Prior to the assessment of quality, relationships must be established and validated
among structure, process, and outcome (Donabedian, 1988). The Donabedian (1988)
model holds that, “good structure increases the likelihood of good process, and good
process increases the likelihood of good outcome” (p. 1745). Our interest here is in
linkages between PCC processes and outcomes. According to Donabedian (1988),
there are two elements of process: (a) technical processes, which include appropriate
diagnoses and strategies for care based on knowledge, judgment, and skill in implementing
the strategies and (b) interpersonal processes, which include exchange of
information necessary for an accurate diagnosis, and to determine preferences and
acceptability for specific care methods. Technical care is implemented through interpersonal
interactions; therefore, the success of technical care depends on interpersonal
processes (Donabedian, 1988). Thus, it is important to learn what specific PCC processes
are indeed related to better outcomes