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1st Annual Crossing the Quality Chasm Summit: A Focus on Communities http://books.nap.edu/catalog/11085.html

EXECUTIVE SUMMARY

Restructuring the current finance system to reward well-integrated care and providing supports for patient self-management, for example, was a recurring topic. Information and communications technology figured prominently as an enabling tool for data collection, decision support, and improved flow of communication across providers. Measurement was a theme for all the strategies—particularly to establish short- and long-term goals. Proposals to support a patient- centered health environment ranged from research to better understand the wants and needs of patients with diabetes, to concrete actions such as ensuring that every patient has portable electronic health summaries.

redesign, some communities are making headway in the struggle to deliver health care that embodies, at least in part, the six aims set forth in the Quality Chasm report. Other communities can learn from and build on those experiences. The summit offered a public forum for “national champions” to step up and announce what they are willing to do to help facilitate community efforts, while also bringing national experts into the discussion to help translate local experiences to speak to a larger audience. It is hoped that the summit will be the first of many such efforts dedicated to further implementing the vision laid out in the Quality Chasm report.

Two working groups—addressing asthma and heart failure—targeted community collaborations to establish partnerships and build capacity and to create mechanisms for patients and families to take control of their chronic illness(es). Training and education on appropriate screening and treatment was a salient issue for the depression group, since depression is a major comorbidity for many chronic conditions, such as diabetes and heart failure. The heart failure group called for greater clinical engagement, focusing on the creation of methods that would make it easier for clinicians to provide efficient evidence- based care, such as dissemination of guidelines and the development and maintenance of registries. For the group addressing pain control in advanced cancer, a tactic proposed was to raise the bar on public awareness—making it inconceivable to tolerate bad cancer pain. This group expressed the need for strong coordinated leadership to “carry the ball” and convene key stakeholder groups. In addition, clinicians’ fears of legal or professional retribution for prescribing opioids—even when warranted— need to be addressed at the regulatory level.

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REFERENCES

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Berwick DM. 2002. A User’s Guide for the IOM’s ‘Quality Chasm’ Report. Health Affairs (Millwood, VA) 21(3):80–90.

Berwick DM. 2004. Crossing the Quality Chasm: Health Care for the 21st Century. Powerpoint Presentation.

Bodenheimer T, Lorig K, Holman H, Grumbach K. 2002. Patient self-management of chronic disease in primary care. The Journal of the American Medical Association 288(19):2469– 2475.

Bridges to Excellence. 2004. Bridges to Excellence: Rewarding Quality across the Health Care System. [Online]. Available: http://www. bridgestoexcellence.org/bte/ [accessed April 29, 2004].

Chassin MR, Galvin RW. 1998. The urgent need to improve health care quality. Institute of Medicine National Roundtable on Health Care Quality. The Journal of the American Medical Association 280(11):1000–1005.

The central message emerging from the 1st Annual Crossing the Quality Chasm Summit is that, despite environmental obstacles to system

Druss BG, Marcus SC, Olfson M, Pincus HA. 2002. The most expensive medical conditions in America: This nationwide study found that the

Copyright © 2004 National Academy of Sciences. All rights reserved. This executive summary plus thousands more available at http://www.nap.edu

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