Box 1 High Quality Health System Framework Domains and Sub-Domains [7]
From: Quality in crisis: a systematic review of the quality of health systems in humanitarian settings
Domain Sub-Domain | Definition |
|---|---|
Domain: Process of Care | Â |
 Competent care and systems | Evidence-based, effective care: systematic assessment, correct diagnosis, appropriate treatment, counseling, and referral; capable systems: safety, prevention and detection, continuity and integration, timely action, and population health management |
 Positive user experience | Respect: dignity, privacy, non-discrimination, autonomy, confidentiality, and clear communication; user focus: choice of provider, short wait times, patient voice and values, affordability, and ease of use |
Domain: Quality Impacts | Â |
 Better health | Level and distribution of patient-reported outcomes: function, symptoms, pain, wellbeing, quality of life, and avoiding serious health-related suffering |
 Confidence in system | Satisfaction, recommendation, trust, and care uptake and retention |
 Economic benefit | Ability to work or attend school, economic growth, reduction in health system waste, and financial risk protection |
Domain: Foundations | Â |
 Population | Individuals, families, and communities as citizens, producers of better health outcomes, and system users: health needs, knowledge, health literacy, preferences, and cultural norms |
 Governance | Leadership; policies: regulations, standards, norms, and policies for the public and private sector, institutions for accountability, supportive behavioral architecture, and public health functions; financing; learning and improvement: institutions for evaluation, measurement, and improvement, learning communities, and trustworthy data |
 Platforms | Assets: number and distribution of facilities, public and private mix, service mix, and geographic access to facilities; care organization; connective systems: emergency medical services, referral systems, and facility community outreach |
 Workforce | Health workers, laboratory workers, planners, managers: number and distribution, skills and skill mix, training in ethics and people-centered care, supportive environment, education, team work, and retention |
 Tools | Hardware: equipment, supplies, medicines, and information systems; software: culture of quality, use of data, supervision, and feedback |