A second challenge is making effective use of information technologies to automate clinical information and make it readily accessible to patients and all members of the care team. An improved information infrastructure is needed to establish effective and timely communication among clinicians and between patients and clinicians.

A third challenge is to manage the growing knowledge base and ensure that all those in the health care workforce have the skills they need. Making use of new knowledge requires that health professionals develop new skills or assume new roles. It requires that they use new tools to access and apply the expanding knowledge base. It also requires that training and ongoing licensure and certification reflect the need for lifelong learning and evaluation of competencies.

A fourth challenge for organizations is coordination of care across patient conditions, services, and settings over time. Excellent information technologies and well-thought-out and -implemented modes of ongoing communication can reduce the need to craft laborious, case-by-case strategies for coordinating patient care.

A fifth challenge is to continually advance the effectiveness of teams. Team practice is common, but the training of health professionals is typically isolated by discipline. Making the necessary changes in roles to improve the work of teams is often slowed or stymied by institutional, labor, and financial structures, and by law and custom.

Finally, all organizations—whether or not health care related—can improve their performance only by incorporating care process and outcome measures into their daily work. Use of such measures makes it possible to understand the degree to which performance is consistent with best practices, and the extent to which patients are being helped.

Recommendation 7: The Agency for Healthcare Research and Quality and private foundations should convene a series of workshops involving representatives from health care and other industries and the research community to identify, adapt, and implement state-of-the-art approaches to addressing the following challenges:

  • Redesign of care processes based on best practices

  • Use of information technologies to improve access to clinical information and support clinical decision making

  • Knowledge and skills management

  • Development of effective teams

  • Coordination of care across patient conditions, services, and settings over time

  • Incorporation of performance and outcome measurements for improvement and accountability

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