Do the Institute of Medicine’s (IOM’s) dimensions of quality capture the current meaning of quality in health care? – An integrative review

Abstract

Aims: The aim of this study was to determine whether the widely adopted Institute of Medicine's dimensions of quality capture the current meaning of quality in health care literature. Design: An integrative review was utilised as there has been a multitude of published papers defining quality in relation to health care, therefore collective analysis may provide new insight and understanding. Method: Papers offering a definition or conceptual understanding of quality in relation to health care were identified by searching relevant databases. Papers were excluded according to predefined criteria. An integrative review was conducted and the Institute of Medicine's dimensions were used as a framework for data extraction and analysis. Findings: The review identified two important additional dimensions of quality; namely caring and navigating the health care system and argues that they require recognition as dimensions in their own right. Conclusion: In the current climate of constrained finances there is a risk that the allocation of resources is directed to current explicit dimensions to the detriment of others. The result may be a reduction in health care quality, rather than improvement.

A systematic review of the validity and reliability of patient‐reported experience measures

“…The Institute of Medicine's (IOM) 2001 report on crossing the quality chasm identified that despite a significant increase in chronic and complex conditions, health care systems are still devoted to acute episodes of care . Overwhelmingly, this sentiment still reigns true today, despite efforts to promote greater integration and coordination of care across and within health care services, as well as patient‐centric, high‐quality health care . For example, this systematic review identified only one peer‐reviewed PREM targeting chronic disease holistically (as opposed to a singular disease focus) and two PREMs focusing on the integration of care.…”

“…Patient‐reported experience measures are gaining attention as an indicator of health care quality and can provide information regarding the patient‐centeredness of existing services as well as areas for potential improvement regarding health care delivery . The purpose of employing PREMs is consistent with the Institute of Medicine's (IOM) definition of health care quality, defined as care that is patient‐centered, effective, efficient, timely, and equitable . In recent years, PREMs have been used to inform pay‐for‐performance (P4P) and benchmarking schemes, adjunct with other health care quality domains, including clinical quality/effectiveness, health information technology, and resource use .…”

“…7 The purpose of employing PREMs is consistent with the Institute of Medicine's (IOM) definition of health care quality, defined as care that is patient-centered, effective, efficient, timely, and equitable. 8 In recent years, PREMs have been used to inform pay-forperformance (P4P) and benchmarking schemes, adjunct with other health care quality domains, including clinical quality/effectiveness, health information technology, and resource use. 9,10 Such schemes see health care services financially rewarded for their performance across these domains of health care quality, as opposed to the traditional fee-for-service payment system, which may inadvertently promote low-value care.…”

A national cross‐sectional study measuring predictors for improved service user outcomes across clinical nurse or midwife specialist, advanced nurse practitioner and control sites

“…A further recent review by Beattie et al . () to determine whether the Institute of Medicine's (IOM's) dimensions of quality capture the current meaning of quality in the healthcare literature identified two important additional dimensions of quality, namely caring and navigating the healthcare system, and authors argue that they require recognition as dimensions in their own right.…”

Oral care quality—Do humanity aspects matter? Nursing staff's and older people's perceptions

“…Humanity highlights the importance of the relationship between patients and nursing staff (Donabedian, ; McCormack, ) and is underpinned by integrating the relational aspects and physical health and psychological well‐being (Edvardsson, ; Ricoeur, ). Humanity is one key attribute of quality (Beattie, Shepard, & Howieson, ; Hanefeld et al, ; World Health Organization, ), and it influences the extent to which patients experience quality care (Edvardsson, Watt, & Frances Pearce, ). The theoretical model of care quality from the patient perspective according to Wilde, Starrin, Larsson, and Larsson () includes humanity aspects such as an identity‐oriented approach concerning information, respect and participation and a sociocultural atmosphere concerning the determination of needs and preferences.…”