![]() ![]() 17–19 Since the released Crossing the Quality Chasm 20 21 by the Institute of Medicine (USA), numerous national and international organisations including the Academies of Sciences 22 and the WHO 23 24 have made repeated calls to develop a framework for advancing the quality of care, ensuring that care is safe, effective, efficient, patient-centred, timely and equitable. The lack of control in processes used to deliver medical care is clearly a major problem in the context of preventable medical errors with lethal damages and high economic costs in many hospitals. 11–15 Canada is another developed country performing poorly in terms of infant and maternal mortality, with 4.7 fatalities out of every 1000 live births and 10.2 maternal deaths per 100 000 births. ![]() live births and the maternal mortality rate was 17.4 per 100 000 births in 2018, both higher than the mean rates for any OECD country. 10 The infant mortality rate in the USA was 5. 10 11 Life expectancy in the USA was the lowest at 78.8 years compared with a range from 80.7 to 83.9 years for other OECD countries. 8 9 However, compared with other OECD countries, the USA performs poorly on process, outcome and patient experience metrics, as well as life expectancy. ![]() 9 This ratio reached 17.7% at the same time in the USA, where the national health spending is projected to reach US$6.2 trillion by 2028, growing at an average annual rate of 5.4%. 6–9 In 2019, Canada spent 10.8% of its gross domestic product on healthcare expenses according to the Organisation for Economic Cooperation and Development (OECD). 4 5 Through the years, health expenditure and financing have increased substantially in developed countries such as the USA and Canada. With the continuous challenges facing healthcare organisations in the past few years, 1–3 many strategies have focused on process improvements with the objective of enhancing efficiency and efficacy to improve patient outcomes while controlling costs. ![]()
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