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American Journal of Public Health, Vol. 71, Issue 4 409-412, Copyright © 1981 by American Public Health Association

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Criteria, norms and standards of quality: what do they mean?

A Donabedian

Quality assessment requires specification of: 1) a set of phenomena that are usually attributes of either process or outcome; 2) a general rule of what constitutes goodness; and 3) a precise numerical statement of what constitutes acceptable or optimal goodness with respect to each of these phenomena. The terms "criteria," "norms," and "standards," as currently employed, do not correspond well with these three components, but they could be used effectively if the basic distinctions were understood. Alternatively, one could use, as corresponding terms, "elements," "parameters," and "standards." The terms "criteria," and "norms" would then be redefined and be available to be used more uniformly, while "standards" could be further differentiated according to method of measurement, configuration, level, and flexibility.




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