![]() ![]() The internationally accepted definition of the Institute of Medicine also recalls health outcomes and gives importance to evidence and professional knowledge. Also, according to Donabedian, quality of care is referred to the whole process of care, where the goal is to maximize general patient welfare and health outcomes. The definition of Donabedian, who defines quality as “the ability to achieve desirable objectives using legitimate means”, is perhaps the one that better describes the concept in healthcare. ![]() Despite the broad literature, disagreement persists on what the expression “quality of care” comprehends and there is no unanimous understanding of the term. These lead to several perspectives such as, for example, area or level of care, type of organization, improvement strategies. Scientific literature on the topic is wide and evidence is available on different aspects of quality of care. It is a current topic on the agenda of policy makers at different levels and worldwide because of a growing need to control costs and guarantee sustainability, reduce variability in healthcare delivery, ensure transparency and accountability, deliver effective, safe and person-centered care, improve patients’ clinical outcomes and their satisfaction. The effort of classifying and systematizing performance measurement techniques across hospitals is essential at the organizational, regional/national and possibly international levels to deliver top quality care to patients.Īddressing issues related to quality of care is one of the major concerns of healthcare systems. Assessing the overall quality of clinical pathways is key in guaranteeing a truly effective and efficient system but, to date, there still exists a lack of awareness and proactivity in terms of measuring performance of nodes within networks. Especially, greater attention is given to the dimensions of effectiveness and efficiency. The research shows emphasis of the importance of patient centeredness, effectiveness, efficiency, and safety dimensions. Three reviews did not specify the indicators related to the dimensions listed, and one article gave a complete definition of the meaning of each dimension and of the related indicators. The following dimensions were described in at least half of the studies: 6 studies classified efficiency (55 indicators analyzed) 5 studies classified effectiveness (13 indicators), patient centeredness (10 indicators) and safety (8 indicators) 3 studies responsive governance (2 indicators), staff orientation (10 indicators) and timeliness (4 indicators). Six reviews ranging 2002–2014 were included. The quality of the studies selected was assessed using the AMSTAR2 tool. Reviews focusing on hospital settings, published January 2000–June 2019 were considered. Methodsįollowing the PRISMA statement, PubMed, Cochrane Library and Web of Science databases were queried to perform an umbrella review. The aim of this review is to identify and classify the dimensions of hospital performance indicators in order to develop a common language and identify a shared evidence-based way to frame and address performance assessment. The Impact HTA Horizon2020 Project wants to address this aspect, developing a toolkit of key indicators to measure hospital performance. Several international agencies have defined performance indicators sets but there exists no unanimous classification. Patients’ increasing needs and expectations require an overall assessment of hospital performance.
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