influences it. To this end, the report provides overall guidance for the systemic reforms it proposes, setting forth six quality aims for the health care system: it should be safe, effective, patient-centered, timely, efficient, and equitable (see Box 1-1).

Numerous private-sector organizations, the federal and local governments, and communities across the country have launched efforts to redesign the nation’s health care system, guided by the vision laid out in the Quality Chasm report (AHRQ, 2004; CMS, 2004; JCAHO, 2004; NCQA, 2004; The Leapfrog Group, 2004). These efforts are not always coordinated to the extent they might be for maximum leverage. And despite what they have accomplished, the system’s level of performance remains inadequate, some would say even unjust, given the resources our country expends on health care (Millenson, 2003).

The 1st Annual Crossing the Quality Chasm Summit: A Focus on Communities was an effort by the IOM to bring together and catalyze the various committed and innovative leaders across the country toward a highly targeted purpose: improving care for a selected set of clinical conditions within the Quality Chasm framework. This report serves as a summary of that 2-day event, held January 6–7, 2004. The committee that planned the summit (see Appendix A for biographical sketches) hopes this report will serve to further activate, coordinate, and integrate the quality efforts of the leaders who attended, as well as other reform-minded individuals from around the nation. While the committee is responsible for the overall quality and accuracy of the report as a record of what transpired at the summit, the views contained herein are not necessarily those of the committee. It is also hoped that this summit will be the first of many such annual events bringing together diverse leaders from across the country to further their work in implementing the vision set forth in the Quality Chasm for a 21st-century health care system.

Box 1-1.
Six Aims for Health Care Improvement

  • Safe—avoiding injuries to patients from the care that is intended to help them.

  • Effective—providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse, respectively).

  • Patient-centered—providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

  • Timely—reducing waits and sometimes harmful delays for both those who receive and those who give care.

  • Efficient—avoiding waste, in particular waste of equipment, supplies, ideas, and energy.

  • Equitable—providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

SOURCE: IOM, 2001:39–40.

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