For the Public Good Highlights from the Institute of Medicine, 1970-1995 (1995) / Chapter Skim
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ORGANIZATIONAL HISTORY, 1970--1995
ORGANIZATIONAL HISTORY, 1970--1995
Pages 5-36
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From page 5... ...
One of the less noted recommendations read as follows: The President should take the necessary steps to arrange for the establishment of a National Academy of Health comparable to the National Academy of Sciences. The purpose of such a non-governmental, independent Academy would be two-fold: a.
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From page 6... ...
In 1967, the formation of the Board on Medicine was authorized by the NAS Council, with a mandate to explore the issues and problems presented by the further evolution of medical education, medical sciences, and health services in the context of rapidly changing social, economic, and scientific settings. The Board was to study, analyze, and evaluate these issues and problems as a basis for developing a body of findings and recommendations that could contribute to their resolution, provide guidance for public policy and 6
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From page 7... ...
Most importantly, because the Board needed to be accepted as being objective and free from the influence of special interests, it was to be composed of people representing all of the health professions, as well as knowIedgeable persons in related areas such as economics, law, and political science (see Box 1~. Singled out for initial examination were the complex issues surrounding the further development of medical education; the improvement of health services, particularly the health status of the urban and rural poor; and the establishment of a National Academy of Medicine.
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From page 8... ...
The Long committee's report included a minor recommendation that drew little attention at the time, that one of the instruments that might be created in reorganizing the NRC to deal with medical issues was something called an "institute." This time the NAS Council approved the establishment of such a body, subject to the development of acceptable bylaws and a charter. At an August 24, 1970, meeting, Dr.
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From page 9... ...
The failure of the IOM to submit its studies to the supervision of the Board was considered a serious threat to the "symmetry" of the newly-constructed Academy structure. This also meant that the NAS Council must go through the arithmetic again of apportioning representation of another partner to the Board [of the NRC]
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From page 10... ...
Scholars and fellows in residence included Clark Havighurst, Robert Ball, Robert Marston, and Don Detmer. Karl Yordy, a central source of institutional memory, leadership, and knowIedge for the TOM, arnved as a senior program officer and staff to the program committee charged with developing the initial TOM program.
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From page 11... ...
Yerby, M.D.* Program Efforts During ~ 970- ~ 975 The TOM program built on the work of the Board on Medicine, which had produced a white paper laying down principles to guide cardiac transplantation, conducted a study on biomedical education for the future, and appointed a pane!
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From page 12... ...
In 1973 a health policy fellowships program was established by the IOM with a 3-year grant of $710,000 from the Robert Wood Johnson Foundation. The first class of six fellows included David Banta, Johnnie Gallemore, Fre 12
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From page 13... ...
Less satisfying, however, was the program's piecemeal growth. The IOM Program Committee and staff undertook a methodical assessment of options for changes in the U.S.
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From page 14... ...
The membership increasingly expressed the concern that a steady preoccupation with large-contract studies would detract from IOM's ability to initiate policy investigations, to direct its efforts toward perceived needs, and to assess the long-range prospects for the nation's health enterprise. To respond to such concerns, in 1977, TOM's program activities were organ~zed around six program divisions, which allowed the Institute to recruit advisory committees for each program area to provide advice on potential activities beyond those the government requested.
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From page 15... ...
These included Elena Nightingale, Division of Health Promotion and Disease Prevention (HPDP) ; Linda DemIo, Division of Health Care Services (HCS)
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From page 16... ...
Thus, for example, efforts to increase the capacity of health professionals were visible through the Robert Wood Johnson Health Policy Fellowships program. Legal and ethical issues, despite considerable debate that bioethics and law deserved their own division, were also mainstreamed and remain as important responsibilities of existing boards and divisions.
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From page 17... ...
A landmark report was issued defining primary care, while the education of health professionals began to be studied-this time nursing education and the recruitment of minorities into health professions. Attention was also directed at the role of academic health centers in the face of stable or reduced overall federal fimbing support.
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From page 18... ...
Four key foundations the Commonwealth Fund, the Robert Wood Johnson Foundation, the W
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From page 19... ...
Fred Robbins transmitted comments of the IOM Task Force on Structure and the deliberations of the IOM Council to this new committee, which was chaired by lames Ebert, a member of the TOM Council, who had been one of the first leaders of the ALS, and who was the NAS vice president. The Ebert committee proposed a major reorganization of the NRC along the following lines: .
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From page 20... ...
The Institute did not wish to adopt the NAE mode! within the Academy with a purely honorific membership; rather, members wished to be closely involved in managing the IOM program.
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From page 21... ...
A nine-member search committee was established with five persons chosen by Frank Press and four by Fred Robbins. Paul Marks was appointed chairman.
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From page 22... ...
Sections were formed to identify suitable candidates and to elicit and review information on their qualifications. Program Despite the almost continual reexamination of the TOM dunug this time, the program continued to grow and to stabilize in the five program divisions: Health Sciences Policy, Health Promotion and Disease Prevention, Mental Health and Behavioral Medicine, Health Care Services, and International Health.
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From page 23... ...
Later that year, Karl Yordy moved from executive officer to become the director of the Division of Health Care Services, and Charlie Miller came from the Public Health Service to become the executive officer. Enriqueta Bond directed the Divisions of Health Promotion and Disease Prevention and Health Sciences Policy, with Barbara FiIner as associate director.
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From page 24... ...
and a virtual guide to NIDA's 1983 research grant program on marijuana. Airline Pilot Age, Health, and Performance, a congressionally mandated study fitnded by the National Institute on Aging, suggested that a fimctional assessment approach instead of ageshould be developed to measure pilot capability.
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From page 25... ...
Funds began to be solicited from the members to establish an endowment for TOM. THE FOURTH FIVE YEARS: ~ 985- ~ 990 A dramatic change took place in the TOM from 1985 to 1990 with the advent of a stable financial base, a greatly expanded program of studies and other health policy activities, a governing council with more policy concerns on its agenda, and increased participation by the members in the Institute's projects.
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From page 26... ...
Board chairs were added to the Program Committee to link together the program direction capability of the organization. True to his word, Frank Press convened another committee chaired by James Ebert, the vice-president of the NAS, to once more examine the overlap of CES's and TOM's programs.
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From page 27... ...
The program committee was now chaired by the president; Floyd Denny chaired HPDP; lack Barchas, BSMD; Walter McNerney, HCS; Claude Bennett replaced Al Fishman in HSP; William Foege chaired TH; Richard Havel, FNB; Richard Remington, MFUA; Edward Brandt, the RW] Health Policy Fellowships Board; and Robert Lawrence, the Committee on Health and Human Rights.
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From page 28... ...
Prenatal Care: Reaching Mothers, Reaching Irritants, built on preventing low birthweight, made a case for reaching mothers who do not receive adequate prenatal care. Improving the Quality of Care in Nursing Homes was translated into law almost immediately after its release.
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From page 29... ...
The IOM program was in excess of $ ~ 3 million. Members were beginning to worry that perhaps we were doing too much rather than too little.
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From page 30... ...
Shine in 1992, the Institute embarked on an evaluation and planning process. The Program Committee guided this process, which was brought to fruition at a retreat.
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From page 31... ...
In addition, our work now appears in journals such as ~JAAl4. In an effort to improve continually the quality of TOM reports, the Program Committee continues to assess the impact of TOM reports in a systematic fashion to determine what factors may lead to more or less "successful" reports.
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From page 32... ...
Also during this time, Mike Stoto became the director of the Division of Health Promotion and Disease Prevention when Gary Ellis departed for NTH. In Health Sciences Policy, Valerie Setiow replaced Ruth Bulger, who left to become vice-president for scientific affairs at the Henry Jackson Foundation.
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From page 33... ...
In its review ofthe mission and development of a strategic plan to guide TOM's work the TOM Council and the Program Committee recommended in 1994 that the TOM also establish a special initiative on quality of care in this era of transition in the health care system. A white paper, "Amenca's Health in Transition: Protecting and Improving Quality," was released by the TOM Council, and a series of other program activities on quality was planned to span all the divi Several short-term studies demonstrated the ability of TOM to complete projects to meet policy deadlines.
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From page 35... ...
Additional endowment is required to support future program efforts, especially issues that are not of interest to government in the short tee. A new goal for the program endowment wall be set in conjunction with the 25th anniversary activities.
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