Quality of can means that the client has access to health care and that the care is delivered by culturally competent nurses to support achieving positive health outcomes. Care that is not focused on the clients' values and ideas is likely to increase cost and diminish quality. For example, when clients are using both folk medicine and traditional Western medicine and nurses fail to assess and use this information in teaching, the clients may not get the full benefits of the treatment protocol. This suggests that positive outcomes, which are indicators of quality, may not be met. When quality is compromised, additional resources may be needed to achieve the health care outcomes. Increased use of resources means that cost is increased.