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Crossing the Quality Chasm : A New Health System for the 21st Century - Committee on Quality of Health Care in America

Crossing the Quality Chasm

A New Health System for the 21st Century

Hardcover Published: 19th August 2001
ISBN: 9780309072809
Number Of Pages: 360

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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.

Executive Summaryp. 1
A New Health System for the 21st Centuryp. 23
The Quality Gapp. 23
Underlying Reasons for Inadequate Quality of Carep. 25
Agenda for the Future and Road Map for the Reportp. 33
Improving the 21st-Century Health Care Systemp. 39
Six Aims for Improvementp. 41
A Vision of Future Carep. 54
Formulating New Rules to Redesign and Improve Carep. 61
Health Care Organizations as Complex Adaptive Systemsp. 63
Ten Simple Rules for the 21st-Century Health Care Systemp. 66
Taking the First Stepsp. 89
The Value of Organizing Around Priority Conditionsp. 92
Applications of Priority Conditionsp. 96
Criteria for Identifying Priority Conditionsp. 103
Providing the Resources Needed to Initiate Changep. 103
Building Organizational Supports for Changep. 111
Stages of Organizational Developmentp. 112
Key Challenges for the Redesign of Health Care Organizationsp. 117
Leadership for Managing Changep. 137
Applying Evidence to Health Care Deliveryp. 145
Backgroundp. 147
Synthesizing Clinical Evidencep. 148
Using Computer-Based Clinical Decision Support Systemsp. 152
Making Information Available on the Internetp. 155
Defining Quality Measuresp. 157
Using Information Technologyp. 164
Potential Benefits of Information Technologyp. 166
Automated Clinical Informationp. 170
Need for a National Health Information Infrastructurep. 176
Aligning Payment Policies with Quality Improvementp. 181
Incentives of Current Payment Methodsp. 184
Barriers to Quality Improvement in Current Payment Methodsp. 191
Adapting Existing Payment Methods to Support Quality Improvementp. 199
Need for a New Approachp. 201
Preparing the Workforcep. 207
Clinical Education and Trainingp. 208
Regulation of the Professionsp. 214
Legal Liability Issuesp. 218
Research Agenda for the Future Health Care Workforcep. 219
Appendixes
Report of the Technical Panel on the State of Quality to the Quality of Health Care in America Committeep. 225
Redesigning Health Care with Insights from the Science of Complex Adaptive Systemsp. 309
Indexp. 323
Table of Contents provided by Syndetics. All Rights Reserved.

ISBN: 9780309072809
ISBN-10: 0309072808
Audience: Professional
Format: Hardcover
Language: English
Number Of Pages: 360
Published: 19th August 2001
Publisher: National Academies Press
Country of Publication: US
Dimensions (cm): 22.9 x 15.2  x 2.54
Weight (kg): 0.68