Related Experiment Video
Updated: Jun 19, 2026
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Evaluation of healthcare quality: a tale of three giants
Grant V Rodkey1, Kamal M F Itani
1Department of Surgery, Veterans Affairs Boston Health Care System and Boston University, Boston, MA, USA.
Insights
Ernest Amory Codman, Avedis Donabedian, and Shukri Khuri pioneered modern surgical quality measurement. Their foundational work, built on predecessors, aimed to improve patient safety and care delivery through determined innovation.
Area of Science:
- Medical quality improvement
- Surgical care delivery systems
- Healthcare measurement and evaluation
Background:
- The concept of quality of care has ancient roots, dating back to King Hammurabi.
- Modern surgical quality evaluation is credited to Ernest Amory Codman, Avedis Donabedian, and Shukri Khuri.
- Avedis Donabedian's systems thinking influenced the engineering design of surgical care.
Discussion:
- These pioneers, though not always crossing paths, built upon prior contributions.
- Their shared determination and belief in progress drove significant advancements.
- Their work laid the groundwork for evaluating and measuring the quality of modern surgical care.
Key Insights:
- Foundational contributions to surgical quality measurement by Codman, Donabedian, and Khuri.
- Donabedian's systems approach is crucial for designing effective surgical care delivery.
- The historical development of quality of care emphasizes continuous improvement.
Outlook:
- Future advancements in surgical quality rely on understanding and building upon this historical foundation.
- Continued dedication to improving surgical safety and patient outcomes is essential.
- Interdisciplinary collaboration, inspired by these pioneers, will shape the future of surgical care.
Abstract:
Although the concept of quality of care goes as far back as King Hammurabi in 1700 bc, and many have worked on improving the quality of care in medicine since, 3 individuals receive credit for laying down the foundation for the evaluation and measurement of quality of care in modern surgery: Ernest Amory Codman, Avedis Donabedian, and Shukri Khuri. Donabedian was not a surgeon, but his concepts in systems of care provided the basis for the modern engineering design of surgical care delivery. Without crossing paths, each of those giants built on the contributions of their predecessors. They shared the traits of tremendous determination in the face of many challenges and adversities and a sense of enthusiasm in a belief that resulted in improved and safer care.
Related Concept Videos
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:11Purpose of Health Records I
Here's a breakdown of how health records serve these purposes:
01:21Tertiary Healthcare System
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...