Towards a Triadic Quality Measurement Framework for U.S. Healthcare

Abstract

ABSTRACTAlthough there are various measures of healthcare quality, such as those used by the Centers for Medicare and Medicaid Services (CMS), an inclusive perspective that considers the patient, the hospital's external and internal relationships, and the nodal organizations is missing. Medical practitioner comments from the authors' interactions, coupled with the findings from their literature review, have motivated the authors to suggest that healthcare quality should be measured using a triadic approach. In this study, the authors offer an overarching conceptual framework for measuring quality in the U.S. healthcare system that utilizes a triadic approach integrating various aspects of quality at three different levels of measurement. At the micro-level, the focus is on patients–admitted and treated–and their perceptions of a hospital's service as well as outcomes. The authors suggest measures related to the healthcare teamwork quality at the meso-level. At the macro- level, in which the organization interacts with external entities, the focus is on the measurement of hospital quality performance. The authors conclude with the managerial implications of the framework and suggest future directions for triadic healthcare quality measurement.