Recently a friend and I were talking about quality management. What it is, what is isn't, how the media makes it so complex.
My friend relayed her experience with a recent total knee replacement (her 7th). She started with one orthopaedic surgeon and shared that he didn't make eye contact during her office visits with him. As a result, she felt conversation during each visit was one-sided (his). In addition, she shared her idea with him of using a newly re-developed brace system. She had reviewed resources for this brace and wanted to explore options for post-surgery treatment. The surgeon responded that he did not think the brace system to be worthwhile and offered no additional explanation.
So she switched physicians and says this doctor makes her feel like she is his most important patient every single time she has an appointment with him! She says he has a welcome demeanor at every visit. He conveys knowledge of her history, makes a social comment and then gets down to business by summarizing the plan for this visit. His collaborative nature in agreeing to order the brace system improved her compliance with all post-surgery orders.
The exchange represents effective communication: The physician asked for her input, built trust with her by listening to her specific request and influenced positive outcome of care by involving her in the decision-making process!
Patient-reported outcomes --those that come directly from the patient -- are indeed the final and ultimate authority on the definition of quality of care. Quality management, then, is figuring out how to duplicate the successful visit over and over again. Each individual is the ultimate authority on the definition of quality.