Quality Management in Health Care

Instead of being solely focused on the quality of a product or a service, the four components of quality management – quality planning, control, assurance and improvements – put the emphasis on the processes that lead to certain positive or negative outcomes, and constantly try to improve them. Quality management is a highly customer focused approach whereby consumer satisfaction is both a priority and a determinant factor influencing the decision-making process of the organization.

While most businesses like trade, finance and manufacturing are quite enthusiastic about quality management, the approach is received with skepticism in the health care industry. Negativity towards quality management in health care comes primarily from physicians, whose view on the matter emphasizes the technical excellence as the only component able to determine the quality of care. Whilst the opinion of health care professionals continues to be widely accepted, other perspectives on quality have gained popularity in recent years. For instance, the view that health care providers including physicians should be responsive and sensitive to the preferences and values of individual patients made consumer opinions an important indicator of quality along with technical excellence.

These recent developments in the understanding of what exactly constitutes quality health care raise a few important questions: Can ‘health’ be treated as any other product or service? Are health consumers’ opinions as important as health providers’ expertise? And if yes, to what extend?

Answering these questions requires deep understanding of the interplay between the groups of actors directly involved in health care – the customers (patients) and the experts (physicians). Beyond them, there are the overarching third parties – the businesses (health insurance companies, or governments) and the institutions (private or public hospitals). Within this structure, patients are customers of the insurance companies; however, physicians are not employees of these businesses, making quality management very difficult. Instead, experts work for enormous private or public institutions - the hospitals that have partnered up with a number of large businesses. The complexity of overlapping relationships in health care between doctor and patient, between business and customer, and between business and public and private institutions make customer focused quality management an inappropriate approach. Certainly, patients’ opinions are not irrelevant, but they are not as decisive as they would be in a purely business environment.

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