Definition of “Quality” in Healthcare
High-quality healthcare in the UK is defined by Lord Darzi’s canonical framing: quality of care = clinical effectiveness + patient safety + patient experience (Darzi, 2008). These three linked dimensions should guide measurement, governance and improvement work.
Quality improvement (QI) is the systematic, evidence‑based use of methods and data to close gaps between current and desired performance across these dimensions and to sustain gains over time.
The three core dimensions
Clinical effectiveness
Care that delivers benefit based on the best available evidence. In practice this means adherence to evidence‑based guidelines and timely delivery of interventions that improve outcomes (for example, following validated pathways for sepsis or stroke). Measures commonly used include pathway compliance, condition‑specific outcomes and readmission/reattendance rates.
Patient safety
The avoidance of preventable harm through error prevention, risk detection and mitigation, and a learning culture that encourages incident reporting. Safety measures include rates and severity of medication incidents, missed critical interventions, and harm detected by case review.
Patient experience
The patient’s perspective on care: dignity, communication, information, involvement in decisions, and respect for preferences. This extends beyond simple satisfaction scores and is captured by patient‑reported experience measures (PREMs), complaints relating to communication or privacy, and measures of the patient journey (for example, time to triage, comfort measures).
Interdependence
These dimensions are interdependent: a change...