Intended for healthcare professionals

Rapid response to:


Measuring the quality of hospital care

BMJ 2009; 338 doi: (Published 18 March 2009) Cite this as: BMJ 2009;338:b569

Rapid Response:

Multi-Dimensional Quality

Measuring quality is a thorny issue, one that is complicated by the
apparent desire to have a single measure of quality.

The Institute of Medicine lays out six characteristics of high-
quality care, which have been widely adopted in healthcare these include
care must be safe, effective and reliable, patient-centered, timely,
efficient and equitable.

All of these dimensions are important in delivering public value. The
key challenge is to balance these potentially conflicting characteristics.
The use of a 'dilemmas approach' (Hampden-Turner) or a 'Balanced Scorecard
Approach' (Kaplan & Norton) may be more beneficial than the reliance
on a single measure.

Competing interests:
None declared

Competing interests: No competing interests

11 April 2009
Rupert J Suckling
Deputy Director Public Health
NHS Doncaster DN4 5DJ