In its 2001 report Crossing the Quality Chasm, the Institute of Medicine outlined 6 domains of quality in medical care: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.1 Anyone practicing medicine or receiving care probably agrees that quality should be defined broadly—as broadly as the IOM has outlined. However, current quality measures for the outpatient setting do not encompass many of these domains. As a result, quality measurement and quality improvement efforts in the outpatient setting have neglected critical domains of high-quality care.
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