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Quality: more than just timeliness
  1. Adrian A Boyle
  1. Emergency Department, Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Adrian A Boyle, Emergency Department, Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; adrian.boyle{at}addenbrookes.nhs.uk

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Defining good quality ED care has vexed clinicians, academics, managers and regulators for many years. Our specialty deals with multiple presentations in varied ways and with wildly different scopes of practice. In the UK, ED care has been measured using time-based metrics, including the 4-hour access standard. While these are easy to measure, they only represent one facet of quality. The US Institute of Medicine defines quality as having six domains; safe, effective, timely, efficient, equitable and people centred.

In England, the Care Quality Commission (CQC) inspects the quality of care given by hospitals. This body is powerful, having the ability to remove hospital …

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