Six Domains Of Healthcare Quality

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Healthcare quality is critical for all providers, patients and their families.  The Institute of Medicine (IOM) has identified six crucial domains of healthcare quality: patient safety, effectiveness, patient-centred, timeliness, efficiency, and equity.

KEY Takeaways

  • Six domains of healthcare quality: Safety, Timeliness, Effectiveness, Efficiency, Equity, and Patient-centered. (STEEEP)
  • Healthcare providers can improve the quality and delivery of healthcare by focusing on these six areas.
  • Understanding these six domains will help you understand what matters most to patients, deliver better care, and improve the quality of the services offered.

Each domain has a vital role in the overall quality of care. Patient safety is essential for preventing injury or death. Effectiveness measures how well a treatment or procedure works in achieving its intended purpose.  Patient-centredness considers the needs and preferences of the patient. Timeliness is essential to ensure that a healthcare service is delivered on time. Efficiency determines how well a resource is used, and equity ensures everyone has an equal chance of getting the best possible care.

Each domain can significantly impact the quality of care delivered by healthcare providers. By understanding each domain and its importance, healthcare providers can improve the quality of their respect for patients across all six domains.

1. Patient Safety

Patient safety is the principle that ensures that people who receive healthcare services are treated with respect and understanding. Patients must be able to trust the healthcare system to provide them with safe, high-quality care. Healthcare providers must take all feasible steps to protect patients from harm, including preventing medical mistakes and injuries.

2. Effectiveness

Effectiveness refers to how well a healthcare service achieves its intended purpose. Effective services are likely to be safe and provide the desired benefits for patients. Healthcare providers must use the most appropriate treatments and procedures to achieve the desired results.

3. Patient-centered

Patient-centred care is a philosophy and approach to health care that emphasizes the importance of the patient's perspective. It involves working with patients to identify their needs and ensuring that their concerns are taken into account when planning and delivering health services. Patient-centred care promotes an individualized approach to healthcare and strives to ensure that patients have control over their healthcare decisions. 

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4. Timeliness

At its most basic level, timely care means providing health services as soon as possible. This is particularly important when it comes to emergency services, which must be available whenever and wherever they are needed. Timeliness also extends to routine medical care, such as check-ups and treatments. Delivering health services on schedule keeps patients safe and allows them to receive the best possible care.    

Delays in care can have serious consequences for patients. For example, delays in diagnosing a serious illness can lead to severe complications or even death. In addition, delayed treatments can cause serious harm or even death.

5. Efficiency

Efficiency is a measure of how well an organization uses resources to produce output. It can be examined in terms of inputs (e.g., financial, human), outputs (e.g., services provided) and processes (e.g., management). Efforts to improve efficiency often aim to identify ways to reduce unnecessary costs or increase production while maintaining or improving quality standards.    

When it comes to delivering quality health services, there are certain aspects that should not consume excessive resources, such as unnecessary diagnostic tests.

6. Equity

Healthcare systems should be equitable, meaning that no one group of people receives better or worse care than another. All members of society should have access to appropriate healthcare regardless of age, gender, ethnicity, religion, sexual orientation, socioeconomic status, physical ability, geographic location or other factors.

The World Health Organization defines equity as "the absence of systematic differences between groups of individuals within a population based on socially determined characteristics." These characteristics include gender, age, race, ethnicity, religion, socio-economic status, disability, sexual orientation, geographic location, and other factors.


The six domains of healthcare quality outlined by the Institute of Medicine are patient safety, effectiveness, patient-centred, timeliness, efficiency, and equity. Each of these is important for ensuring that patients receive high-quality care. Efforts to improve healthcare quality must be coordinated and strategic to achieve maximum impact.

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