Learning to Accept Uncertainty as a Quality of Care Dimension

Abstract

Uncertainty in clinical decision-making is integral to the pathways chosen while applying available knowledge to a patient’s care process. This chapter explores the ways in which uncertainty can be incorporated into the understanding of better performance approaches, and is thus proposed as an enabling dimension of performance. Tracing the keystone definitions of uncertainty from Hippocrates to Osler, the discussion addresses the dimensions of decision - making appropriateness, its timeliness, the expected and actual value of the care services, and the role of systematic communication between providers of care as well as with patients. The crucial role of Health Information Technology is emphasized, and a unifying model is proposed where the inclusion of uncertainty as a dimension of performance promotes an encompassing evaluation of the quality of health care services.