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Structure-Process-Outcome and Quality Management System

The structure-process-outcome model (SPO) and the quality management system (QMS) is different when it comes to defining and measuring quality outcomes. The SPO model does not fully rely on patients’ medical records or direct clinical observations to measure outcomes. In this model, outcomes are defined as patients’ recovery and the restoration of functions (Ayanian & Markel, 2016).

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As the model proposes, apart from illness management, quality outcomes should be measured with reference to disease prevention, patient rehabilitation, care coordination, and relationships between healthcare clients and physicians (Ayanian & Markel, 2016). As for QMS, ISO 9001 that is increasingly used by healthcare organizations requires healthcare organizations to have well-documented quality policies to define quality outcomes (Tozzo, Mazzi, Aprile, Rodriguez, & Caenazzo, 2018). With reference to measuring quality, the QMS model is more generic compared to the SPO, and it values realistic and standardized metrics that can vary depending on the type of service being evaluated.

The SPO or Donabedian model best supports the framework of EBM when it comes to defining and measuring quality outcomes. Basically, the SPO model was intended to be used in healthcare settings, whereas the QMS model provides basic recommendations pertaining to any field of activity. The use of evidence from properly designed research is among the basic prerequisites to EBM. The SPO model provides multiple recommendations concerning how to organize such research in healthcare, including the use of reproducible and reliable quality measures (Ayanian & Markel, 2016). Also, the model can help address gaps in evidence by measuring and considering all ways of how healthcare affects the patient.

To ensure that their healthcare services provide value to patients, healthcare organizations should evaluate the quality of services and place this information in the context of costs and risks. It is critical to pay attention to diverse aspects of quality, for instance, whether the services are easy to access when the need for them arises, whether provider communication is appropriate, and so on. Apart from assessments that emphasize objective outcomes and quality indicators, it is possible for organizations to make use of patient-reported information to ensure providing value to clients. As an example, feedback received from patients can help to determine whether there are unmet needs that particular services do not address.

References

Ayanian, J. Z., & Markel, H. (2016). Donabedian’s lasting framework for health care quality. The New England Journal of Medicine, 375(3), 205-207.

Tozzo, P., Mazzi, A., Aprile, A., Rodriguez, D., & Caenazzo, L. (2018). Certification ISO 9001 in clinical ethics consultation for improving quality and safety in healthcare. International Journal for Quality in Health Care, 30(6), 486-491.

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