The inadequacy of M/SU health care is a dimension of the poor quality of all health care. The quality problems of overall health care received substantial attention among the health care community and the public at large as a result of two previous Institute of Medicine (IOM) reports: To Err Is Human: Building a Safer Health System (IOM, 2000) and Crossing the Quality Chasm: A New Health System for the 21st Century (IOM, 2001). The Quality Chasm report also garnered consensus around a framework and strategies for achieving substantial improvements in quality. The framework identifies six aims for high-quality health care (see Box S-1) and 10 rules for redesigning the nation’s health care system (see Box S-2).

Crossing the Quality Chasm’s framework and recommendations have attracted the attention of many health care leaders, including those addressing health care for mental and substance-use conditions. As a result, the Annie E. Casey Foundation, the CIGNA Foundation, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, The Robert Wood Johnson Foundation, the Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. Department of

The Six Aims of High-Quality Health Care

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, including 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, 2001:5–6.

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