Policy Perspective: Accountability for Quality

Quality must be measured so that consumers and purchasers are able to make informed decisions, and physicians and their patients share responsibility for their judgments about treatment options. Public access to outcomes data reflecting the performance of health systems and health professionals should be considered a civil right which, if denied, abridges a person's autonomy and may place a person at physical risk. Governments should operationalize a consumer entitlement to information as a means to informed consent, and a provider imperative to improve through collaborative peer review.

The accreditation and certification standards of professional organizations and the licensure standards of government should incorporate the best currently achievable levels of quality. Health care delivery organizations and health care professionals bear responsibility for monitoring and improving the quality of the care they provide, and for meeting recognized accreditation or certification standards. They must collect information regarding patient outcomes, patient satisfaction, and the resolution of complaints, and make such information readily available and understandable.

Quality must be a key factor in evaluating the impact of new technologies, new processes for health care delivery, and new public policies. The ultimate validation of quality is to be found in its contribution to the improvement in health status of the American population. High quality health care is therefore primary, preventive care in which the provider assumes responsibility and accountability for the coordination, integration, and continuing management of the patient's total health care and related services.