Advancing the Quality of Health Care: Key Issues and Fundamental Principles

Contents

• Committee to Develop a Policy Statement on Mechanisms for Advancing the Quality of Health Care
• I. INTRODUCTION AND SUMMARY
  • Summary of Major Conclusions
  • The Context of the Conclusions
  • Historical Development of Regulation of the Quality of Health Care
• II. THE PRINCIPLES OF QUALITY ASSURANCE
  • Scope
  • Methods and Data Requirements
• III. THE FUTURE OF QUALITY ASSURANCE
  • Anticipating the Unexpected
  • What Can We Hope For?
• IV. THE IMPLICATIONS OF THE PRINCIPLES FOR THE PSRO PROGRAM
  • Geographic Scope, Recommendation, Page 8
  • Size of Geographic Area, Recommendation, Page 9
  • Population-Based Data, Recommendation, page 9
  • Providers Subject to Review, Recommendation, Page 10
  • Participation of All Types of Practitioners, Recommendation, Page 10
  • Review of Ambulatory Services, Recommendation, Page 11
  • Initial Methods for Quality Assessment, Recommendation, Pages 20 and 21
  • Relating Processes to Outcomes, Recommendation, Page 22
  • Data Requirements, Recommendation, Page 23
  • Uniform Terms, Definitions and Classifications, Recommendation, Page 25
  • Use of Computer Technology, Recommendation, Page 25
  • Compatibility with Other Health Care Data, Recommendation, Pages 26 and 27
  • Confidentiality of Patient Data, Recommendation, Page 27
  • Entrusting the Patient with his Record, Recommendation, Page 28
  • Development of Norms and Standards, Recommendation, Page 29
  • Bearing the Costs of Quality Assurance, Recommendations, Page 31
  • Improving Provider Performance, Recommendations, Pages 32-34
  • Consumer Participation, Recommendation, Page 38
  • Federal Management, Recommendations, Pages 38-40
  • Research, Development, and Evaluation, Recommendation, Page 41
• COMMENT AND DISSENT
• APPENDIX Bibliography

NOTICE: This is the report of a project undertaken with the approval of the Council of the Institute of Medicine, National Academy of Sciences. Such approval manifests the judgment that the project is of national importance and appropriate both to the purposes and professional resources of the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Acadmey of Sciences to enlist distinguished members of medical and other professions for the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 Congressional charter responsibility to be an advisor to the Federal Government, and its own initiative in identifying issues of medical care, research, and education.