Quality to me means good level of care where physicians and hospitals implement the most appropriate ways to save the patients life, make a quick diagnosis, reduce morbidity or even effective pain management. It also means delivering services to patients without having them go through gruelling insurance claims.So Quality of care comes not only from people providing direct care but also providers who set up insurance policies and carry them out.
It is true that most patients receive undue services and others get scoffed at. That I think stems from the inequality in the way care is delivered; managed versus public care. Also people with higher end insurance policies are more likely to get appropriate care with good quality rather than those with low end ones. This inequality based on monetary gains is what drives the process of inequitable distribution of quality care.
It seems difficult to improve quality because the way our system is engineered favouring those who have the resources to buy the best care they can afford. When the system is designed to function based on monetary benefits rather than on who needs care most, it is likely that its going to fail, it is likely its going to have quality issues. Also there is no uniformity in processes implemented in hospitals. Providers cater to diverse populations which need different methods of care but that does not mean quality has to be compromised in.
Best practices guidelines could help streamline processes in ensuring standard care. Reporting adverse events, outcomes could make providers accountable. It would also ensure competitiveness. Good team work needs to be encouraged where different health care professionals function effectively with good coordination. Implementing electronic records systems would help.