IOM Releases Report on Patient Safety

A recent report on patient safety from the Institute of Medicine (IOM) of the National Academies, Crossing the Quality Chasm: A New Health System for the 21st Century, criticizes the US health care delivery system, finding it to be poorly designed and inept at meeting the needs of patients. To address these problems, the system needs to be revamped, according to the report. To this end, the authors of the report propose that Congress create a $1 billion “innovation fund” to support the reform effort; they insist that only such a firm financial commitment will be adequate to address current concerns with the health care system.

One of their major criticisms of the system is that it is fragmented and that communication between field specialties is poor. A more multidisciplinary approach to patient treatment would result in a broader range of services being made available to the patient, the report claims. Furthermore, breakdown in communication and disorganization within the system has led to duplication and wasting of resources.

Another complaint filed by the report is that new communication technologies have not been sufficiently used by health care providers to relay patient data and communicate directly with patients. The report committee urges the replacement of outdated paper records with more accessible electronic ones and suggests that patients could more quickly and accurately have their needs met if they could communicate with health care personnel via e-mail. Automated medication order entry systems, it is thought, could render drug prescribing and dosing more accurate and safer for patients. Overall, a national, integrated, technologically updated information infrastructure is needed to speed up and facilitate communication between health care providers and patients.

In terms of improving quality, the report advises the Department of Health and Human Resources to oversee and evaluate qualitative progress made in six essential areas: safety, effectiveness, responsiveness to patients, timeliness, efficiency, and equity. Furthermore, payment policies geared toward rewarding improvements in quality are also recommended by the report.

The report committee, in summarizing its concerns about patient safety, accessibility of information to patients, and better communication between patients and health care professionals, also presents 10 rules for improving the health care delivery system overall: