Aligning health care: quality as a learning system

Quality health care in the United States is a multi-faceted and multi-dimensional concept based on scientific principles, while at the same time interacting with value judgments, customs, and perspectives. There are a wide variety of quality concept definitions and various approaches to the measurement of quality. However, there continues to be a lack of uniformity within the health care field itself. The methodology and approach used to evaluate different services creates a polemical multi-directional process and outcome. This paper will explore the concepts of quality health care in the U.S., Donabedian¿s methods for Quality Assessment ¿ structure-process-outcome, and the disputatious goal of improving health care quality for all stakeholders.