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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.
As U.S. military forces appear overcommitted and some ponder a possible return to the draft, the timing is ideal for a review of how the American military transformed itself over the past five decades, from a poorly disciplined force of conscripts and draft-motivated "volunteers" to a force of professionals revered throughout the world. Starting in the early 1960s, this account runs through the current war in Iraq, with alternating chapters on the history of the all-volunteer force and the analytic background that supported decisionmaking. The author participated as an analyst and government policymaker in many of the events covered in this book. His insider status and access offer a behind-the-scenes look at decisionmaking within the Pentagon and White House. The book includes a foreword by former Secretary of Defense Melvin R. Laird. The accompanying DVD contains more than 1,700 primary-source documents-government memoranda, Presidential memos and letters, staff papers, and reports-linked directly from citations in the electronic version of the book. This unique technology presents a treasure trove of materials for specialists, researchers, and students of military history, public administration, and government affairs to draw upon.