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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.
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
To lead the US Air Force into the future, it is necessary to understand the past and present nature of the force. With this in mind, Air Force leaders have always sought to arm members of the force with a basic knowledge and understanding of Air Force culture and history. This volume is a contribution to that ongoing educational process, but as the title states, this is only an introduction. The information provided here merely scratches the surface of the fascinating stories of the people, equipment, and operations of the Air Force Topics that are covered here in only a few short paragraphs have been, and will continue to be the subject of entire books. We hope this volume will be a starting point and a reference work to facilitate your continuing study of aerospace power. The reader should keep in mind that all the people, operations, and aerospace craft included in this book have been important to the US Air Force, but they are not the only ones that have been important. The US Air Force has gained much from other nations, other US military services, and civilian organizations and these outside influences on the US Air Force are not included in this volume. This Introduction to the United States Air Force is organized into two parts and five appendices. The first part is organized chronologically and groups significant operations and personalities together in several critical periods in the development of the US Air Force. The second part covers aerospace craft and is organized by type (fighters, bombers, missiles, etc,) in order to show the development of each type over time. Following Part II are appendices listing the senior leaders of the early air forces (before the creation of the US Air Force in 1947), the Air Force Chiefs of Staff, the Chief Master Sergeants of the Air Force, Fighter Aces, and Medal of Honor Winners.
This report is the last of a six-volume series in which RAND explores the elements of a national strategy for the conduct of U.S. foreign policy. It analyzes U.S. strengths and weaknesses, and suggests adaptations for this new era of turbulence and uncertainty. The report offers three alternative strategic concepts and evaluates their underlying assumptions, costs, risks, and constraints.