health plans, and purchasers involved in M/SU health care should take to ensure patient-centered care for individuals with M/SU problems and illnesses. It further recommends actions to preserve patient-centered care when coercion into treatment is unavoidable.


Crossing the Quality Chasm defines “patient-centered care” as care that is “respectful of and responsive to individual patient preferences, needs, and values and ensur[es] that patient values guide all clinical decisions” (emphasis added) (IOM, 2001:40). A number of the rules for redesigning health care set forth in the Quality Chasm report (see Box 2-2 in Chapter 2) relate to achieving patient-centered care (see Box 3-1).

The aim of patient-centered care and its associated rules emphasize (1) clinical care that is based on individual patient preferences, needs, values, and decision making; and (2) patient access to and receipt of information that permits well-informed health care decisions. Yet consumers of all types of health care face substantial barriers to making such decisions. These

BOX 3-1
Rules for Patient-Centered Care

Customization based on patient needs and values. The system of care should be designed to meet the most common types of needs but have the capability to respond to individual patient choices and preferences.

The patient as the source of control. Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over health care decisions that affect them. The health system should be able to accommodate differences in patient preferences and encourage shared decision making.

Shared knowledge and the free flow of information. Patients should have unfettered access to their own medical information and to clinical knowledge. Clinicians and patients should communicate effectively and share information.

The need for transparency. The health care system should make available to patients and their families information that allows them to make informed decisions when selecting a health plan, hospital, or clinical practice, or choosing among alternative treatments. This should include information describing the system’s performance on safety, evidence-based practice, and patient satisfaction.

Anticipation of needs. The health system should anticipate patient needs, rather than simply reacting to events.

SOURCE: IOM, 2001:8.

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