LAUSR

The World Health Organization (WHO) defines quality of care as “the extent to which health care services provided to individuals and patient populations improve desired health outcomes.” The WHO goes on to define that “health care must be safe, effective, timely, efficient, equitable and people centered.” There has been a growing emphasis on quality of care. It leaves one to ponder what were we focused on before the emphasis on quality of care? Sure, in some jurisdictions, provision of any care was and remains the priority. However, in most first world health care systems surely we have been focused on providing quality care. Given resource constraints we need to improve in the efficient delivery of care. In this issue of the journal Keely and colleagues describe the use of e-consults to improve access to thrombosis specialists [1]. The use of e-consultations allows practitioners to access specialist advice without the patient being physically seen by the specialist, sparing health care systems and patients the burden of an in person consultation visit. In this issue of the journal Crowther and colleagues explore the safety of Warfarin resumption following an anticoagulant associated intracranial hemorrhage. Their systematic review and meta-analysis provide qualified guidance in the highest stake decision of when to resume anticoagulation after this dreaded complication of anticoagulation [2]. In a people centered approach, we must consider the acceptability of our interventions and not just assume that patients will be happy with our interventions and compliance will be high with these interventions. In his issue of the journal Streiff and colleagues explore the impact of route of administration (oral or subcutaneous) on patient acceptability for venous thrombosis prevention interventions [3]. Finally, quality of care also needs to ensure that we are providing services equitably and that complications of our therapies and effectiveness of our therapies are known in diverse groups of patients with consideration of age, gender, ethnicity and socio-economic status. In this issue of the journal Dukanovic explores the risk of bleeding and stroke in a Danish nation-wide study across these diverse patient groups [4]. Overall, if we want to improve the burden of disease in thrombosis medicine we must ensure the safe, effective, timely, efficient, equitable and people centered delivery of care.