Introduction To Crossing The Quality Chasm : A New Health System For The 21st Century

Over the course of our countries history, the delivery of our health care system has tried to meet the needs of our growing and changing population. However, we somehow seem to fall short in delivering our goals of providing quality, affordable and accessible healthcare to our citizens. The history of our delivery system will show we continuously changed the delivery of our system however never mange to control cost. If we can come up with efficient ways to cut cost, the delivery of quality care will follow.

By 2001 it was brutally apparent that the U.S. Health Care system was in dire need of a reform in regards to quality and patient safety. Following two separate reports issued by The Institute of Medicine (IOM), To Err is Human (1999) and Crossing the Quality Chasm: A New Health Care System for the 21st Century(2001) the U.S. Congress requested the IOM review quality processes across multiple government funded health care programs. And understandably, “these reports described America’s healthcare system as a tangled, highly fragmented web that often wastes resources by duplicating efforts, leaving unaccountable gaps in coverage, and failing to build on the strengths of all health professionals” (Brown J., p. I – 15, 2013). Thus, the Committee on the Quality of Health Care in America released 6 aims to address key dimensions that require improvement in our health care system. These aims propose that our system needs to strive to be more Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable (STEEEP). All of which were created to help overhaul our current health care system and, more importantly, narrow the quality chasm.

Better quality health care will affect the life expectancy rate and the expenses. Patients expect doctors and hospitals to deliver the best possible care. The major issue with the quality of health care is “medical errors result from faulty systems… not individuals” (Hughes). In order to ensure patient safety and positive outcomes, hospitals have to assess for themselves the various different aspects they need to improve on. For example, hospitals could have a shortage ranging from staff, medication, or equipment. Through universal health care, “doctors… can focus on patient care”, which will aid in improving treatments for each individual (White). Along with this, there will be more government funding to improve hospitals as a means to help patients. Countries under universal health care coverage have a better quality of care, while the “United States [is ranked] last overall” (“Right to Health Care”). These benefits of medical treatments of universal health care are vital to American

This IOM Report on crossing the Quality Chasm efficiently describes the method of work in health care system. The complete concept is based upon more knowledge, managing capabilities, monitoring and so on. The growing

Quality Improvement (QI) is an organizational approach leading to the quality of patient care and patient services through use of specific guidelines, principles, and methods to ensure quality of care for every patient and health care facility throughout the world. Quality outcomes focus on the principles of quality management. These measurements investigate the quality of care, patient outcomes and consumer needs, through being part of the participant group. This quality improvement discussion will review the foundational frameworks of QI and explanation of each framework in detail. Included in this QI report will be

This quality improvement discussion will review the purpose of quality management in health care industry and why it is needed. Included in this QI report will be an explanation of the

Quality can be difficult to measure, which is what has halted the strong pursuit of quality in the past. Healthcare organizations use quality assessment to measure quality against some established standard. This includes “defining how quality is to be determined, identification of specified variables... and the collection of appropriate data to make the measurement possible (Shi, 2015, pg. 493). The Affordable Care Act set new standards and incentives for achieving quality of care. This includes offering Medicare reimbursements for hospitals with low readmission rates, and ensuring that (not-for-profit) hospitals complete a community health needs assessment (to ensure that the needs of the community are being met) and by implementing HCAHPS scores, which measures efficiency and efficacy of care using patient surveys. HCAHPS and hospital readmission good example of how quality of care can be measured in efficiency as well as

In 2001, the US Institute of Medicine’s seminal report, ‘Crossing the Quality Chasm: A New Health System for the 21st Century’, recommended six goals for improvement in healthcare, with one focusing on patient-centred care (Institute of Medicine [IOM], 2011). Furthermore, various international organisations, such as the Institute for Patient- and Family-

Policy makers created the Medicare Hospital Readmissions Reduction Program (HRRP) in an attempt to improve quality of patient care and lower costs (James, 2013). In order to avoid these penalties, healthcare leaders must recognize that CMS has identified a correlation between readmissions and a lack of quality care. Therefore, the aim is not to focus solely on hospital readmissions, but to seek clinical excellence by investing in quality improvement (Silow-Carrol, Edwards & Lashbrook, 2011). However, reducing readmissions is a complex undertaking, because not all readmissions can or should be prevented. Indeed, some readmissions are planned as part of sound clinical care. Furthermore, while hospitals work to reduce readmissions caused

The Quality Chasm report underscores the lack of quality healthcare, cost concerns, poor use of information technology, absence of progress in restructuring the health care system, and the underutilization of resources (Stevens, et al., 2006). The quality issue that this writer has chosen to address is the poor use of information technology. According to the Quality Chasm Report, health science and technology have advanced at a very rapid pace, but due to poor use of information technology, the healthcare delivery system has not maintained delivery of high-quality healthcare services. Research results are not translated into practice, and practice lags behind knowledge (Stevens, et al.,

Quality Improvement can be defined as the combined effort of health care professionals including, doctors, nurses, healthcare managers who ensure better patients outcome such as quality care, safety, better system performance and better professional development. Healthcare system always goes through changes, whether its implementation of new systems or diagnosis of new disease. Therefore, health organizations are always in need of some improvement and advancement. In order to achieve improvement, systems have to go through a series of change; however, not all changes can be called an improvement. To ensure the improvement in these systems, some powerful strategies are planned, designed and implemented. These formal strategies analyze the systemic efforts and measure performance in order to improve the entire system and is called quality improvement or QI program.

The purpose of this paper is to identify a quality safety issue. I will summarize the impact that this issue has on health care delivery. In addition, I will identify quality improvement strategies. Finally, I will share a plan to effectively implement this quality improvement strategy.

Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.

Quality is something that every health care agency strives to achieve. The Institute of Medicine (IOM) suggests that health care organizations develop a culture of safety such that an organization's care processes and workforce are focused on improving the reliability and safety of care for patients (Groves, Meisenbach, & Scott-Cawiezell, 2011). In order to address an issue related to health care quality, it is important to look at the frameworks that will analyze an organization and identify opportunities to improve performance. The purpose of this paper is to provide a description of an organization and an analysis of the following: mission, vision and values, strategic plan, goals,

Safe, effective, patient-centered care delivered in a timely and efficient manner is the goal of quality healthcare. Unfortunately, the delivery of such quality faces serious concerns. The Institute of Medicine (2001) describes the quality gap in healthcare as having three types of problems, “overuse, underuse, and misuse” (p. 23). In recent years, emphasis on improving the quality of care has increased (IOM, 2001). Quality improvement methods, such as plan-do-study-act (PDSA), have successfully enabled health care providers to address the quality gap. The purpose of this paper is to identify a quality healthcare problem, discuss the quality improvement plan, and describe the strategy for implementing effective change using the PDSA method.