This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Since 1972, The Robert Wood Johnson Foundation has been the nation's largest philanthropy devoted exclusively to health. To further its mission of improving the health and health care of all Americans, it provides funds for demonstration projects, educational and communications activities, training, policy analysis, and research. As part of the Foundation's efforts to inform the public, To Improve Health and Health Care, the seventh volume in The Robert Wood Johnson Foundation Anthology series, provides an in-depth look into the programs it funds. Written for policy makers and practitioners as well as interested members of the public, the series offers useful lessons for leaders and educators developing plans for the coming years. The cases discussed in To Improve Health and Health Care provide a critical analysis of the Foundation's activities and how it tackles health and health care issues. Written by the country's leading science and medical journalists, as well as experts from universities and The Robert Wood Johnson Foundation, this volume includes chapters on The Fighting Back Program Join Together and Community Anti-Drug Coalitions of America Containment of Health Care Costs The Teaching Nursing Home Program The Clinical Scholars Program Increasing Minorities in the Health Professions The National Health Policy Forum The Injury Free Coalition for Kids The Homeless Prenatal Program Response to Emergencies: September 11th, Bioterrorism, and Natural Disasters

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

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.

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

Praise for previous volumes of To Improve Health and Health Care: "The particular strength of the book is the critical nature of the articles. These are not glossy renditions of the good deeds of the foundation; rather they examine in depth both what went right and what went wrong with the projects the foundation sponsored. Anyone with an interest in improving health care in America will want to know what can be done, and perhaps even more importantly, what cannot be done even by an independent institution with substantial resources to invest in new ideas." -- Jeremy Holtzman, MD MS, University of Minnesota Medical School, Doody Publishing (2002). "This is a useful guide to both the grant seeker and the planner of similar projects who address health and healthcare needs in communities." -- Ann H. Cary, PhD, MPH, RN, George Mason University, (Doody Publishing, 1999.) Since 1972, The Robert Wood Johnson Foundation has been the nation's largest philanthropy devoted exclusively to health. To further its mission of improving the health and health care of all Americans, the Foundation strives to foster innovation, develop ideas, disseminate information, and enable committed people to devote their energies to improving the nation's well-being. As part of the Foundation's efforts to inform the public, To Improve Health and Health Care, the on-going anthology of The Robert Wood Johnson Foundation, provides an in-depth look into the programs it funds. Written for policy makers and practitioners, as well as interested members of the public, the series offers valuable lessons for leaders and educators developing plans for the coming years. This volume of the anthology covers Improving Quality of Care, Vulnerable Populations, Combating Substance Abuse, and other areas of concern