Semantics shape our thinking.  We throw around terms that have multiple meanings.  Often we make statements that we understand but that listeners interpret differently.

So I am urging that we avoid the term quality in medicine, because quality has become a nebulous term.  We can talk about performance measurement or we can talk about safety parameters.  We can talk about patient satisfaction or we can even try to analyze outcomes measures like death rates or readmission rates.  But I urge us to stop calling any of these quality measures.  Quality reminds me more of jazz and we cannot measure jazz.

Why jazz is more interesting than bowling

We need a focus on safety.  Safety matters.

We do not know if quality matters, because we really do not understand what quality is.  Ask 10 people to describe quality parameters for health care, and I would predict we would get 10 different answers.  We cannot measure quality because quality lives in the eyes of each beholder.  We cannot really measure quality because quality differs between patients, physicians and situations.  Safety is a constant.  We should champion safety improvement and devote resources there.