The Institute Of Medicine ( Iom )

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.

The main objective of healthcare professionals is to provide the best quality of patient care and the highest level of patient safety. To achieve that objective, there are many organizations that help improve the quality of care. One of the best examples is the Joint Commission. Unfortunately, the healthcare system is not free from total risks. In healthcare activities, there are possible errors, mistakes, near miss and adverse events. All of those negative events are preventable. But, it is clear that errors caused in healthcare result in thousands of deaths in the United States.

It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).

Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency

The changes in healthcare over the last several years have been dramatic. All parties, providers, insurers, and the Federal Government are looking for ways to reduce cost and increase quality. The report by the Institute for Medicine in 1999, “To Err is Human” spurred increasing scrutiny in medical care to improve quality at same and looking for ways to reduce risk to patients and increase safety. Discussion of solutions

The Institute of Medicine (IOM) is a nonprofit organization that provides guidance to the Nation on issues related to biomedical science, medicine, and health and improving the Nation 's quality of care (.AHRQ, 2011). The organization established in 1970 as a component of the US National Academy of Sciences that works outside the framework of government to provide evidence-based research and recommendations for public health and science policy (IOM, 2016). The institute of medicine is well known for its health care quality initiative launched 1996.The health care quality Initiative is an ongoing process that focused on improving quality of healthcare nationwide. According to AHRQ the initiative is divided into three phases: The first phase (1996-1999) brought to light the Nation 's overall quality problem and outlined the gulf between good quality care and what really exists. The second phase (1999-2001) described a vision of how the health care system and the related policy environment must be transformed to close the gap. The third phase is ongoing and focuses on the efforts required to achieve this vision. (AHRQ, 2011)

(IOM) issued the 1999 report, “To Err is Human: Building a Safer Health Care System”. The

Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” What are the other dimensions of quality care and why are they important? What has changed since the days when “doctor knows best?”

The Institute of Medicine’s (IOM) publication of the landmark reports To Err is Human and Crossing the Quality Chasm: A New Health System for the 21st Century led many healthcare agencies to begin investigating ways to transform the healthcare industry. To Err is Human, published in 1999 outlined that despite rising healthcare costs, quality and patient outcomes were not improving. To Err is Human hypothesized that faulty processes and not people were to blame and set a goal that in the five years following the report, a reduction of 50% of healthcare errors would occur. In 2001, IOM published their report, Crossing the Chasm. In the years since their first published report, there was no noticeable improvement in the quality of healthcare. In the Crossing the Chasm report, the IOM introduced a six-aim framework to transform healthcare and improve quality. Fast-forward to 2010 and the Affordable Care Act. In the face of rising healthcare costs, 17% of the gross domestic product and rising, the government sought to control costs and improve quality by shifting from a fee for service healthcare system to a health care system where providers and hospitals receive reimbursement related to the quality of care and outcomes.

Errors pervade in our lives whether it is our home, in our workplace, or in our society. The effects of healthcare errors have impacted all our lives either directly or indirectly. Patient safety and quality care are at the core of healthcare system which strongly depends upon nurses. “To achieve goals in patient safety and quality, thereby improve healthcare, nurses must assume the leadership role. Nurses need to ensure that they and other healthcare providers center healthcare on patients and their families. Even though the quality and safety of healthcare is heavily influenced by the complex nature

Healthcare is a business and a large one at that. Hospital spending alone is expected to reach one trillion dollars when final numbers are released for 2015 (Centers for Medicare and Medicaid, 2016). With this type of spending, hospitals are uniquely charged with improving the health of the residents in their communities. At no time, should the health care provider cause harm. However, harm is what has occurred in health care. Due to a fragmented health care system, health care is in turmoil (Kohn, Corrigan, & Donaldson, 1999). It was estimated in the 1999 book, To Err is Human that anywhere from 44,000 to 98,000 people die each year in hospitals due to medical errors (Kohn, Corrigan, & Donaldson, 1999). Initiatives were put into place to combat

The United States spends the most on health care than any other country. This is an issue. Even though we spend a higher fraction of its gross domestic product on health care, we have a low infant mortality and life expectancy rate. These are indicators of quality health care. According to Mukamel, Haeder, and Weimer (2014), An Institute of Medicine (IOM) study stated that between 44,000 and 98,000 Americans die every year due to medical errors. Year after year, 100,000 die from health care acquired infections. Per patient day, US hospitals typically average one medication error. These occurrences are examples that are dragging health care quality down. According to Mukamel, Haeder, and Weimer (2014), the IOM explains quality as “[t]he degree

In today’s health care system, “quality” and “safety” are one in the same when it comes to patient care. As Florence Nightingale described our profession long ago, it takes work and vigilance to ensure we are doing the best we can to care for our patients. (Mitchell, 2008)

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.

The relationship between communication and errors has been well established in the healthcare setting, affecting patient safety and placing the organization in a position of risk (Friesen, Hughes and Zorn, 2007; Wasserman, 2014, Sears et al, 2013). Errors still occur, however, and there is a focus on how healthcare can learn from the behaviors of high-reliability industries (Verschoor et al, 2007). One such behavior is that of a Safety Briefing (DSB), through which an organization empowers every employee to be able to report issues that have an effect, or potential effect on safety processes (Kelly, 2013; Rice, 2013; Steelman, 2014). The members of the DSB then have the responsibility for identification of poor processes, system failures and remediation of issues.