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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 book includes six chapters that cover Virginia history from initial settlement through the 20th century plus one that deals with the important role of underwater archaeology. Written by prominent archaeologists with research experience in their respective topic areas, the chapters consider important issues of Virginia history and consider how the discipline of historic archaeology has addressed them and needs to address them . Changes in research strategy over time are discussed , and recommendations are made concerning the need to recognize the diverse and often differing roles and impacts that characterized the different regions of Virginia over the course of its historic past. Significant issues in Virginia history needing greater study are identified.