systems - Accessible and acceptable services - Rights - Continuity of care - Drug management and equipment - Environment of care and infection control |