A hospital quality team is evaluating a dialysis unit. They assess the physical infrastructure and equipment available, then the actual process of care delivered to patients, and finally the survival rates and quality of life achieved. This three-level framework for assessing quality of care was described by:

• A Crosby
• B Deming
• C Juran
• D Donabedian ✓

Explanation

Avedis Donabedian proposed that quality of care be evaluated through structure (resources, staff, equipment), process (what is actually done), and outcome (results achieved). Deming is linked to the PDCA cycle and his 14 points, Juran to the Juran trilogy of quality planning, control and improvement, and Crosby to the concept of zero defects and doing it right the first time. The sequence given in the stem, infrastructure followed by process followed by results, maps exactly onto Donabedian's triad.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.