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October 6, 1999

Service Excellence in Health Care

Author Affiliations

Author Affiliations: Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC (Dr Mayer); Department of Emergency Medicine (Drs Mayer and Cates) and Flight Services, Inova Medical AirCare, Inova Fairfax Hospital (Dr Mayer); and Fairfax County Fire & Rescue & Police Helicopter Unit (Dr Mayer), Falls Church, Va.

JAMA. 1999;282(13):1281-1283. doi:10.1001/jama.282.13.1281

Assessing and reporting on the quality of health care has become a fact of life.1-7 Quality outcomes are now compared among institutions and reported in both the consumer press and peer-reviewed literature to the delight of some and the consternation of others.8-10 Into this debate on comparing quality of care among institutions and clinicians come some unsettling notions. Can clinicians effectively measure and compare not only quality of care but quality of service? What is the link between defined clinical outcomes and perception of the quality of service in delivering patient care? Can patients rate both the skill and service of physicians and nurses? What is more important—outcome or satisfaction? Despite a rapidly expanding body of research on service quality in health care, these intriguing questions are still largely unanswered.