A multidimensional quality model: an opportunity for patients, their kin, healthcare providers and professionals to coproduce health

Background: It is twenty years since the US Institute of Medicine (IOM) defined quality in healthcare, as comprising six domains: person-centredness, timeliness, efficiency, effectiveness, safety and equity. Since then, a new movement has emerged, with development numerous interventions aimed at improving quality, focus on accessibility, effectiveness care. Further gains equity timeliness have proven even more challenging. The challenge: With emergence “service-oriented” systems, complexity science, challenges climate change, growth social media internet reality COVID-19, original domains proposed by IOM invite reflection their relevance possibility for improvement. possible solution: In this paper we propose revised model that built never-ending learning includes domains, such Ecology Transparency, which reflect changing worldview healthcare. We also introduce concept person- or “kin-centred care” to emphasise shared humanity people involved interdependent work. This expansive view what “person-centredness” began. The delivery health healthcare requires working differing roles, explicit attention lived realities roles professional patient. will provide construct may make attainment kindness all.