What are the IOM's core domains of quality and illustrate with a healthcare example for each?

• A. Safe, Effective, Patient-Centered, Timely, Efficient, Equitable
• B. Safe, Accurate, Accessible, Timely, Efficient
• C. Safe, Effective, Patient-Centered, Accessible, Affordable
• D. Safe, Reliable, Compassionate, Timely

Answer: (A)

The IOM frames quality in health care around six aims: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. This means care should avoid harm, be based on solid evidence, respect patient preferences, be delivered without unnecessary delay, use resources wisely, and be fair to all patients regardless of background.

For safety, care must prevent harm from the care process itself. A concrete example is using checklists and proper medication administration protocols to avoid wrong-site or wrong-dose errors and to reduce hospital-acquired infections.

For effectiveness, interventions should produce the desired health outcomes based on solid evidence. An example is following evidence-based guidelines for treatments, such as appropriate use of proven therapies for acute conditions or chronic disease management that has demonstrated benefits in outcomes.

For patient-centeredness, care should honor individual patient values and needs, engaging patients in decisions about their treatment. An example is shared decision-making where patients’ goals and preferences guide choices about procedures or therapies.

For timeliness, care should be provided promptly to reduce waiting and delays that can worsen outcomes. An example is providing rapid access to emergency care for time-sensitive conditions or streamlining scheduling to reduce wait times.

For efficiency, care should make good use of resources and avoid waste. An example is coordinating care to prevent unnecessary duplicate tests and using data systems to eliminate redundant procedures.

For equity, care should be delivered fairly, with no variation in quality due to factors like race, gender, or socioeconomic status. An example is ensuring preventive services and treatments are equally accessible across all populations, addressing disparities in care.

Because the listed six domains match these IOM aims, that option is the best representation of the framework.