1st Annual Crossing the Quality Chasm Summit

177 Pages·2004·2.1 MB·English

by  Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System

Committee on the Crossing the Quality Chasm:
Next Steps Toward a New Health Care System

Board on Health Care Services

Karen Adams, Ann C. Greiner, and Janet M. Corrigan, Editors
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the Na-
tional Research Council, whose members are drawn from the councils of the National Academy of Sci-
ences, the National Academy of Engineering, and the Institute of Medicine. The members of the com-
mittee responsible for the report were chosen for their special competences and with regard for appropri-
ate balance.

This study was supported by Contract No. 046718 between the National Academy of Sciences and The
Robert Wood Johnson Foundation. It was also supported by a subcontract from The Johns Hopkins
Bloomberg School of Public Health with funds provided by Grant No. 037049 from the Robert Wood
Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publi-
cation are those of the author(s) and do not necessarily reflect the view of the organizations or agencies
that provided support for this project.

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COMMITTEE ON CROSSING THE QUALITY CHASM:
NEXT STEPS TOWARD A NEW HEALTH CARE SYSTEM

REED V. TUCKSON (Chair), Senior Vice President, Consumer Health and Medical Care
Advancement, UnitedHealth Group, Minnetonka, MN
RON J. ANDERSON, President and Chief Executive Officer, Parkland Memorial Health and
Hospital System, Dallas, TX
REGINA M. BENJAMIN, Founder and Chief Executive Officer, Bayou La Batre Rural Health
Clinic, Inc., Bayou La Batre, AL
LINDA BURNES BOLTON, Vice President and Chief Nursing Officer, Cedars-Sinai Medical Center
and Burns and Allen Research Institute, Los Angeles, CA
BRUCE E. BRADLEY, Director Health Plan Strategy and Public Policy, Health Care Initiatives,
General Motors Corporation, Detroit, MI
ALLEN S. DANIELS, Chief Executive Officer, Alliance Behavioral Care, University of Cincinnati
Department of Psychiatry, Cincinnati, OH
LILLEE S. GELINAS, Vice President and Chief Nursing Officer, VHA Inc., Irving, TX
CHARLES J. HOMER, President and Chief Executive Officer, National Initiative for Children's
Healthcare Quality, Boston, MA
DAVID C. KIBBE, Director of the Center for Health Information Technology, American Academy of
Family Physicians, Chapel Hill, NC
MARY ANNE KODA-KIMBLE, Professor and Dean, School of Pharmacy, University of California
San Francisco, San Francisco, CA
PETER V. LEE, President and Chief Executive Officer, Pacific Business Group on Health,
San Francisco, CA
KATE R. LORIG, Professor of Medicine, Stanford University, Stanford, CA
JOANNE LYNN, Director, The Washington Home Center for Palliative Care Studies, and Senior
Scientist with The RAND Corporation, Washington, DC
DAVID M. NATHAN, Director, Diabetes Center, Massachusetts General Hospital and Professor of
Medicine, Harvard Medical School, Boston, MA
CHERYL M. SCOTT, President and CEO, Group Health Cooperative, Seattle, WA
JOHN A. SPERTUS, Director of Cardiovascular Education and Outcomes Research, Mid America
Heart Institute and Professor of Medicine at the University of Missouri-Kansas City,
Kansas City, MO
I. STEVEN UDVARHELYI, Senior Vice President and Chief Medical Officer, Independence Blue
Cross, Philadelphia, PA

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Study Staff

KAREN ADAMS, Co-Study Director
1
ANN C. GREINER , Co-Study Director
DANITZA VALDIVIA, Senior Project Assistant

Board on Health Care Services

JANET M. CORRIGAN, Senior Director, Board on Health Care Services
ANTHONY BURTON, Administrative Assistant

Auxiliary Staff

2
THOMAS M. MADDOX , Gustav Leinhard Fellow in Health Sciences Policy
3
PATSY O'MEARA , Project Intern

Editorial Consultants

RONA BRIERE, Briere Associates, Inc.
ALISA DECATUR, Briere Associates, Inc.

1
Served through January, 2004.
2
Served through May, 2003.
3
Served through December, 2003.
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Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and
technical expertise, in accordance with procedures approved by the NRC's Report Review Committee.
The purpose of this independent review is to provide candid and critical comments that will assist the
institution in making its published report as sound as possible and to ensure that the report meets institu-
tional standards for objectivity, evidence, and responsiveness to the study charge. The review comments
and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to
thank the following individuals for their review of this report:

GEORGE ISHAM, HealthPartners, Inc., Bloomington, MN
ARTHUR AARON LEVIN, Center for Medical Consumers, New York, NY
ANGELA BARRON MCBRIDE, Indiana University; Institute of Medicine Scholar-in-Residence
JOSEPH E. SCHERGER, University of California, San Diego, CA
LISA SIMPSON, All Children's Hospital; University of South Florida, St. Petersburg, FL

Although the reviewers listed above have provided many constructive comments and suggestions,
they were not asked to endorse the conclusions or recommendations nor did they see the final draft of
the report before its release. The review of this report was overseen by Elaine L. Larson, Columbia
University, and Don E. Detmer, University of Cambridge and University of Virginia. Appointed by the
National Research Council and Institute of Medicine, they were responsible for making certain that an
independent examination of this report was carried out in accordance with institutional procedures and
that all review comments were carefully considered. Responsibility for the final content of this report
rests entirely with the authoring committee and the institution.
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Preface

This report represents an important addition to a series of studies generated by the Institute of
Medicine dedicated to improving the quality and safety of health care. It is firmly grounded in the
st
principles articulated in Crossing the Quality Chasm: A New Health System for the 21 Century as a
guide for the transformation of our current health care delivery system—namely the six aims of safety,
effectiveness, patient-centeredness, timeliness, efficiency, and equity.

st
The 1 Annual Crossing the Quality Chasm Summit was convened specifically to address the
redesign of the nation’s currently broken health care delivery system. As recommended in the Quality
Chasm report, the summit was focused on improving care processes for a targeted set of priority areas,
in this case five common, high-burden chronic conditions: asthma, depression, diabetes, heart failure,
and pain control in advanced cancer.

The summit benefited from the contributions and expertise of more than 200 local and national
health care leaders who convened to collaborate on the development of strategies for improving the
quality of care for individuals with these five chronic illnesses. As described in this report, significant
progress is being made toward implementing the above six aims in communities across the country. It is
our hope that readers will be encouraged by the support of the national champions who participated in
the summit and expressed their support for efforts to facilitate the broad achievement of key strategic
priorities.

The reader of this report will also appreciate how much more is required from every stakeholder in
the American health care system if the goals of optimal quality and safety are to be achieved.

I am deeply appreciative of the support of our sponsor, The Robert Wood Johnson Foundation; my
colleagues on the Institute of Medicine committee who helped organize and lead the summit; and all
who so generously contributed their experience, judgment, and expertise to this effort.

Reed V. Tuckson, M.D.
Chair
August 2004
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