2024 the best health care system in the world review

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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.

Publisher ‏ : ‎ National Academies Press; 1st edition (August 19, 2001)
Language ‏ : ‎ English
Hardcover ‏ : ‎ 360 pages
ISBN-10 ‏ : ‎ 0309072808
ISBN-13 ‏ : ‎ 978-0309072809
Item Weight ‏ : ‎ 1.5 pounds
Dimensions ‏ : ‎ 6.1 x 1 x 9.1 inches
Reviewer: Amazon Customer
Rating: 5.0 out of 5 stars
Title: Understand the US Healthcare System better, especially if you work in it
Review: The IOH, Institute of Health, published two exhaustive reports on healthcare: To Err is Human and Crossing the Quality Chasm. They are dry, academic, ponderous and difficult to read. However they are two of the most important books written about healthcare in the United States and mandatory reading for anyone in the field of medicine. Virtually every other book on improving healthcare quotes or uses the research from these two books.Healthcare is under a radical transformation based on enormous economic and demand pressures. In order to be successful we have to understand the system, warts and all. We have to have solutions based on empirical peer reviewed data. These IOH reports do just that. While they may seem dated and many of the initiatives advocated by these books are well underway, these books remain 'bibles' of a sort for understanding the US medical system. I strongly recommend reading this books because so much of the current reform, language, and subsequent published literature is based on these two reports.I recently attended a training by Intermountain Healthcare in UT - the hospital system discussed during the election debates. The CFO quoted from these books. That is just one illustration of how influential and important these books are. Even if you don't work in medicine these books will help you manage and direct your own care. Read also "Overtreated" by Shannon Brownlee, which also uses IOH data and research.Not easy reads but few important reads are.

Reviewer: George Dawson
Rating: 4.0 out of 5 stars
Title: This book will not get you there
Review: This book is written as the product of an Institute of Medicine initiative to reduce the mortality and morbidity from errors in the American healthcare system. The Institute of Medicine is a private organization created by congressional charter to advise the federal government on specific matters. Their mission statement is to "advance and disseminate knowledge to improve human health." This book is the final report of the Committee on the Quality of Health Care in America. Their homepage is available by searching the Internet using the full committee name. Membership of the committee and sponsors of the project are available at that web site.The format of the book is to present evidence for quality problems in healthcare in America and make recommendations. The operational definition of quality used in the book is "The degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." There are thirteen recommendations presented initially and are discussed in relevant chapters. The recommendations vary in scope from suggesting that multiple parties need to be committed to quality as a way to decrease the burden of disease to suggestions that specific agencies fund pilot studies to look at how reimbursement can be aligned with quality. Six major parameters are discussed as guiding quality and it is suggested that 15 specific conditions be a focus for improving quality.There is no difficulty in identifying literature studies that demonstrate quality problems in hospital and clinical populations. A survey of current research is included in Appendix A. A review of the tables in this appendix show the types of quality markers that are typically studied in the literature. The authors make the argument that errors due to quality lapses or deficiencies need to be actively worked on and that the current high error rates are not acceptable. Health care has become a major political issue and the political factions are shaping up to be government and business on one side and physicians and other health care providers on the other. There has been a major revamping of the health care system in the past decade to control costs. That required the active cooperation of the insurance industry and government. There is still medical inflation and limited access with 40 million Americans uninsured. Should we believe that another cooperative effort between industry and government will improve quality any more than it has controlled cost or improved access?The authors acknowledge weaknesses in their suggestions about changing the face of American medicine, but they minimize the adverse impact of the current funding mechanisms for medical care and the issue of information systems integration and security. A good example can be found in their application of engineering principles to clinical settings - - where teams see patients for four hours of direct contact time and the remaining time is for documentation and returning calls. That plan would not be economically feasible in many settings. The high cost and lack of flexibility of the current reimbursement schemes are not mentioned as a potential reason why these plans won't work.Information technology is seen as a way to enhance both productivity and safety. The authors suggest that e-mail can lead to productive exchanges between physicians and patients. Many physicians have been doing this for years. Many have also stopped with the advent of security concerns about medical privacy. With larger IT systems the critical issue is backward compatability with older systems. That usually requires custom designs that are extremely expensive. Those problems usually need to be solved before bedside computing and decision support can be developed. Security is acknowledged as a problem that needs to be solved. In spite of a federal initiative in this area, the important precedent to remember is how the financial privacy of Americans was protected. The authors point out that medical privacy requirements need to be more stringent than other industries. At the same time they point out that some opinions suggest that there is a trade off between privacy protections and the need to advance information technology in health care. If they are suggesting that the Internet should be at the heart of this infrastructure and the Internet is not secure, what does that mean?A practical approach might be to focus on the areas where data is entered into computer systems and make sure that non-human analysis occurs at those levels. For example, all hospitals enter pharmacy orders into computer systems. Many hospitals require that physicians write separate discharge orders. Both of these points are areas where there could be immediate improvements in accuracy. A focused study and solution could be engineered now. The necessary software and hardware requirements could be placed on a central web site and available for download by hospital and clinic IT staff. Existing reviewers could be charged with documenting the baseline level of errors and the degree of improvement.This book succeeds as a broad survey of what has been done about quality in certain settings. It contains some interesting ideas about what can possibly be accomplished by applying conceptual advances from other fields. It does not discuss the significant drawbacks of evidence based medicine. It lacks a practical plan for transitioning to a new system and in effect creates a new chasm. With a work like this, whether you like the conclusions depends a lot on your interpretation of the evidence and your personal experience. As a practicing physician and a previous quality reviewer I have significant areas of disagreement with what is presented in this book. Areas of controversy are not elaborated upon. I suppose you could say that level of analysis is not required, but recommendations about the future of health care in America should at least meet the criteria of "evidence based" and all the evidence should be discussed.George Dawson, MD

Reviewer: Kip Piper
Rating: 5.0 out of 5 stars
Title: Essential Reading for Everyone in Health Care
Review: If you are in anyway involved in health care, this is essential reading. Physicians, hospital administrators, purchasers, health plan execs, and grad students must immediately put this on the top of their reading list. Lives may depend on it.In it, the highly respected Institute of Medicine builds a powerful case for how the current health care system is severely broken and how it has produced a "chasm" between what we known must be done for patients (based on current science of medicine) and what is actually done. The information conveyed is shocking but true. Even more importantly, the Institute gives us a plan for building a new, more accountable quality-driven approach to health care.Read it and perhaps you too will be motivated to take action to improve health care delivery in America.

Reviewer: Nari Kannan
Rating: 5.0 out of 5 stars
Title: Summarizes the results of workshops in which the best minds in healthcare
Review: The original book for healthcare reform! Tracks Institute of Medicine (IOM)'s diagnosis of root causes of healthcare costs and inffectiveness. Summarizes the results of workshops in which the best minds in healthcare, computer sciences and policy come together to understand and observe various dimensions of healthcare and its problems. Addressing root causes always better than addressing symptoms. That's what this book represents!

Reviewer: Amazon Customer
Rating: 5.0 out of 5 stars
Title: Mint condition
Review: The copy I received looks and feels brand new!

Reviewer: S. Sanders
Rating: 4.0 out of 5 stars
Title: quality
Review: Great reference for anyone interested in quality in our health care system. it is unfortunate that many of the policy makers haven't really read this and digested what the lessons were. It was written a decade ago and we are still struggling with recommendations that were made then. I would recommend this to anyone interested in this topic.

Reviewer: paulo
Rating: 5.0 out of 5 stars
Title: Five Stars
Review: THE BOOK WAS OK, BUT I DIDN'T KNOW IT WAS DOWNLOADABLE FOR FREE ON THE IHI SITE. UGH.

Reviewer: Amazon Customer
Rating: 3.0 out of 5 stars
Title: Three Stars
Review: Not what I expected. Old information.

Reviewer: ESE
Rating: 5.0 out of 5 stars
Title:
Review: Got a bargain from other sellers. Great book, arrived on time.

Reviewer: The Cognologist
Rating: 5.0 out of 5 stars
Title:
Review: While a bit controversial for reasons only others will consider worth worrying about, this is a class study that put safety on the formal agenda, despite many of us making it a focus of our careers. Should be read along with the less read Surplus Powerlessness by Michael Lerner, who also asked why we have dangerous work places if we though quality and safety were so important.