A Prescription for Change: Bridges to Cross the Quality Chasm

Abstract

The second report of the Committee on the Quality of Health Care in America, Crossing the Quality Chasm: A New Health System for the 21st Century is currently available as an advanced copy (uncorrected proofs). It expands the committee's work beyond the focus on medical and medication error in To Err Is Human: Building a Safer Health System to a larger issue: the need to improve the quality of health care. 2 The new report outlines aims and principles for an improved design for the delivery of care. The text emphasizes that it is written not to present specifics but to present a new perspective on the purpose, intents, interactions, and processes of health care. The authors acknowledge that it will be necessary to redesign structures and processes of organizations and of professionals and their interactions. They also acknowledge that the practices of the nation's health care system, providers, and users must change to include improvements in dissemination and application of knowledge and potential advances in care. They state that the nation's health care system, providers, and users must have access to and use information technology in practice. Changes must be made to fiscal (payment) policies to facilitate new and better options and to reward better outcomes, and health care providers must be better educated. The committee emphasizes that the report was written as a vision of what is possible and that changes must be made to the system to achieve the vision. The first report of the Committee on the Quality of Health Care in America, To Err Is Human: Building a Safer Health System, was summarized previously in this journal (J Managed Care Pharm 2001:62-68). The goals of this continuing education program are to inform readers about this important report and to present the committee's recommendations for building organizational support for change.