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	<title>Comments on: Can we measure quality?</title>
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	<description>Internal medicine, American health care, and especially medical education</description>
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		<title>By: curious</title>
		<link>http://www.medrants.com/archives/4707/comment-page-1#comment-528779</link>
		<dc:creator>curious</dc:creator>
		<pubDate>Sat, 01 Aug 2009 00:12:01 +0000</pubDate>
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		<description>So after all that, both you and O&#039;Niell favor implicit quality measurement (which you call &quot;judging&quot;...fine).  Why didn&#039;t you just say so in the first place?

If you&#039;ll do a little background reading on the distinction between implicit and explicit quality measurement, you&#039;ll see that there&#039;s nothing new under the sun.  Or on your blog.  You might also learn a thing or two about the inherent problems of implicit quality measurement.</description>
		<content:encoded><![CDATA[<p>So after all that, both you and O&#8217;Niell favor implicit quality measurement (which you call &#8220;judging&#8221;&#8230;fine).  Why didn&#8217;t you just say so in the first place?</p>
<p>If you&#8217;ll do a little background reading on the distinction between implicit and explicit quality measurement, you&#8217;ll see that there&#8217;s nothing new under the sun.  Or on your blog.  You might also learn a thing or two about the inherent problems of implicit quality measurement.</p>
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		<title>By: Jan Krouwer</title>
		<link>http://www.medrants.com/archives/4707/comment-page-1#comment-528753</link>
		<dc:creator>Jan Krouwer</dc:creator>
		<pubDate>Tue, 28 Jul 2009 10:17:29 +0000</pubDate>
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		<description>I think you first have to define what you mean by quality. You have previously distinguished “safety” from “quality” and I think you agree that one can easily measure (medical) error rates – which you call safety. 

Performance measures, however bad and irrelevant can still be measured.

Here is the American Society for Quality definition: A subjective term for which each person or sector has its own definition. In technical usage, quality can have two meanings: 1. the characteristics of a product or service that bear on its ability to satisfy stated or implied needs; 2. a product or service free of deficiencies. According to Joseph Juran, quality means “fitness for use;” according to Philip Crosby, it means “conformance to requirements.”</description>
		<content:encoded><![CDATA[<p>I think you first have to define what you mean by quality. You have previously distinguished “safety” from “quality” and I think you agree that one can easily measure (medical) error rates – which you call safety. </p>
<p>Performance measures, however bad and irrelevant can still be measured.</p>
<p>Here is the American Society for Quality definition: A subjective term for which each person or sector has its own definition. In technical usage, quality can have two meanings: 1. the characteristics of a product or service that bear on its ability to satisfy stated or implied needs; 2. a product or service free of deficiencies. According to Joseph Juran, quality means “fitness for use;” according to Philip Crosby, it means “conformance to requirements.”</p>
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		<title>By: Claudia Rutherford PhD</title>
		<link>http://www.medrants.com/archives/4707/comment-page-1#comment-528747</link>
		<dc:creator>Claudia Rutherford PhD</dc:creator>
		<pubDate>Mon, 27 Jul 2009 16:36:31 +0000</pubDate>
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		<description>I couldn&#039;t agree with you more. As a clinical psychologist I am always questioning how quality of care can be measured in a quantifiable manner, as so many people suggest doing. Certainly in mental health treatment, this is not an easy thing to do and you can argue that given the chronicity of some people&#039;s illnesses, you are measuring a moving target. Every quality of care measure I have seen has been wildly reductionist and does not seem to really reflect an understanding of what mental health care entails. I am sure the same is true with medicine. I really enjoy your blog, thank you for always being thought-provoking and forthright.</description>
		<content:encoded><![CDATA[<p>I couldn&#8217;t agree with you more. As a clinical psychologist I am always questioning how quality of care can be measured in a quantifiable manner, as so many people suggest doing. Certainly in mental health treatment, this is not an easy thing to do and you can argue that given the chronicity of some people&#8217;s illnesses, you are measuring a moving target. Every quality of care measure I have seen has been wildly reductionist and does not seem to really reflect an understanding of what mental health care entails. I am sure the same is true with medicine. I really enjoy your blog, thank you for always being thought-provoking and forthright.</p>
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		<title>By: Web Media Daily &#8211; July 27, 2009</title>
		<link>http://www.medrants.com/archives/4707/comment-page-1#comment-528746</link>
		<dc:creator>Web Media Daily &#8211; July 27, 2009</dc:creator>
		<pubDate>Mon, 27 Jul 2009 16:14:26 +0000</pubDate>
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		<description>[...] Can we measure quality?&#8230;   DB&#8217;s Medical Rants [...]</description>
		<content:encoded><![CDATA[<p>[...] Can we measure quality?&#8230;   DB&#8217;s Medical Rants [...]</p>
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		<title>By: Twitted by hjluks</title>
		<link>http://www.medrants.com/archives/4707/comment-page-1#comment-528743</link>
		<dc:creator>Twitted by hjluks</dc:creator>
		<pubDate>Mon, 27 Jul 2009 11:05:40 +0000</pubDate>
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		<description>[...] This post was Twitted by hjluks [...]</description>
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		<title>By: Twitted by medrants</title>
		<link>http://www.medrants.com/archives/4707/comment-page-1#comment-528742</link>
		<dc:creator>Twitted by medrants</dc:creator>
		<pubDate>Mon, 27 Jul 2009 10:55:55 +0000</pubDate>
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		<description>[...] This post was Twitted by medrants [...]</description>
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