The need for a global clinical standard Defining quality is not easy and there is not always consensus on what good quality means, says Alf Theodorou, CEO and Founder of NewCourse
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he on-going pandemic has been an incredible challenge for all of us, none more so than those involved in healthcare delivery across the world. In all corners of the globe, people took note of the extraordinary efforts of those working to provide care to our sick and needy, standing in unison to show their support for the new heroes of our generation. The pandemic also brought into sharp focus key elements of healthcare delivery, from the role of technology and attitudes to whether bricks and mortar hospitals are the right places to receive care; to the importance of leadership, the human workforce and the stark inequalities in funding, resources and capacity that exist. We have also seen rapid innovation, the like of which we might not have seen for many years to come, with young and old, clinical and non-clinical embracing technology; and a seismic shift in attitudes to our expectations of care and the importance of healthcare to us.
What do we mean by good quality care? Perhaps the best place to start is to say that we all want to be able to access high quality care - that is, care that is most likely to result in the outcome we want. Defining quality is not easy and there is not always consensus on what good quality means. If you ask a clinician you will get a different answer to a patient, and again asking a friend or relative of those needing care and your answer might change again. Across the world’s economies and healthcare systems you will also see variation in definition. It is a question that needs answering. Healthcare organisations, regulators, governments and accreditation agencies have all defined quality either on a national or international basis. There are plenty of league tables that rank hospitals, and their criteria as well as defined healthcare standards – such as the Care Quality Commission in the UK – are
easily available. Good quality can mean that other clinicians would recommend a hospital; it can mean an excellent patient experience with hotel-like infrastructure and waterfalls in reception. Good can mean that care is evidence-based or that the results of treatment are positive. The definition, like the delivery of healthcare, is subject to huge variation. And we have not tried to measure anything yet. Why is it important to think about what good looks like? Healthcare consumption – if I can use that expression – has changed forever. From a patient perspective we are much more aware of our expectations from our healthcare provider and much more informed about our options for care. As measures of quality from patient experience to clinical outcome become more readily available, we will want to compare and contrast our options more than ever. Globalisation – despite the restrictions of the pandemic – has seen significant movement of people both for work and pleasure. The result is that we are often accessing healthcare in a country we were not born in and so we inadvertently begin the internal process of benchmarking against what we know. Health funders and payers are ever more conscious about the need to achieve value
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