Crossing the Quality Chasm: A New Health System for the 21st Century

Hardcover, 364 pp
ISBN 0309072808
978-0309072809
National Academy Press
July 2001
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"Institute for Healthcare Improvement committee has done an excellent job... [This book] identifies and analyzes with great insight and clarity deficiencies in the quality of our present medical care delivery system, and it is persuasive in outlining how the system ought to work... The report is thoughtful, painstaking, and totally reasonable." -- New England Journal of Medicine

Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers:

A set of performance expectations for the 21st century health care system.
A set of 10 new rules to guide patient-clinician relationships.
A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality.
Key steps to promote evidence-based practice and strengthen clinical information systems.

Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

This is the second in a series of publications from the Institute of Medicine's Quality of Health Care in America project. This reports builds on the findings of the first IOM report To Err is Human and addresses quality problems that detract from the health, functioning, dignity, comfort, satisfaction, and resources. You may also be interested in the 1st Annual Crossing the Quality Chasm Summit. You may also be interested in Building a Better Delivery System.

The Institute for Healthcare Improvement (IHI) is a not-for-profit organization driving the improvement of health by advancing the quality and value of health care. IHI is a reliable source of energy, knowledge, and support for a never-ending campaign to improve health care worldwide. We develop and nurture will, energizing a movement for profound change in health care. We spread improvement knowledge across the globe, and provide methods, tools, and other supports, largely through partnerships, for thousands of health care organizations to turn knowledge into improved results. We initiate and support innovation efforts, so as to discover, cultivate, and demonstrate the feasibility of new, more capable, designs. We exercise academic rigor in this work. We work to change the skills, attitudes, and knowledge of the workforce, both in the ongoing development of young professionals and in life-long education, so as to reduce profession-specific silos that limit collaborative effort for the well-being of patients. We seek to improve joy in work, and to help all who work in health care to become better able to help improve care.

The Institute of Medicine serves as adviser to the nation to improve health. As an independent, scientific adviser, the Institute of Medicine strives to provide advice that is unbiased, based on evidence, and grounded in science. The mission of the Institute of Medicine embraces the health of people everywhere.

The National Academies Press (NAP) was created by the National Academies to publish the reports issued by the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council, all operating under a charter granted by the Congress of the United States. The NAP publishes more than 200 books a year on a wide range of topics in science, engineering, and health, capturing the most authoritative views on important issues in science and health policy. The institutions represented by the NAP are unique in that they attract the nation's leading experts in every field to serve on their award-winning panels and committees.

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