INQUAT

— stands for “Integrative Quality Care Assessment Tool.” It is a scientifically tested taxonomy that provides a theoretically grounded, evidence-based framework to guide healthcare managers in a comprehensive assessment of all aspects related to the quality of care at their healthcare institution.

Premise

Improving healthcare is a global goal. In order to reach this goal, we need evidence-based criteria, indicators and instruments for an objective assessment and measurement of “quality care.” A considerable amount of literature has been published to this topic. But there is still no consensus definition of quality care and its key dimensions. In midst of a healthcare landscape that is increasingly characterized by growing demand, rising costs, constrained resources, variations in practice, medical errors, inequalities and lack of accountability (OECD), we need one coherent approach for monitoring and reporting valid quality indicators — also as a reliable scientific fundament for the measurement of intervention effects. The INQUAT fills this void: It was developed based on a scientific integration of all stakeholders’ perspectives into one coherent conceptualization of “quality care” — and it serves an encompassing assessment and measurement of the construct across professional, institutional, and even geographical boundaries.

Content

The INQUAT contains four meta-categories:

  1. Structure refers to the attributes of the setting in which care occurs (Donabedian, 1988). The INQUAT measures indicators of organizational, staff and facility resources in the structural setting of the healthcare institution.

  2. Context describes the contextual situation in which the care episode takes place. It comprises both clinical factors and patient-related factors.

  3. Process indicates what is actually done in giving and receiving care (Donabedian, 1988). The INQUAT assesses indicators related to communication, professional diligence, timeliness, errors, and continuity of care. Our research has consistently shown that most quality indicators fall into the process category.

  4. Outcome denotes the effects of care on the health status of patients and populations (Donabedian, 1988). The INQUAT also measures effects on institutions and interpersonal relationships. In addition, it captures both short-term and longer-term outcomes.

Scientific Background

Amati, R., Bellandi, T., Kaissi, A. A. & Hannawa, A. F. (2019). Testing the Integrative Quality Care Assessment Tool (INQUAT): Comparing U.S. and Italian managers’ perceptions of quality. International Journal of Health Care Quality Assurance, 33(1):120-144.

Amati, R., Kaissi, A. A., & Hannawa, A. F. (2018). Determinants of good and poor quality as perceived by U.S. health care managers: A grounded taxonomy based on evidence from narratives of care. Journal of Health Organization and Management.

Amati, R., Brook, R. H., Kaissi, A. A., & Hannawa, A. F. (2017). Evolving dimensions of quality care: Comparing physician and managerial perspectives. In A. M. McDermott, M. Kitchener & M. Exworthy, Managing improvement in healthcare: Attaining, sustaining and spreading quality. Palgrave Macmillan.