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 am; Institute of Medicine (U. S.)

• ISBN13: 9780309072809
• ISBN10: 0309072808
• Format: Hardcover
• Copyright: 2001-07-01
• Publisher: Natl Academy Pr

Summary

(Institute of Medicine) The second in a series of texts from the Institute of Medicine's Quality of Health Care in America project, making an urgent call for fundamental change to close the gap in quality of health care. Documents the causes of the quality gap, identifying current practices impeding quality health care today. DNLM: Health Care Reform--methods--United States.

Table of Contents

Executive Summary	1	(22)
A New Health System for the 21st Century	23	(16)
The Quality Gap	23	(2)
Underlying Reasons for Inadequate Quality of Care	25	(8)
Agenda for the Future and Road Map for the Report	33	(6)
Improving the 21st-Century Health Care System	39	(22)
Six Aims for Improvement	41	(13)
A Vision of Future Care	54	(7)
Formulating New Rules to Redesign and Improve Care	61	(28)
Health Care Organizations as Complex Adaptive Systems	63	(3)
Ten Simple Rules for the 21st-Century Health Care System	66	(23)
Taking the First Steps	89	(22)
The Value of Organizing Around Priority Conditions	92	(4)
Applications of Priority Conditions	96	(7)
Criteria for Identifying Priority Conditions	103	(1)
Providing the Resources Needed to Initiate Change	103	(8)
Building Organizational Supports for Change	111	(34)
Stages of Organizational Development	112	(5)
Key Challenges for the Redesign of Health Care Organizations	117	(20)
Leadership for Managing Change	137	(8)
Applying Evidence to Health Care Delivery	145	(19)
Background	147	(1)
Synthesizing Clinical Evidence	148	(4)
Using Computer-Based Clinical Decision Support Systems	152	(3)
Making Information Available on the Internet	155	(2)
Defining Quality Measures	157	(7)
Using Information Technology	164	(17)
Potential Benefits of Information Technology	166	(4)
Automated Clinical Information	170	(6)
Need for a National Health Information Infrastructure	176	(5)
Aligning Payment Policies with Quality Improvement	181	(26)
Incentives of Current Payment Methods	184	(7)
Barriers to Quality Improvement in Current Payment Methods	191	(8)
Adapting Existing Payment Methods to Support Quality Improvement	199	(2)
Need for a New Approach	201	(6)
Preparing the Workforce	207	(116)
Clinical Education and Training	208	(6)
Regulation of the Professions	214	(4)
Legal Liability Issues	218	(1)
Research Agenda for the Future Health Care Workforce	219	(6)
APPENDIXES
A Report of the Technical Panel on the State of Quality to the Quality of Health Care in America Committee	225	(84)
B Redesigning Health Care with Insights from the Science of Complex Adaptive Systems	309	(14)
Index	323