Table of Contents
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Front Matter	i-xxii
Executive Summary	1-22	(skim)
1 A New Health System for the 21st Century	23-38	(skim)
2 Improving the 21st-Century Health Care System	39-60	(skim)
3 Formulating New Rules to Redesign and Improve Care	61-88	(skim)
4 Taking the First Steps	89-110	(skim)
5 Building Organizational Supports for Change	111-144	(skim)
6 Applying Evidence to Health Care Delivery	145-163	(skim)
7 using Information Technology	164-180	(skim)
8 Aligning Payment Policies with Quality Improvement	181-206	(skim)
9 Preparing the Workforce	207-224	(skim)
Appendix A: Report of the Technical Panel on the State of Quality to the Quality of ealth Care in America Committee	225-308	(skim)
Appendix B: Redesigning Health Care with Insights from the Science of Complex Adaptive Systems	309-322	(skim)
Index	323-337	(skim)

Description

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.

Reviews

"The 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, August 30, 2001

"The enormous body of compelling evidence marshaled to support the analysis and recommendations is difficult to refute. ... Crossing the Quality Chasm is the state-of-the-art report on redesigning our health care system. It is required reading for all of us in health care. "
-- Journal of the American Medical Association, February 6, 2002

"...even bolder and farther-reaching than To Err Is Human, the Chasm report essentially extends the findings of the patient safety report to other important dimensions of quality of care. ... The Committee's strong findings and bold vision will give new momentum to the processes of change in American health care."
-- Institute for Healthcare Improvement

"...filled with well-informed opinions and viewpoints on the state of the healthcare system... it is packed with references from academe and includes case studies that are nice offerings as exemplars of what goes wrong in healthcare."
-- Journal for Healthcare Quality, September/October 2002

"...an excellent road map for improving patient quality and safety through process change. ... A key strength of the book is that the message is wide-ranging, providing a template for change instead of cookie-cutter solutions."
-- Healthcare Financial Management, March 2003

"I enjoyed reading this book. It is written in an easy-to-follow, friendly-to-the-eyes format. The extensive bibliography...makes this report an excellent source of reference for healthcare administrators and planners. ... I would recommend this book as a 'must read' for the younger generation in graduate medical education as what it outlines could very well be their reality."
-- Aviation, Space, and Environmental Medicine, June 2002

"[This book] should be widely read by people involved in clinical governance... The report manages to express some challenging concepts clearly and engagingly ...there are ideas here that all clinical governance leads would find thought-provoking, and indicators towards practical action."
-- Journal of Clinical Governance, 2002

Authoring Organizations

• Institute of Medicine (IOM)
• More Titles from IOM

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NOTES

  The IOM Health Care Quality Initiative