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 nation's health care system has changed dramatically and the country is debating further significant changes. Comprehensive information is needed to guide policymakers in understanding and evaluating the current problems and in formulating federal health care policy. This book contains an evaluation of the plan developed by the National Center for Health Statistics for restructuring its existing provider surveys. It identifies current and future data needed by researchers and policymakers to assess the effect of changes in financing, organization, and delivery of health care on access, quality, costs, and outcomes of care and determines the extent to which the design and content of the proposed survey can meet these data needs. The book goes beyond a simple review and recommends a design framework to develop a coordinated and integrated data system to gather information about people and their illness over time and to link this information to costs and health care outcomes.
Toward a 21st Century Health System is a collection of thoughtful analyses that explore a key element of the health care delivery system-physician group practices. Edited by policy experts Alain Enthoven and Laura Tollen, and written by a blue ribbon panel of health policy scholars and leaders including Stephen Shortell, Hal Luft, Donald Berwick, James Robinson, and Helen Darling, this resource addresses a variety of topics, including Organized delivery systems Quality of care in prepaid group practice versus other types of managed care The role of physician leadership and culture in group practice Prepaid group practice and the formation of national health policy This comprehensive resource also covers such topics as pharmacy benefit management, technology assessment, health services research, and employer purchasing of benefits– all as they relate to prepaid group practice.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
“This is a remarkable, much-needed book that fills a significant gap in the health and social care literature in the early decades of the 21st century—public, global, clinical, ecological. It is powerful, ambitious, comprehensive, and sweeping at the same time that it is visionary, focused, and deep. Its power and passion are about the potential of population health and well-being optimally applied around the globe to help in creating a world that is healthier, safer, more just, and more sustainable.” —Barbara K. Rimer, DrPH, Alumni Distinguished Professor and Dean UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill (From the Foreword) Drawing on current research and the expertise of world-recognized leaders in public, global, clinical, and social health in both developed and developing nations, this book delivers an evidence-based examination of 21st-century challenges in global population health and well-being. With special attention given to major initiatives of the United Nations, especially its Sustainable Development Goals (SDGs) 2016–2030, and the priorities of the World Health Organization (WHO) and the World Bank, Dr. Lueddeke articulates an imperative to adopt a “One World, One Health” view that recognizes the interdependence of humans, animals, plants, and the environment. The book/text promotes innovative and transformative paradigms for global public health practice, curricula, workforce training, and leadership. Intended for undergraduate and postgraduate courses in global public health, it will also be a welcome addition to the libraries of practitioners and policy-makers at all levels in the public/population/global health continuum. KEY CONTENT AREAS INCLUDE: The historical context of public health from early medicine to present day Exemplary educational initiatives: WHO education guidelines; curriculum commentaries from China, South Africa, and Cuba; a proposed Global Framework for Public Health Services and Functions; and case studies from South America (PAHO/ WHO), India (IPHF), and South Africa (PHASA) The changing roles and educational expectations of public and global health professionals in the early decades of the 21st century The complex interdependence of natural, socioeconomic, and political systems at local, national, regional, and global levels The causes of interstate conflicts and longer-term challenges Leading change in a new era, transforming mind-sets, and improving and sustaining the health and well-being of the planet and its people An epilogue on global health, governance, and education with contributions from a think tank of 35 practitioners from 27 nations Supplemental materials, including text aims and objectives and a guide to research and learning resources developed by experts in the United States, Brazil, and the Netherlands, are available as digital downloads ALSO HIGHLIGHTED: 65 profiles of leading global health (and health-related) organizations 15 profiles of highly recognized schools and institutes of public health
In the last 20 years, there has been a remarkable emergence of innovations and technological advances that are generating promising changes and opportunities for sustainable agriculture, yet at the same time the agricultural sector worldwide faces numerous daunting challenges. Not only is the agricultural sector expected to produce adequate food, fiber, and feed, and contribute to biofuels to meet the needs of a rising global population, it is expected to do so under increasingly scarce natural resources and climate change. Growing awareness of the unintended impacts associated with some agricultural production practices has led to heightened societal expectations for improved environmental, community, labor, and animal welfare standards in agriculture. Toward Sustainable Agricultural Systems in the 21st Century assesses the scientific evidence for the strengths and weaknesses of different production, marketing, and policy approaches for improving and reducing the costs and unintended consequences of agricultural production. It discusses the principles underlying farming systems and practices that could improve the sustainability. It also explores how those lessons learned could be applied to agriculture in different regional and international settings, with an emphasis on sub-Saharan Africa. By focusing on a systems approach to improving the sustainability of U.S. agriculture, this book can have a profound impact on the development and implementation of sustainable farming systems. Toward Sustainable Agricultural Systems in the 21st Century serves as a valuable resource for policy makers, farmers, experts in food production and agribusiness, and federal regulatory agencies.
Eminent international authors - medical and social scientists Addresses topical areas of political debate on health, welfare and the NHS Inter-disciplinary approach with evidence from Europe and North America Stresses the pressing need for greater investments to combat low educational standards and high unemployment which cause poor health
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.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
