Understanding and Implementing Quality Dimensions in Healthcare Delivery
Learn the basics of healthcare quality dimensions: safety, timeliness, effectiveness, patient-centred care, efficiency, and equity to improve patient care.
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The Six Dimensions of Healthcare Quality
Added on 09/28/2024
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Speaker 1: Healthcare is about how health services are organised and delivered to support people in maintaining or improving their health. To ensure we deliver the best healthcare, we need to embed the dimensions of healthcare quality into our everyday practice. The dimensions are safety, timeliness and accessibility, effectiveness and appropriateness, patient-centred care, efficiency and equity. Applying these dimensions leads to a reliable healthcare system. Reliability is when safe, appropriate care is provided by the right people, to the right patient, in the right place, at the right time, every time. It's important to foster partnership and teamwork. It is also important to recognise what goes well and to learn from our reliable systems. We need to celebrate the great work that is done by healthcare teams every day. This module introduces the basics of the quality dimensions, so you can better understand how to apply them in your workplace. This will help you to recognise opportunities to improve the care and service we deliver to our patients. Safety in healthcare is about reducing the risk and impact of incidents that can harm patients. A safety incident is an unplanned event that results in or could result in injury, damage or loss. It includes near misses. An example of a safety incident could be a medication error, such as the wrong drug or wrong dose being given. Other examples include preventable falls or pressure injuries. Safety incidents don't have to be clinical. Sometimes information can be mistyped into a computer, or a patient may be given the wrong meal, which may result in them having an allergic reaction. Most often, it is the design of the system that has resulted in the incident, rather than human error. Most of the time patients receive safe, reliable, effective and compassionate care. So how can you play a part in making sure safety incidents don't occur in your workplace? Timeliness is about how quickly patients receive the healthcare they need. Our aim is to ensure that there aren't any barriers to patients receiving timely access to the care they need. Timely healthcare involves reducing wait time and delays. Do we need to reduce the wait time for elective surgery? Time to be seen in the emergency department or to be discharged from the ward? Are there any delays in bed availability, room cleaning or maintenance completion? Do we answer patient bedside call bells promptly? Reliable healthcare is about patients getting their needs met when they need it, wherever they are. This includes reducing geographical, financial, medical or social issues that prevent the patient getting the right care at the right time. Do we have reliable systems to ensure patients living in remote or rural areas have access to the care they need in a timely way? What part can you play in ensuring timely and accessible care or service delivery in the area where you work? Effective healthcare is providing services and treatment that are based on scientific knowledge and evidence-based practice. We remind ourselves of what works well in providing patients with services and treatment that are appropriate and based on research. Effective and appropriate care can also mean not providing tests, medications, treatments or services to those not likely to benefit from them. We always need to question what are the most appropriate medicines, therapy or tests for our patients. Appropriate care is also about how we can reduce over-treatment or under-treatment to our patients. Over-treatment could be as simple as not following blood transfusion guidelines and transfusing blood to a patient unnecessarily. Under-treatment could be not performing risk screening for delirium, pressure injury or falls risk. Effectiveness also involves our everyday interactions, such as the effectiveness of our team's clinical handover processes or the effectiveness of our communication with team members and patients. How can you play a part in ensuring effective and appropriate care, service delivery and communication in the area where you work? Patient-centred care is about putting the patient in the centre of the care system. It's providing care that is respectful of, and open to, individual patient preferences, needs and values. Does your daily routine consider the patient's needs and support their experience of comfortable, timely, reliable and safe care? Sometimes it's easy to forget that the patient is the fundamental part of the healthcare team. Partnering with patients allows for sharing of knowledge and decision making. How can you play a part in ensuring patient-centred care is at the forefront in the area where you work? Efficient healthcare is about getting the most out of available resources to deliver the best value healthcare we can. We need to ensure our models of care are clinically appropriate and our procurement is cost effective, avoiding any waste. Can we think of things that can be done a different way so that we deliver better value healthcare? For example, should we routinely admit the patient as an inpatient if it is equally effective and appropriate for the procedure or care to be delivered in a day case or outpatient setting? How can you play a part to ensure efficient and effective service delivery where you work? Equitable healthcare is about delivering care that is of high quality, regardless of personal characteristics. These include age, gender, geographical location, ethnicity, religion, socioeconomic, disability or health status. Is access to our healthcare fair for everyone? How can you be involved in ensuring that care is equitable in your workplace? These dimensions are not just definitions of quality healthcare. They help us find ways to improve and promote safety and quality in the NSW healthcare system. The next step is to get involved and be a part in improving the quality of your healthcare service.

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