Abstract
Health care organizations have appropriately begun to focus increased attention on the quality of medical services they provide to their patients.1 Reports from the Institute of Medicine (IOM) have illustrated how frequently errors occur in our hospitals and have outlined many areas in which medical services could be improved. As long as a decade ago, the IOM was emphasizing the urgent need to monitor and improve the quality of health care in our society.2 However, it remains a challenge to decide how quality should best be defined.What is quality? The IOM has suggested that quality of care should reflect . . .