Avedis Donabedian's name is synonymous with quality of medical care. He unraveled the mystery behind the concept by defining it in clear operational terms and provided detailed blueprints for both its measurement(known as quality assessment) and its improvement(known as quality assurance). Many before him claimed that quality couldn't be defined in concrete objective terms. He demonstrated that quality is an attribte of a system which he called structure, a set of organized activities whihc he called process, and an outcome which results from both.
In this book Donabedian tells the full story of quality assessment and assurance in simple, clear terms. He defines the meaning of quality, explicates its components, and provides clear and systematic guides to its assessment and enhancement. His style is lucid, succinct, systematic and yet personal, almost conversational.
Reviewer:John K Yost, Ph.D., M.A.,, MDiv.,CCBE. CBE(Bradley University)
Description:The late Avedis Donabedian, a pioneering scholar-teacher on quality assurance in healthcare, provides a fresh statement of his conceptual framework for improving the quality of healthcare. He brings together for general professionals and commencing students a summary reflection in a personal way of his creative insights into research he has done in the 1970s through the 1990s on quality assurance to improve healthcare. What he has to say about the meaning and components of healthcare quality and the methods of monitoring it precede the quality improvement process of the Institute of Medicine that begins about the time Donabedian finishes his book. Yet, it becomes all the more valuable in 2003 for his fundamental insights into the conceptual framework and monitoring criteria IOM's "Quality Chasm" series.
Purpose:Donabedian came to the conviction that a summary statement of his work would contribute a fundamental body of knowledge showing continuity even in a new age of concern for quality assurance. He believed it worthwhile to revitalize his concept, approach, and methodology for a more general audience. Perhaps without knowing it, his book has appeared in a timely way given the priorities of DHHS and the IOM with improving the quality of U.S. healthcare, and exceeds his objectives.
Audience:Beginning medical students and general professionals will benefit from this book as will policymakers struggling with the challenge to improve the quality of healthcare. This book has hit the target both in regard to the author's audience, and the fundamentals of quality assurance about which he was an expert. The author died in 2000.
Features:The book provides an excellent and refreshing summary statement of his scholarly articles and three-volume work n defining, monitoring, and assessing quality in healthcare. What he says throughout the book about quality in healthcare and the system for how to monitor it have special value. Unfortunately, he misses what has been done in the later 1990s about improving the quality of healthcare as he readily acknowledges content with articulating his fundamentals.
Assessment:It will be interesting to see if the 21st-century movement in the U.S. will find value in Donabedian's work. Certainly, he provides a valuable example of how important it is to formulate a conceptual framework in the effort to improve the quality of healthcare.