A study of the criteria used by healthcare professionals, managers and patients to represent and evaluate quality care.
OBJECTIVE
To explore the perceptions of and criteria used by healthcare professionals, managers, patients and relatives to represent and evaluate their concept of quality care.


METHODS
A qualitative approach using grounded theory was adopted in this exploratory descriptive study. Data collected by semi-structured interviews from a purposive sample of nurses, doctors, managers (n = 36), patients (n = 34) and relatives (n = 7) from one acute medical ward, were subjected to content, question and thematic analysis, using an inductive categorizing scheme.


RESULTS
Three categories of criteria relating to Care Resources, Processes and Outcomes were identified by healthcare professionals, managers, patients and relatives. Resource criteria included Human Resources: staff numbers, ratio to patients, skill mix; as well as Environmental/Physical and Financial Resources. Process criteria included Care Functions, Practices and Standards as well as Interpersonal Processes. Outcome criteria were either patient-focused: feeling comfort, happy, informed and satisfied; or health-related: maintenance or progress with health problems and goals.


CONCLUSIONS
The criteria used by healthcare stakeholders in this study were not unusual; virtually all were supported by the literature, a proportion of which was evidence-based. The criteria identified in this study are however consensual, agreed upon by healthcare professionals, managers, patients and relatives as representing their view of quality care. These consensual criteria could be used as unifying constructs for the development and testing of more comprehensive, reliable and valid methods of evaluating quality care which represent its multiple dimensions and perspectives.
Attree
M
M
School of Nursing, Midwifery and Health Visiting, University of Manchester, Coupland III, Coupland Street, Oxford Road, Manchester M13 9PT, UK.
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D003258:Consumer Behavior; D003657:Decision Making; D004739:England; D019317:Evidence-Based Medicine; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D010043:Outcome and Process Assessment, Health Care; D019984:Quality Indicators, Health Care