The U.S. leads the way in many areas into the future of economy, wealth and civilization. America spends more on heath care than any other nation with quality and safety being a key focus. Nevertheless, evidence of improvement of decreased errors is limited. We lack answers to financial stability and providing quality health care to all (Becher & Chassin, 2001). Nationally, everyone is engaged in improving the quality and safety of healthcare. We need to be awakened to preventing errors and providing safer care (Laureate, 2009). The purpose of this paper is to discuss the initiative to improve quality and safety of health care with the “Six Dimensions of Goodness in Healthcare.” A quality and/or safety initiative
Healthcare facilities are engaging in the prevention of medical errors and providing better care. Many institutions are implementing process improvement focused on six key dimensions to enhance the quality and safety in their healthcare setting (Laureate, 2009). The six dimensions are: Safety-to avoid injury to patients from the care that is intended to help them; Timeliness-to reduce waits and harmful delays; Effectiveness-to provide services based on scientific knowledge to all who could benefit and refrain from providing services to those not likely to benefit (avoiding overuse and underuse, respectively); Efficiency-to avoid waste; Equitability-to provide care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographical location, and socioeconomic status; and Patient centeredness-to provide care that is respectful of and responsive to individual patient preferences, needs, and values (Madhok, 2002).
Reasons for the initiative
The Institute of Medicine (IOM) has a growing concern about medical errors. The IOM report “Crossing the Quality Chasm,” asked for a basis change, recommending that the delivery of health care be based on six key dimensions. We have an interaction between the errors of individuals and system flaws that need to be prevented. We need to strengthen our defense systems (Madhok, 2002). The report, “To Err is Human” estimated that 44,000 Americans die per year as a result of medical errors. More deaths occur in a given year from medical errors than from motor vehicle accidents, breast cancer, or AIDS. National costs of preventable medical errors were estimated between $17 billion - $29 billion (Madhok, 2002). Healthcare institutions are embracing new initiatives for safer care based on the six dimensions. Healthcare systems are implementing the six dimensions as a basic initiative to improve quality. The IOM states that American healthcare must make vast changes to have clinically safe and quality care (Madhok, 2002). The six dimensions can influence and direct the overall process of improvement (Laureate, 2009). Payment systems such as Pay for Performance are causing facilities to incorporate the six dimensions. Pay for Performance initiatives advocate financial rewards to hospitals demonstrating outstanding preventative and care giving practices (Sultz & Young, 2011). Poor outcomes with medication errors, skin breakdown, patient falls, isolation procedures, and drug protocols can effect payment to hospitals (Laureate Education Inc, 2009). High quality medical care at an affordable cost is a growing goal for healthcare institutions. Effective, safe, and affordable health care leads to higher patient satisfaction (Quality Initiatives, 2004).
Strengths and limitations of the initiative
The six dimensions encourage a strong focus on health care quality and error prevention. They encourage policymakers, purchasers, regulators, health professionals, health care trustees, management, and consumers to commit to a national system level of process improvement for quality health care. They encourage a shared agenda to pursue safer care (Madhok, 2002). This can cause...