Evaluating quality of care in the new health care environment.

Today's health care environment explicitly emphasizes quality monitoring and improvement systems. To better understand the new concepts of quality, the quality systems currently used and under development at the Doheny Eye Institute, Los Angeles, Calif, and The Wilmer Ophthalmological Institute, Baltimore, Md, were reviewed and the underlying principles and pertinent examples extracted. In the future, quality monitoring will require measurement of rates of conformance with indicators of each of the three components of quality of care, ie, structures, processes, and outcomes. As such, significant changes in the philosophy of quality monitoring and development of newer and more advanced measures and indicators will be needed to meet the challenges of quality review in the new health care environment.

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