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INSTI TUTE O F MEDI CINE ADVANCING THE QUALITY O F HEALTH CARE: KEY ISSUES AND FUNDAMENTAL PRINCIPLES A Po] icy Statement by a Committee of the Institute of Medicine Augus t 19 7 4 National Academy of Sciences Washington, D. C.

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NOTICE This is the report of a project undertaken with the approval of the Counci] of the Institute of Medicine, National Academy of Sciences. Such approval manifests the judgment that the project is of national importance and appropriate both to the purposes and professional resources of the Institute of Medicine. The members of the committee appointed to conduct the project and prepare the report were selected for recognized competence and with due consideration for the balance of disciplines ap- propriate to the project. Responsibility for the substantive aspects of the report rests with that committee. Each report issuing from a study committee of the Institute of Medicine is reviewed by an inde- pendent group of qualified individuals according to procedures established and monitored by the National Academy of Sciences. Only upon satis- factory completion of the review process is dis- tribution of a report approved. The Institute of Medicine was chartered in 1970 by the National Acadmey of Sciences to en- list distinguished members of medical and other professions for the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 Congressional charter responsibility to be an ad- visor to the Federal Government, and its own ini- tiative in identifying issues of medical care, research, and education. 2101 Constitution Ave., N.W., Washington, D.C. 20418 Area 202/389-6891 TOM Publication 74-04 .

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Committee to Develop a Policy Statement on Mechanisms for Advancing the Quality of Health Care MEMBERS ';Robert J. Haggerty, M.D. (chairman) Professor and Chairman Department of Pediatrics The University of Rochester School of Medicine and Dentistry Rochester, New York Robert H. Brook, M.D. Medical Officer National Center for Health Services Research and Development Rockville, Maryland - ';E. L. Burwell, M.D. Physician Falmouth, Massachusetts Rick J. Carlson Consultant West Village, Colorado L. W. Coppleson, M.D. Associate Professor Division of Emergency Medicine Pritzker School of Medicine University of Chicago Chicago, Illinois Jay W. Friedman, D.D.S. Dental Director United States Administrators Beverly Hills, California David M. Kessner, M.D. Director Health Services Research Office Georgetown University Washington, D.C. STAFF: Karl Don *Member of Institute of Medicine #Resigned from the committee .';Anne Kibrick, R.N., Ed.D. Professor and Director Department of Nursing Boston State College Boston, Massachusetts Mildred A. Morehead, M.D. Director, Evaluation Unit Department of Community Health Albert Einstein College of Medicine Bronx, New York W. B. Nestler, M.D. Medica] Coordinator Overlook Hospital Summit, New Jersey Donald C. Riedel, Ph.D. Professor of Public Health (Medical Care) Health Services Research Program Yale University New Haven, Connecticut '#Lawrence L. Weed, M.D. Professor of Medicine University of Vermont School of Medicine Burlington, Vermont 'Kerr L. White, M.D. Professor Department of Health Care Organization The Johns Hopkins University School of Hygiene and Public Health - Baltimore, Maryland D. Yordy E. Detmer, M.D. i

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