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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.
"The Drillmaster of Valley Forge-Baron Von Steuben-correctly noted in his "Blue Book" how physical conditioning and health (which he found woefully missing when he joined Washington's camp) would always be directly linked to individual and unit discipline, courage in the fight, and victory on the battlefield. That remains true today. Even an amateur historian, choosing any study on the performance of units in combat, quickly discovers how the levels of conditioning and physical performance of Soldiers is directly proportional to success or failure in the field. In this monograph, Dr. Whitfield "Chip" East provides a pragmatic history of physical readiness training in our Army. He tells us we initially mirrored the professional Armies of Europe as they prepared their forces for war on the continent. Then he introduces us to some master trainers, and shows us how they initiated an American brand of physical conditioning when our forces were found lacking in the early wars of the last century. Finally, he shows us how we have and must incorporate science (even when there exists considerable debate!) to contribute to what we do-and how we do it-in shaping today's Army. Dr. East provides the history, the analysis, and the pragmatism, and all of it is geared to understanding how our Army has and must train Soldiers for the physical demands of combat. Our culture is becoming increasingly ''unfit," due to poor nutrition, a lack of adequate and formal exercise, and too much technology. Still, the Soldiers who come to our Army from our society will be asked to fight in increasingly complex and demanding conflicts, and they must be prepared through new, unique, and scientifically based techniques. So while Dr. East's monograph is a fascinating history, it is also a required call for all leaders to better understand the science and the art of physical preparation for the battlefield. It was and is important for us to get this area of training right, because getting it right means a better chance for success in combat.
This manual suggests design operating and performance criteria for specific surface water quality conditions to provide the optimum protection from microbiological contaminants.
Dr. Greg Zacharias, former Chief Scientist of the United States Air Force (2015-18), explores next steps in autonomous systems (AS) development, fielding, and training. Rapid advances in AS development and artificial intelligence (AI) research will change how we think about machines, whether they are individual vehicle platforms or networked enterprises. The payoff will be considerable, affording the US military significant protection for aviators, greater effectiveness in employment, and unlimited opportunities for novel and disruptive concepts of operations. Autonomous Horizons: The Way Forward identifies issues and makes recommendations for the Air Force to take full advantage of this transformational technology.