Application of S-P-O model to an episode of health care observed as a consumer of health care services

The S-P-O model is important in assessing the kind of services provided in health institutions and in modeling the relationship between structure, process and outcomes (Nicholson, 2008). In this model, the quality of health care include parts that are similar to the behaviors of the institution of each health care provider (structure), the clinical and non clinical processes involved in care delivery (process), and the impacts care has on the consumers’ and  society’s health status (outcomes).

Episode of health care service

The kind of services provided in health care institution in the section of antenatal and post natal clinics requires much assessment. This was experienced during my visit to postnatal clinic; the nurses keep the patients waiting that there is congestion in the hospital by the time they start attending to them. The services are delivered slowly in that patients spent the whole day in the health institutions and the nurses are rude to the patients. Insufficient health information is provided to the patients since the nurses are after time.  Lack of enough nurses in the institution also causes poor service delivery in this institution.

Staffing as a structural component and involving the institution’s human resources that considers quantity and quality is important in this kind of episode.  To improve the health care quality this case, staffing should be linked to other structural components like financial status of the institution and the organization of the physical and human resources. The process also involves provision of patient; which include the activities carried out by the health care staff, including their communications ad interactions with each other and the patients, and the things they do to, or for patients that contribute to the patient’s health and well-being. For nurses this process includes assessing, planning, delivery, and evaluation of nursing care. With structure, patient care processes in this episode can be performed well by observing the professional standards and guidelines, and in a timely manner (Wan, T.H, et al, 2010).

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Donabedian (1988) describes out come as the change in a patient’s present and future health status that can be attributed to precursor health care. He mentioned two types of outcomes in which he gave their differences. The first one is technical outcomes which includes the physical and functional aspects of care. The second type is interpersonal outcomes which includes the dimensions of the “art” of medicine. These outcomes include satisfying the patient satisfaction with care and its effect on the quality of patient’s life. The specific health care episode discussed above gives both types of outcomes; the two types of outcomes are interdependent, they cannot be separated when evaluating the quality of health care. In the specific episode the outcomes observed include reduced levels of health risk behaviors in client populations, increased levels of clinical status measures in client populations, and increased levels of satisfaction with care in client populations. The outcomes of these services are measured through patient satisfaction, functional status, recovery from illness, mental and social health, management of pain and chronic illness and other factors.

The three quality elements of structure, process and outcome are related in one way or another. The first two elements (structure and process) contain indirect measures that influence the third element (outcome). All the three elements are linked with each other, hence, insight into just one of the three is sufficient to measure and evaluate integral quality. The structure element includes equipments and properties the personnel and management (players) can reach in a health care institution. The structure also reflects the institutional environment that the main processes happen. The process element involves the actions that occur between the service providers and the patients. Just like the outcome element, in the process element there is differentiation of processes of practical and interpersonal distinction between technical and interpersonal processes. Technical process specifies the improvement in the patient’s health, but not raising the risk, second process specifies communication between the service providers and their patients both socially and psychologically. The outcome element contains the effects on the employees and consumers health and well being due to introduction processes. The three elements are linked in that good structure in a health institution should promote good process, which n turn should promote good outcomes (Healy, 2011).


Donabedian model has been considered as the best model for studying health care quality. The model provides a framework where safety is defined as a critical component of health care outcomes. Practitioner’s safety is considered as the main element of the process element function of the framework as it determines the outcomes of patients, plus all components of the model are interdependent. Health care consumers’ outcomes depend on the interplay and interdependency of structure and process.

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