Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

The Speaker of the House of Representatives is the most powerful partisan figure in the contemporary U.S. Congress. How this came to be, and how the majority party in the House has made control of the speakership a routine matter, is far from straightforward. Fighting for the Speakership provides a comprehensive history of how Speakers have been elected in the U.S. House since 1789, arguing that the organizational politics of these elections were critical to the construction of mass political parties in America and laid the groundwork for the role they play in setting the agenda of Congress today. Jeffery Jenkins and Charles Stewart show how the speakership began as a relatively weak office, and how votes for Speaker prior to the Civil War often favored regional interests over party loyalty. While struggle, contention, and deadlock over House organization were common in the antebellum era, such instability vanished with the outbreak of war, as the majority party became an "organizational cartel" capable of controlling with certainty the selection of the Speaker and other key House officers. This organizational cartel has survived Gilded Age partisan strife, Progressive Era challenge, and conservative coalition politics to guide speakership elections through the present day. Fighting for the Speakership reveals how struggles over House organization prior to the Civil War were among the most consequential turning points in American political history.

Newton genealogy, genealogical, biographical, historical being a record of the descendants of Richard Newton of Sudbury and Marlborough, Massachusetts 1638, with genealogies of families descended from the immigrants, Rev. Roger Newton of Milford, Connecticut; Thomas Newton of Fairfield, Connecticut; Matthew Newton of Stonington, Connecticut; Newtons of Virginia; Newtons near Boston.