A user's manual for the IOM's 'quality chasm' report
A user's manual for the IOM's 'quality chasm' report
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DOI：
10.1377/hlthaff.21.3.80
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发表时间：
2002-05-01
期刊：
影响因子：
9.7
通讯作者：
Berwick, DM
中科院分区：
文献类型：
--
作者：
Berwick, DM
在发布关于患者安全的报告（人皆有错）15个月后，医学研究所发布了《跨越质量鸿沟》。虽然没有患者安全报告那么耸人听闻，但质量鸿沟报告更全面，从长远来看也更重要。它要求在六个方面的医疗保健性能的改进：安全性，有效性，以病人为中心，及时性，效率和公平;它断言，这些改进不能在现有的护理系统的限制内实现。它提供了一个重新设计美国医疗保健系统的基本原理和框架，分为四个层次：患者的经验;实际提供护理的“微系统”;容纳和支持微系统的组织;以及塑造组织行动的法律，规则，支付，认证和专业培训的环境。
Fifteen months after releasing its report on patient safety (To Err Is Human), the Institute of Medicine released Crossing the Quality Chasm. Although less sensational than the patient safety report, the Quality Chasm report is more comprehensive and, in the long run, more important. It calls for improvements in six dimensions of health care performance: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity; and it asserts that those improvements cannot be achieved within the constraints of the existing system of care. It provides a rationale and a framework for the redesign of the U.S. health care system at four levels: patients' experiences; the "microsystems" that actually give care; the organizations that house and support microsystems; and the environment of laws, rules, payment, accreditation, and professional training that shape organizational action.