You were asked to read the classic article by Donabedian on structure, process, and outcomes. This article is fundamental to understanding the evolution of performance improvement in health care and aligns closely with systems thinking. As a current or future health care administration leader, how might Donabedian’s model impact your health services organization?
Review the Donabedian’s model and reflect on the model for health services organizations. Think about how you might apply Donabedian’s model to a health services organization, including how the model might be important for systems thinking.
The Assignment: (4 pages)
- Explain how you might apply Donabedian’s model to your health services organization or one with which you are familiar.
- Describe the structures, processes, and outcomes of the health services organization you selected.
- Draw a diagram representing Donabedian’s model specific for the health services organization you selected.
- Explain the importance of understanding Donabedian’s model and how this model links to systems thinking.
Resources
Ross, T. K. (2014). Health care quality management: Tools and applications. San Francisco, CA: Jossey-Bass.
Chapter 2, “Error and Variation” (pp. 37–61)
Expert Solution Preview
Introduction:
Donabedian’s model of structure, process, and outcomes is a fundamental concept for health care professionals to understand. As a medical professor in charge of creating assignments for medical college students, one of the assignments I created was to reflect on how this model can impact health services organization. In this answer, I will explain how Donabedian’s model can be applied to a health services organization, describe the structures, processes, and outcomes of the organization, draw a diagram, and explain the importance of understanding this model and how it relates to systems thinking.
Answer:
Donabedian’s model of structure, process, and outcomes can impact a health services organization by providing a framework for evaluating its performance. I will apply this model to a hypothetical health services organization that provides primary care services to a population of about 10,000 people.
Structures: The structures of this organization include the physical facilities, equipment, and personnel. The organization has two primary care clinics located in the community. Each clinic has a receptionist, a nurse, and two primary care physicians. The equipment includes examination tables, medical instruments, and electronic health record systems.
Processes: The processes of this organization include the activities that take place during patient visits, such as taking a medical history, conducting a physical exam, and ordering laboratory tests. The organization follows evidence-based guidelines for preventive care, such as screening for hypertension, diabetes, and cancer. The organization also uses a patient-centered approach to care, which involves engaging patients in their health care decisions and providing education and counseling.
Outcomes: The outcomes of this organization include the quality and effectiveness of the care provided, patient satisfaction, and health outcomes. The organization measures these outcomes through patient surveys and quality improvement initiatives. The organization has achieved high rates of preventive screening and good control of chronic conditions such as diabetes and hypertension.
Diagram: The diagram representing Donabedian’s model for this organization would show how the structures, processes, and outcomes are interconnected. It would show the physical facilities and personnel as the structures, the activities that take place during patient visits as the processes, and the quality and effectiveness of care provided as the outcomes. The diagram would also show how the processes are influenced by the structures and how the outcomes are influenced by the processes.
Importance: Understanding Donabedian’s model is important for health care professionals because it provides a framework for evaluating the performance of a health services organization. Applying this model to a health services organization helps identify areas for improvement and facilitates the development of quality improvement initiatives. The model links to systems thinking by recognizing that structures and processes are interconnected and that the quality of care provided is dependent on both.
