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Such a stance would not only militate against mistaking Quality of Care models for the reality of care itself, but act against the potential for procedural imperatives to become privileged over the ends of health care.
This expresses many contradictions regarding visions and goals and the prevailing reality of care.
It must also be emphasized that the reality of care is reflected by a naturalistic study design.
The advantage of the QPP-PC is that the instrument includes measures of both subjective importance and perceived reality of care.
This study has pointed to the possibility of knowing the reality of care in the Pediatric ICU and Neonatal in Brazil, through indicators that monitor important adverse events such as infection, even in the face of different realities within a country of continental dimensions and not always homogeneous.
However, they also acknowledged that the reality of care was sometimes less than ideal, often due to time pressures or gaps in provision: "We would like to think that we were aiming to provide a high quality of care in a very timely way…but the reality is probably a bit different to that unfortunately".
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com