Question

Describe what is meant by “structure, process, and outcome” in assessing the quality of medical care. Give some examples of each dimension. How are the three dimensions related?

Answer 1

Donabedian model gives an information which will talk about quality of care. It can be collected from these dimensions like structure, process and outcome.

Structure explains about the organisational characteristics like infrastructure , facilities and technology which can be related with health care. It gives an information about professional scheme that can also be correlated with quality of health care.

Process states that the process of care can be given for the patient. The major part is to fulfill the requirements of the patient.

Outcome describes about the expected result of the care which can be given by the health staff.To check about the functional status of the patient. It is divided into two types : 1) Technical 2) Interpersonal outcome.

Examples of each dimension:

Example of structure:Environmental setup of the organisation.Examples like accessibility of the supplies and equipment.Training of staffs and demographics of the patient.

Example of Process:patients are convinced with physician orders. Coordination of the patient plays a vital role. Nursing treatment gives an effective part to be recover. Example like sepsis condition.

Examples of Outcome:Satisfaction of the patient. Examples like morbidity and mortality.

Relationship between three dimensions:The relationship between structure and outcome is good . Good structure will enhance the good process. At the same time good process will enhance the good outcome. These are all about unidirectional path. Now mediation path explains about good structure directly develops good outcome. These three dimensions will correlated with each other and benefitted to the patient. If nurses actively participate in this assessment of quality of medical care, patient will get interested and cooperate with the treatment.