Donabedians

Donabedians are adherents and scholars who engage with the work of Avedis Donabedian, the foundational figure in health care quality measurement. They study and apply methods to evaluate healthcare quality through Donabedian's triad of structure, process, and outcomes.

The term is derived from Donabedian's surname. He proposed that quality of care can be assessed by examining the settings and resources (structure), how care is delivered (process), and the results for patients (outcomes). Donabedians apply this framework across hospitals, clinics, and health systems.

Practices commonly used by Donabedians include developing and using indicators for structure (staffing levels, facility adequacy), process (timeliness, guideline adherence), and outcomes (infection rates, readmissions, patient satisfaction). They emphasize measurement validity, risk adjustment, and the use of benchmarking, audits, and quality improvement cycles.

The influence of Donabedians spans health services research, governance, and policy implementation, supporting accreditation programs and public reporting on performance. Critics note that the triad can oversimplify care, underplay social determinants, and challenge attribution of outcomes to individual structures or processes.

In contemporary discourse, the term tends to describe researchers, clinicians, and administrators who base practice on Donabedian's framework rather than a formal school. While Donabedian himself outlined the theory, Donabedians interpret and extend it in diverse health care settings.

Related topics include the Donabedian model, quality of care, health services research, patient safety, and quality improvement initiatives.