1st Annual Crossing the Quality Chasm Summit: A Focus on Communities http://books.nap.edu/catalog/11085.html
1ST ANNUAL CROSSING THE QUALITY CHASM SUMMIT
SETTING THE CONTEXT FOR THE SUMMIT
In launching the summit, Reed Tuckson, chair of the IOM committee that organized this event, set the stage by positioning the patient as “true north”—serving as a compass to steer and guide health care reform efforts (Berwick, 2002). In this vein, the summit was organized to reinforce the Quality Chasm report’s core tenet of patient- centered health care. Patient-centered care has different meanings for each patient. For some patients it may mean care only for themselves; for others it includes both patients and their families; while for others it comprises non– professionally trained caregivers who serve as a safety net. When the “patient” is referred to in this report, the term implicitly represents this full range of circumstances.
their disease, but taking a more holistic approach to their care. The summit was deliberately structured to reflect this philosophy, emphasizing solutions that transcend any one chronic illness, in the belief that applying lessons from the core set of five priority conditions to other conditions would be expedited if the cross-cutting areas were the central focus.
“The ultimate judge of the quality of our work is the patient, end of story.”
Don Berwick, summit keynote speaker
At the summit, participants first heard from Martha Whitecotton, a registered nurse, who poignantly described the shortfalls of the current health care delivery system by relaying her family’s experiences in trying to obtain high- quality care for a child with major depression. She highlighted gaps and deficiencies in care relevant not only to depression, but to all chronic conditions. Examples included lack of a well-coordinated care plan, poor communication among multiple clinicians involved in a patient’s care, and failure to inform patients and their families about best practices. Redressing these deficiencies became the focus of the work at the summit.
Continuing on this theme during his keynote speech, Don Berwick, President of the Institute for Healthcare Improvement, reiterated the emphasis on honoring the patient—respecting patients’ preferences, needs, ethnicity, and diversity, and viewing them as the ultimate source of control. He translated the Quality Chasm aims from the patient’s perspective: “to have health care with no needless deaths, no needless pain or suffering, no unwanted waiting, no helplessness, and no waste” (Berwick, 2004). Embracing this approach requires not segregating patients into silos as defined by
The confirmed diagnosis of a broken, fragmented health care delivery system led directly to the identification of the six cross- cutting areas enumerated above. These areas largely reflect those discussed in the Quality Chasm series of reports, with one exception— community coalition building, added to reflect the interests and needs of summit participants from communities. The purpose of the sessions in these six areas was to identify strategies and opportunities for overcoming barriers to high- quality care, learning from communities that have made promising advances, as well as from distinguished individuals and organizations recognized as leaders in these fields. Following is a synthesis of the key strategies to be explored as identified by the summit participants (summarized in Boxes ES-3 through ES-8).
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