The Joint Commission for Hospital Accreditation developed a framework in 1993 for improving healthcare provider performance, defining nine aspects of performance. One aspect was timeliness, defined as, "the degree to which care is provided to the patient at the most beneficial or necessary time." Since then, timeliness has emerged as a key component of monitoring the quality of healthcare. The Institute of Medicine in 2001 brought it into sharper focus by discussing the consequences of a lack of timeliness, ranging from long waiting times that patients may interpret as lack of respect from providers to delay in the diagnosis or treatment of an illness. The National Health Care Quality report card included a conceptual framework for quality of healthcare with four dimensions: safety, effectiveness, patient centeredness, and timeliness. The report defines timeliness as "obtaining needed care and minimizing unnecessary delays in getting that care." It also defines three sub-categories of timeliness (1) access to the system of care, (2) timeliness in getting to care for a particular problem, and (3) timeliness within and across episodes of care. In developing countries, timeliness relating to safe motherhood was brought to the fore by the three-delay model, which specifies three types of delays that contribute to the likelihood of maternal death in the event of a complication: (1) delay in deciding to seek care, (2) delay in reaching a treatment facility, and (3) delay in receiving adequate treatment at the facility. (excerpt)