The document discusses patient expectations of health care. It notes that understanding patient expectations is important for improving patient satisfaction and delivering patient-centered care. However, most research has focused only on expectations for specific diseases. The document aims to better understand how patients conceptualize their expectations across different clinical contexts and conditions. Quality improvement approaches can play a role in enhancing the quality of health services provided at primary, secondary and tertiary levels. A quality improvement intervention is defined as a change process intended to increase the likelihood of optimal clinical quality and positive health outcomes. Quality improvement requires an ongoing feedback loop to identify opportunities to enhance care and outcomes for future patients.

1. HEALTH SERVICES:
EXPECTATIONS
DEVELOPMENTS
INVESTIGATIONS

2. • Understanding and measuring patient expectations of health care is central to
improving patient satisfaction and delivering patient-centered care. However, most
empiric research in this field has focused on measuring patient expectations for
specific diseases only. Patient expectations common to a variety of settings and
clinical contexts need to be better understood to design measures with wider utility.
We aimed to understand how patients express and conceptualize their expectations
of health care across a range of clinical contexts and conditions.
• The importance of understanding patient expectations of health care is being
increasingly recognized. Expectations can significantly influence health outcomes.

3. Improvement in the quality of
health care is a pivotal entry
point for health systems
strengthening.
Quality improvement (QI) approaches
play a role in improving the
quality of health services
delivered across the various
levels of the health system
– primary, secondary and
tertiary.

4. Focusing on change processes, a quality
improvement intervention can be defined as “a
change process in health care systems, services,
or suppliers for the purpose of increasing the
likelihood of optimal clinical quality of care
measured by positive health outcomes for
individuals and populations”
Quality improvement is the action of every person
working to implement iterative, measurable
changes, to make health services more effective,
safe and people-centred.

5. Published literature on quality
improvement demonstrate
its benefits in a variety of
settings, particularly those with
limited resources. The
science of improvement has
evolved over time. The wellknown
Donabedian model
describes three parameters for
quality of care: structure (or
input), process and outcomes.
This can be a useful approach
to conceptualize the wide
range of potential improvement
methods and interventions.

6. Structures, or inputs, refers
to the setting in which care
is delivered, for example the
health facility and the human
and financial resources
underpinning it; process
relates to the provision of care
itself, including all aspects of
the transaction between the
receivers and providers of care and outcome is the measurable
effect on health status, which
may be affected by a wide
range of factors.

7. Inputs process indicators and
output measures act as key drivers
for achieving improved quality of
care, person satisfaction positive
experience and desired health
outcomes.
quality: quality planning, quality
control, and quality improvement.
This can be a useful structure to
conceptualize the different
domains that can be addressed
when selecting quality
interventions.

8. Quality improvement / continuous quality improvement is the sum
of all the activities which create the desired change in quality. In the
health care setting, quality improvement requires a feedback loop which
involves the identification of patterns of the care of individuals (or of the
performance of other systems involved in care), the analysis of those
patterns in order to identify opportunities for improvement (or instances
of departure from standards of care), and then action to improve the
quality of care for future patients. An effective quality improvement
system results in step-by-step increases in quality of care.

9. Health care delivery requires
structure (eg. people, equipment,
education, prospective registry
data collection) and process
(eg.policies, protocols, procedures),
which, when integrated, produce a
system
( eg. programmes, organizations,
cultures) leading to certain
outcomes such as patient safety,
quality, satisfaction.

10. •Thank you for your attention