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JAMA Patient Page
October 22 2008

Quality of Care

JAMA. 2008;300(16):1962. doi:10.1001/jama.300.16.1962

Health care quality means that patients receive appropriate care for medical problems in order to achieve the best possible outcomes. Quality of care is a cooperative effort that involves patients, doctors, nurses, and other health care professionals, as well as institutions (such as hospitals, nursing homes, mental health centers, and home health care agencies). Part of providing quality health care involves following standards, guidelines, and evidence-based practices. Evidence-based medicine involves using results from research studies such as clinical trials (scientific tests of treatments) and findings from other investigations to guide medical decisions. When results from such research indicate that a particular way of treating a disease is best, guidelines are developed to help clinicians and patients make good decisions about medical care. The October 22/29, 2008, issue of JAMA is a theme issue on the health of the nation and includes articles about the US health care system.

Measuring quality

Collecting data on evidence-based practices and their outcomes is an important part of quality care. Some examples of quality measures are use of beta-blockers (a type of medication that helps control the heart rate) after a myocardial infarction (heart attack), regular measurements of hemoglobin A1c (a blood test measuring glucose control) in diabetes care, and proper use of antibiotics to prevent wound infections after surgery.

Improve your own quality of care

Improving communication in health care means that patients need to participate actively: ask questions, speak up if you do not understand what is explained to you, and bring a list of your medications each time you visit a doctor. Bring a family member or trusted friend to help you at health care visits, especially if you have a hard time hearing, understanding, or reading or if concerns about the visit limit your ability to communicate.

Looking for quality in a health care professional

  • Board certification indicates that a doctor has achieved a level of knowledge that meets a high standard for that specialty.

  • Good communication with doctors, nurses, and office staff about your care is essential for quality care.

  • Institutions (hospitals, surgery centers, and mental health facilities) should have accreditation from an appropriate national organization showing that they have met standards for care.

  • You should understand who is taking care of you: doctors, physician assistants, nurse practitioners, other nurses and nursing assistants, and other health care professionals all work together to take care of patients, although they have different education, training, and scope of practice (what they are qualified and licensed to do).

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English, Spanish, and French. A Patient Page on evidence-based medicine was published in the September 6, 2006, issue; one on randomized controlled trials was published in the June 21, 2006, issue; one on medical journals was published in the April 19, 2006, issue; and one on supporting medical research was published in the September 21, 2005, issue.

Sources: Institute of Medicine, Agency for Healthcare Research and Quality, The Joint Commission

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.