EVALUATING QUALITY OF CARE IN THE NEW HEALTH-CARE ENVIRONMENT

Today's health care environment explicitly emphasizes quality monitori ng and improvement systems. To better understand the new concepts of q uality, the quality systems currently used and under development at th e Doheny Eye Institute, Los Angeles, Calif, and The Wilmer Ophthalmolo gical Institute, Baltimore, Md, were reviewed and the underlying princ iples and pertinent examples extracted. In the future, quality monitor ing will require measurement of rates of conformance with indicators o f each of the three components of quality of care, ie, structures, pro cesses, and outcomes. As such, significant changes in the philosophy o f quality monitoring and development of newer and more advanced measur es and indicators will be needed to meet the challenges of quality rev iew in the new health care environment.