'Quality' is a widely invoked concept in healthcare, which broadly captures how good or bad a healthcare service is. While quality has long been thought to be multidimensional, and thus constitutively plural, we suggest that quality is also plural in a further sense, namely that different conceptions of quality are appropriately invoked in different contexts, for different purposes. Conceptual diversity in the definition and specification of quality in healthcare is, we argue, not only inevitable but also valuable. To treat one conception of healthcare quality as universally definitive of good healthcare unjustifiably constrains the ways in which healthcare can be understood to be better or worse. This indicates that there are limits to the extent to which improvement activities should be coordinated or standardized across the healthcare sector. While there are good reasons to advocate greater coordination in healthcare improvement activities, harmonization efforts should not advance conceptual uniformity about quality.

中文翻译：

---

定义什么是好：多元化和医疗质量。

“质量”是医疗保健中广泛使用的概念，它广泛地反映了医疗保健服务的优劣。尽管长期以来人们一直认为质量是多维的，因此构成上是复数的，但我们建议质量在另一个意义上也是复数的，即在不同的上下文中出于不同的目的适当引用了不同的质量概念。我们认为，医疗保健质量定义和规范中的概念多样性不仅是不可避免的，而且是有价值的。将一种医疗保健质量的概念视为对良好医疗保健的普遍定义是不合理的，这限制了人们可以更好地理解医疗保健的方式。这表明在整个医疗保健部门中，应在多大程度上协调或标准化改进活动。尽管有充分的理由主张在医疗保健改进活动中加强协调，但协调工作不应促进质量概念上的统一。