| Performance is what is done and how well it is done to provide health care. The level of performance in health care is
• The degree to which what is done is efficacious and appropriate for the individual patient; and
• The degree to which it is available in a timely manner to patients who need it, effective, continuous with other care and care providers, safe, efficient, and caring and respectful of the patient
Characteristics of what is done and how well it is done are called dimensions of performance:
• The degree to which an organization does the right things and does them well is influenced strongly by its design and operation of a number of important functions - many of which are described in this manual.
• The effect of an organization’s performance of these functions is reflected in patient outcomes and in the cost of its services.
• Patients and others judge the quality of the health care based on patient health outcomes (and sometimes on their perceptions of what was done and how it was done).
• Patients and others may also judge the value of the health care by comparing their judgments about quality with the cost of the health care.
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| I. Doing the Right Thing
The efficacy of the procedure or treatment in relation to the patient’s condition
The degree to which the patent’s care and services have been shown to accomplish the desired or projected outcome(s)
The appropriateness of a specific test, procedure1 or service to meet the patient’s needs
The degree to which the care and services provided are relevant to the patient's clinical needs, given the current state of knowledge
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| II. Doing the Right Thing Well
The availability of a needed test, procedure, treatment, or service to the patient who needs it
The degree to which appropriate care and services are available to meet the patient’s needs
The timeliness with which a needed test, procedure, treatment, or service is provided to the patient
The degree to which the care and services are provided to the patient at the most beneficial or necessary time
The effectiveness with which tests, procedures, treatments, and services are provided
The degree to which the care and services are provided in the correct manner, given the current state of knowledge, to achieve the desired or projected outcome for the patient
The continuity of the services provided to the patient with respect to other services, practitioners, and providers and over time
The degree to which the patient’s care is coordinated among disciplines, among organizations, and over time
The safety of the patient and others to whom the services are provided
The degree to which the risk of an intervention and risk in the care environment are reduced for the patient and others, including the health care provider
The efficiency with which care and services are provided
The relationship between the outcomes (results of care) and the resources used to deliver patient care and services
The respect and caring with which care and services are provided
- The degree to which those providing care and services do so with sensitivity and respect for the patient’s needs, expectations, and individual differences
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- The degree to which the patient or a designee is involved in his or her own care and service decisions
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