Putting Software Quality in Context


Applying generic quality management processes in software development won’t necessarily result in an optimal quality system for every application. As part of re-assessment of our current quality system, we discovered that domain-specific quality guidance could be a rich source of insights.

With our focus on patient care systems, we naturally looked to thought leaders in medicine. One of the key studies in healthcare systems quality was published by the Institute of Medicine in their 2001 report “Crossing the Quality Chasm: A New Health System for the 21st Century”.

The full text of the report is available here; IOM Quality Chasm Report.

IOM defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”. As software developers we can adapt this vision to guide the features and functions implemented in our software, as well as our development process.

IOM identifies the following six measures of quality:

1. Safe: Avoiding injuries to patients from the care that is intended to help them.

2. Effective: Providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit.

3. Patient-Centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.

4. Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.

5. Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.

6. Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

During our review process, we added a seventh measure to this list:

7. Confidential: Respecting the privacy of patient health care information.

We can now evaluate our quality system processes, as well as our design and requirements management, using these additional domain-specific guideposts for quality. Similar approaches in other software development domains may be just as beneficial.



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