In its Quality of Care document[i], the WHO uses a working definition which suggests that a health system should seek to make improvements in six areas or dimensions of quality, which are named and described below:

  • Effective: delivering health care that is adherent to an evidence base and results in improved health outcomes for individuals and communities, based on need;
  • Efficient: delivering health care in a manner which maximises resource use and avoids waste;
  • Accessible: delivering health care that is timely, geographically reasonable, and provided in a setting where skills and resources are appropriate to medical need;
  • Equitable: delivering health care which does not vary in quality because of personal characteristics such as gender, race, ethnicity, geographical location, or socioeconomic status;
  • Safe: delivering health care which minimises risks and harm to service users.

[i]     Quality of care: a process for making strategic choices in health systems. (2006). Retrieved 28 December 2016, from

Recommended reading:

Baker Richard W.; Implementing Change with Clinical Audit (Medical Sciences) Paperback; John Wiley & Sons; 5 Jan 1999

Bhoresh Dhamija, Margaret Keane, Chen Shen Low, Robert Ghosh; Clinical Audit for Doctors and Healthcare Professionals: A comprehensive guide to best practice as part of clinical governance 2nd Edition (BPP Learning Media) (Progressing Your Medical Career),

Bowling A; Research Methods In Health: Investigating Health And Health Services.. Open University Press; 2014; Google Books.

Burgess Robin, John Moorhead; New Principles of Best Practice in Clinical Audit Paperback – 20 Jan 2011 BPP Learning Media; 2nd Revised edition 2012

De Oliveira Matias, Joao Carlos, and Coelho Denis A. “The integration of the standards systems of quality management, environmental management and occupational health and safety management.” International Journal of Production Research 40.15 (2002): 3857-3866.

Hulshof, C. T., et al. “Evaluation research in occupational health services: general principles and a systematic review of empirical studies.” Occupational and environmental medicine 56.6 (1999): 361-377.

Fontaine G., Brahimi C., Fortier M., Institut national de Santé publique, Quebec; Occupational Health Competency Framework for Public Health in Québec; (Accessed: 2016-12-29)

Macdonald, E. B. “Audit and quality in occupational health.” Occupational Medicine 42.1 (1992): 7-11.

Mohamad, Fadzilah, et al. “Management systems integration for organizational sustainability: Quality, environmental, occupational health and safety, and energy.” Applied Mechanics and Materials. Vol. 465. Trans Tech Publications, 2014.

Morrell C., Harvey G; The Clinical Audit Handbook: Improving the Quality of Health Care; Baillière Tindall, 1999

OSH Wiki: Auditing, reviewing and certifying occupational safety and health management systems;,_reviewing_and_certifying_occupational_safety_and_health_management_systems; (Accessed: 2017-03-02)

Reese, Charles D. Occupational Health and Safety Management: A Practical Approach, Third Edition, CRC Press, Taylor & Francis Group, 2016.

Slovak, A. J. M. “21. AUDIT IN OCCUPATIONAL HEALTH.” Current Approaches to Occupational Health 3 (2013): 327.