Torrie, thank you for the week 1 discussion post. The discussion post notes an important example of a structure, process, and outcome breakdown in quality service. One key point is the process interaction between staff and the patient. The concept of process improvement programs requires the understanding and integration of the terms quality of care and efficiency. Spath and Kelly (2017) defines characteristics of quality in healthcare that focuses around three principles: 1) customer focus, 2) continuous improvement, and 3) teamwork. Leonard, Frankel, and Simmonds (2004) recognize human performance characteristics directly play a role in the process of care. Process may also influence the change in the culture of the organization, in which human competencies are clearly reflected in service delivery