What Is High Quality Care

The 2001 IOM report proposed that high-quality care should be:

■ Patient centered—providing respectful, responsive, individualized care

■ Safe—avoiding injury from care that is intended to help

■ Timely—reducing waits and harmful delays in care

■ Equal—providing equal care regardless of personal characteristics, gender, ethnicity, geography, or socio-economic status

■ Effective—avoiding under use, overuse, or misuse of services

■ Efficient—avoiding waste of all kinds

These suggested six aims have gained wide acceptance and have been incorporated into the national directives for health care in both Sweden and Norway.

Don Berwick, a pediatrician by training, and President, CEO of the Institute for Healthcare Improvement in Boston (www.ihi.org) has proposed the dimensions of high-quality care in a " 'No'-list" which is easily translated into daily clinical work. In health care there should be: No needless deaths, No needless pain, No helplessness, No unwanted waiting, No waste...for anyone (8).

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