Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System's Books

The 1st Annual Crossing the Quality Chasm Summit

A Focus on Communities: Report of a Summit

By: Institute of Medicine,Board on Health Care Services,Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System

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The 1st Annual Crossing the Quality Chasm Summit

A Focus on Communities: Report of a Summit

By: Institute of Medicine,Board on Health Care Services,Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System

In January 2004, the Institute of Medicine (IOM) hosted the 1st Annual Crossing the Quality Chasm Summit, convening a group of national and community health care leaders to pool their knowledge and resources with regard to strategies for improving patient care for five common chronic illnesses. This summit was a direct outgrowth and continuation of the recommendations put forth in the 2001 IOM report Crossing the Quality Chasm: A New Health System for the 21st Century. The summit's purpose was to offer specific guidance at both the community and national levels for overcoming the challenges to the provision of high-quality care articulated in the Quality Chasm report and for moving closer to achievement of the patient-centerd health care system envisioned therein.

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177

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National Academies Press

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ISBN 10

0309093031

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9780309093033

Crossing the Quality Chasm

A New Health System for the 21st Century

By: Institute of Medicine,Committee on Quality of Health Care in America

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Crossing the Quality Chasm

A New Health System for the 21st Century

By: Institute of Medicine,Committee on Quality of Health Care in America

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project 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.

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360

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National Academies Press

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ISBN 10

0309072808

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9780309072809

Crossing the Quality Chasm

A New Health System for the 21st Century

By: Institute of Medicine (U.S.). Committee on Quality of Health Care in America

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Crossing the Quality Chasm

A New Health System for the 21st Century

By: Institute of Medicine (U.S.). Committee on Quality of Health Care in America

The National Academy Press, based in Washington, D.C., presents the full text of a book entitled "Crossing the Quality Chasm: A New Health System for the 21st Century," authored by the Institute of Medicine and originally published in 2001. The book highlights improvements to the health care system, rules concerning the redesign and improvement of care, organizational support for change, and the alignment of payment policies with quality improvement.

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335

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ISBN 10

0309073227

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9780309073226

Crossing the Global Quality Chasm

Improving Health Care Worldwide

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Board on Global Health,Committee on Improving the Quality of Health Care Globally

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Crossing the Global Quality Chasm

Improving Health Care Worldwide

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

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399

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National Academies Press

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ISBN 10

0309477891

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9780309477895

The 1st Annual Crossing the Quality Chasm Summit

A Focus on Communities: Report of a Summit

By: Institute of Medicine,Board on Health Care Services,Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System

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The 1st Annual Crossing the Quality Chasm Summit

A Focus on Communities: Report of a Summit

By: Institute of Medicine,Board on Health Care Services,Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System

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177

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0309093031

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9780309093033

Improving the Quality of Health Care for Mental and Substance-Use Conditions

By: Institute of Medicine,Board on Health Care Services,Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders

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Improving the Quality of Health Care for Mental and Substance-Use Conditions

By: Institute of Medicine,Board on Health Care Services,Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

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529

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National Academies Press

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ISBN 10

0309100445

ISBN 13

9780309100441

Quality Through Collaboration

The Future of Rural Health

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Rural Health Care

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Quality Through Collaboration

The Future of Rural Health

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Rural Health Care

Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.

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288

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National Academies Press

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ISBN 10

0309133475

ISBN 13

9780309133470

Quality Through Collaboration

The Future of Rural Health

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Rural Health Care

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Quality Through Collaboration

The Future of Rural Health

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Rural Health Care

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289

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ISBN 10

0309094399

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9780309094399

Leadership by Example

Coordinating Government Roles in Improving Health Care Quality

By: Institute of Medicine,Committee on Enhancing Federal Healthcare Quality Programs

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Leadership by Example

Coordinating Government Roles in Improving Health Care Quality

By: Institute of Medicine,Committee on Enhancing Federal Healthcare Quality Programs

The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government's role in health care.

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206

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ISBN 10

0309168880

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9780309168885

Crossing the Global Quality Chasm

Improving Health Care Worldwide

By: National Academies of Sciences, Engineering, and Medicine (U.S.). Committee on Improving the Quality of Health Care Globally

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Crossing the Global Quality Chasm

Improving Health Care Worldwide

By: National Academies of Sciences, Engineering, and Medicine (U.S.). Committee on Improving the Quality of Health Care Globally

This report minces no words about the magnitude and costs of the "global quality chasm." Although evidence is scattered and incomplete, the conclusion is inescapable: For billions of people, universal health coverage--the important mainstay of the World Health Organization's (WHO's) Sustainable Development Goal (SDG) 3--will be an empty vessel unless and until quality improvement, for all nations, becomes as central an agenda as universal health coverage itself"--Preface.

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374

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0309477905

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9780309477901

Envisioning the National Health Care Quality Report

By: Institute of Medicine,Board on Health Care Services,Committee on the National Quality Report on Health Care Delivery

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Envisioning the National Health Care Quality Report

By: Institute of Medicine,Board on Health Care Services,Committee on the National Quality Report on Health Care Delivery

How good is the quality of health care in the United States? Is quality improving? Or is it suffering? While the average person on the street can follow the state of the economy with economic indicators, we do not have a tool that allows us to track trends in health care quality. Beginning in 2003, the Agency for Healthcare Research and Quality (AHRQ) will produce an annual report on the national trends in the quality of health care delivery in the United States. AHRQ commissioned the Institute of Medicine (IOM) to help develop a vision for this report that will allow national and state policy makers, providers, consumers, and the public at large to track trends in health care quality. Envisioning the National Health Care Quality Report offers a framework for health care quality, specific examples of the types of measures that should be included in the report, suggestions on the criteria for selecting measures, as well as advice on reaching the intended audiences. Its recommendations could help the national health care quality report to become a mainstay of our nation's effort to improve health care.

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257

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ISBN 10

030907343X

ISBN 13

9780309073431

Patient Safety

Achieving a New Standard for Care

By: Institute of Medicine,Board on Health Care Services,Committee on Data Standards for Patient Safety

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Patient Safety

Achieving a New Standard for Care

By: Institute of Medicine,Board on Health Care Services,Committee on Data Standards for Patient Safety

Americans should be able to count on receiving health care that is safe. To achieve this, a new health care delivery system is needed â€" a system that both prevents errors from occurring, and learns from them when they do occur. The development of such a system requires a commitment by all stakeholders to a culture of safety and to the development of improved information systems for the delivery of health care. This national health information infrastructure is needed to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. In addition, this infrastructure must capture patient safety information as a by-product of care and use this information to design even safer delivery systems. Health data standards are both a critical and time-sensitive building block of the national health information infrastructure. Building on the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Patient Safety puts forward a road map for the development and adoption of key health care data standards to support both information exchange and the reporting and analysis of patient safety data.

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551

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National Academies Press

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ISBN 10

0309090776

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9780309090773

Improving Diagnosis in Health Care

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care

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Improving Diagnosis in Health Care

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

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473

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ISBN 10

0309377692

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9780309377690

Priority Areas for National Action

Transforming Health Care Quality

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying Priority Areas for Quality Improvement

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Priority Areas for National Action

Transforming Health Care Quality

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying Priority Areas for Quality Improvement

A new release in the Quality Chasm Series, Priority Areas for National Action recommends a set of 20 priority areas that the U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans. The priority areas selected represent the entire spectrum of health care from preventive care to end of life care. They also touch on all age groups, health care settings and health care providers. Collective action in these areas could help transform the entire health care system. In addition, the report identifies criteria and delineates a process that DHHS may adopt to determine future priority areas.

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160

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National Academies Press

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ISBN 10

0309085438

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9780309085434

Future Directions for the National Healthcare Quality and Disparities Reports

By: Institute of Medicine,Board on Health Care Services,Committee on Future Directions for the National Healthcare Quality and Disparities Reports

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Future Directions for the National Healthcare Quality and Disparities Reports

By: Institute of Medicine,Board on Health Care Services,Committee on Future Directions for the National Healthcare Quality and Disparities Reports

As the United States devotes extensive resources to health care, evaluating how successfully the U.S. system delivers high-quality, high-value care in an equitable manner is essential. At the request of Congress, the Agency for Healthcare Research and Quality (AHRQ) annually produces the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). The reports have revealed areas in which health care performance has improved over time, but they also have identified major shortcomings. After five years of producing the NHQR and NHDR, AHRQ asked the IOM for guidance on how to improve the next generation of reports. The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the health care system. In addition to being sources of data on past trends, the national healthcare reports can provide more detailed insights into current performance, establish the value of closing gaps in quality and equity, and project the time required to bridge those gaps at the current pace of improvement.

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247

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National Academies Press

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ISBN 10

0309159725

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9780309159722

Fostering Rapid Advances in Health Care

Learning from System Demonstrations

By: Institute of Medicine,Board on Health Care Services,Committee on Rapid Advance Demonstration Projects: Health Care Finance and Delivery Systems

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Fostering Rapid Advances in Health Care

Learning from System Demonstrations

By: Institute of Medicine,Board on Health Care Services,Committee on Rapid Advance Demonstration Projects: Health Care Finance and Delivery Systems

In response to a request from the Secretary of the Department of Health and Human Services, the Institute of Medicine convened a committee to identify possible demonstration projects that might be implemented in 2003, with the hope of yielding models for broader health system reform within a few years. The committee is recommending a substantial portfolio of demonstration projects, including chronic care and primary care demonstrations, information and communications technology infrastructure demonstrations, health insurance coverage demonstrations, and liability demonstrations. As a set, the demonstrations address key aspects of the health care delivery system and the financing and legal environment in which health care is provided. The launching of a carefully crafted set of demonstrations is viewed as a way to initiate a "building block" approach to health system change.

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108

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National Academies Press

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ISBN 10

0309087074

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9780309087070

Knowing What Works in Health Care

A Roadmap for the Nation

By: Institute of Medicine,Board on Health Care Services,Committee on Reviewing Evidence to Identify Highly Effective Clinical Services

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Knowing What Works in Health Care

A Roadmap for the Nation

By: Institute of Medicine,Board on Health Care Services,Committee on Reviewing Evidence to Identify Highly Effective Clinical Services

There is currently heightened interest in optimizing health care through the generation of new knowledge on the effectiveness of health care services. The United States must substantially strengthen its capacity for assessing evidence on what is known and not known about "what works" in health care. Even the most sophisticated clinicians and consumers struggle to learn which care is appropriate and under what circumstances. Knowing What Works in Health Care looks at the three fundamental health care issues in the United States-setting priorities for evidence assessment, assessing evidence (systematic review), and developing evidence-based clinical practice guidelines-and how each of these contributes to the end goal of effective, practical health care systems. This book provides an overall vision and roadmap for improving how the nation uses scientific evidence to identify the most effective clinical services. Knowing What Works in Health Care gives private and public sector firms, consumers, health care professionals, benefit administrators, and others the authoritative, independent information required for making essential informed health care decisions.

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278

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National Academies Press

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ISBN 10

0309134196

ISBN 13

9780309134194

Best Care at Lower Cost

The Path to Continuously Learning Health Care in America

By: Institute of Medicine,Committee on the Learning Health Care System in America

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Best Care at Lower Cost

The Path to Continuously Learning Health Care in America

By: Institute of Medicine,Committee on the Learning Health Care System in America

America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

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437

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National Academies Press

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ISBN 10

0309282810

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9780309282819

Health Professions Education

A Bridge to Quality

By: Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit

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Health Professions Education

A Bridge to Quality

By: Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

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191

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National Academies Press

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ISBN 10

030913319X

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9780309133197

Taking Action Against Clinician Burnout

A Systems Approach to Professional Well-Being

By: National Academies of Sciences, Engineering, and Medicine,National Academy of Medicine,Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being

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Taking Action Against Clinician Burnout

A Systems Approach to Professional Well-Being

By: National Academies of Sciences, Engineering, and Medicine,National Academy of Medicine,Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

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335

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National Academies Press

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ISBN 10

0309495474

ISBN 13

9780309495479

Keeping Patients Safe

Transforming the Work Environment of Nurses

By: Institute of Medicine,Board on Health Care Services,Committee on the Work Environment for Nurses and Patient Safety

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Keeping Patients Safe

Transforming the Work Environment of Nurses

By: Institute of Medicine,Board on Health Care Services,Committee on the Work Environment for Nurses and Patient Safety

Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.

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485

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ISBN 10

0309133270

ISBN 13

9780309133272

Assessing Health Care Reform

By: Institute of Medicine,Committee on Assessing Health Care Reform Proposals

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Assessing Health Care Reform

By: Institute of Medicine,Committee on Assessing Health Care Reform Proposals

This book establishes a framework for assessing health care reform proposals and their implementation. It helps clarify objectives, identifies issues to be addressed in proposals, distinguishes between short- and long-term expectations and achievements, and directs attention to important but sometimes neglected questions about the organization and provision of health care services. In addition, the volume presents a discussion and analysis of issues essential to achieving fundamental goals of health care reform: to maintain and improve health and well-being, to make basic health coverage universal, and to encourage the efficient use of limited resources. The book is a useful resource for anyone developing or assessing options for reform.

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ISBN 10

0309049261

ISBN 13

9780309049269

Toward Quality Measures for Population Health and the Leading Health Indicators

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Quality Measures for the Healthy People Leading Health Indicators

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Toward Quality Measures for Population Health and the Leading Health Indicators

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Quality Measures for the Healthy People Leading Health Indicators

The Institute of Medicine (IOM) Committee on Quality Measures for the Healthy People Leading Health Indicators was charged by the Office of the Assistant Secretary for Health to identify measures of quality for the 12 Leading Health Indicator (LHI) topics and 26 Leading Health Indicators in Healthy People 2020 (HP2020), the current version of the Department of Health and Human Services (HHS) 10-year agenda for improving the nation's health. The scope of work for this project is to use the nine aims for improvement of quality in public health (population-centered, equitable, proactive, health promoting, risk reducing, vigilant, transparent, effective, and efficient) as a framework to identify quality measures for the Healthy People Leading Health Indicators (LHIs). The committee reviewed existing literature on the 12 LHI topics and the 26 Leading Health Indicators. Quality measures for the LHIs that are aligned with the nine aims for improvement of quality in public health will be identified. When appropriate, alignments with the six Priority Areas for Improvement of Quality in Public Health will be noted in the Committee's report. Toward Quality Measures for Population Health and the Leading Health Indicators also address data reporting and analytical capacities that must be available to capture the measures and for demonstrating the value of the measures to improving population health. Toward Quality Measures for Population Health and the Leading Health Indicators provides recommendations for how the measures can be used across sectors of the public health and health care systems. The six priority areas (also known as drivers) are population health metrics and information technology; evidence-based practices, research, and evaluation; systems thinking; sustainability and stewardship; policy; and workforce and education.

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135

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National Academies Press

Published Date

ISBN 10

0309285577

ISBN 13

9780309285575

Computational Technology for Effective Health Care

Immediate Steps and Strategic Directions

By: National Research Council,Division on Engineering and Physical Sciences,Computer Science and Telecommunications Board,Committee on Engaging the Computer Science Research Community in Health Care Informatics

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Computational Technology for Effective Health Care

Immediate Steps and Strategic Directions

Despite a strong commitment to delivering quality health care, persistent problems involving medical errors and ineffective treatment continue to plague the industry. Many of these problems are the consequence of poor information and technology (IT) capabilities, and most importantly, the lack cognitive IT support. Clinicians spend a great deal of time sifting through large amounts of raw data, when, ideally, IT systems would place raw data into context with current medical knowledge to provide clinicians with computer models that depict the health status of the patient. Computational Technology for Effective Health Care advocates re-balancing the portfolio of investments in health care IT to place a greater emphasis on providing cognitive support for health care providers, patients, and family caregivers; observing proven principles for success in designing and implementing IT; and accelerating research related to health care in the computer and social sciences and in health/biomedical informatics. Health care professionals, patient safety advocates, as well as IT specialists and engineers, will find this book a useful tool in preparation for crossing the health care IT chasm.

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121

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National Academies Press

Published Date

ISBN 10

0309155843

ISBN 13

9780309155847

Preventing Medication Errors

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying and Preventing Medication Errors

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Preventing Medication Errors

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying and Preventing Medication Errors

In 1996 the Institute of Medicine launched the Quality Chasm Series, a series of reports focused on assessing and improving the nation's quality of health care. Preventing Medication Errors is the newest volume in the series. Responding to the key messages in earlier volumes of the seriesâ€"To Err Is Human (2000), Crossing the Quality Chasm (2001), and Patient Safety (2004)â€"this book sets forth an agenda for improving the safety of medication use. It begins by providing an overview of the system for drug development, regulation, distribution, and use. Preventing Medication Errors also examines the peer-reviewed literature on the incidence and the cost of medication errors and the effectiveness of error prevention strategies. Presenting data that will foster the reduction of medication errors, the book provides action agendas detailing the measures needed to improve the safety of medication use in both the short- and long-term. Patients, primary health care providers, health care organizations, purchasers of group health care, legislators, and those affiliated with providing medications and medication- related products and services will benefit from this guide to reducing medication errors.

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481

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National Academies Press

Published Date

ISBN 10

0309101476

ISBN 13

9780309101479

Clinical Practice Guidelines We Can Trust

By: Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines

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Clinical Practice Guidelines We Can Trust

By: Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

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217

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National Academies Press

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ISBN 10

030921646X

ISBN 13

9780309216463

Book's by Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System

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