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Why Not Give Consumers A Framework for Understanding Quality?

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Background: Consumers care about the quality of medical care but do not pay attention to currently available quality information or use it to make more informed health care choices. According to the theory of constructed preferences, when people are in a situation that is both complex and unfamiliar, they likely do not have fixed ideas about what is important to them. This theory seems to describe the situation of consumers and comparative quality information. The alternative would be to help consumers understand the overall concept of quality and the different elements that make up quality of care. The Institute of Medicine (IOM) report Crossing the Quality Chasm provides a framework for understanding, measuring, and evaluating the quality of medical care.

Impact of Providing a Framework for Understanding Quality: Focus groups were conducted in 2001 to determine what performance information they would like to see to help them select a physician. The findings indicated that consumers' understanding of health care quality information was expanded to include a broader array of factors when a cogent framework was used to present quality information.

Using the IOM Framework for All Public Reporting on Quality: The IOM framework or a modified version should be used for all public reporting on health care quality. The consistent use of some or all of the six IOM categories of performance reporting will reinforce the message that this is what constitutes high-quality care and it is what the public should expect to know when they make health care choices.

Document Type: Miscellaneous

Publication date: 2004-06-01

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  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect ( For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit for more information. All other readers, please visit to subscribe to the journal or to claim your access for an existing subscription.
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