IOM quality report: The goals to tackle medical errors are laudable. But will they be reached?

The Institute of Medicine tries again with a new report.

Editorial. March 26, 2001.

The Institute of Medicine's second of two reports on quality in American health care, "Crossing the Quality Chasm," doesn't seem to have made quite as big a splash as the first.

That earlier report, "To Err is Human," made famous the figure of up to 98,000 patient deaths yearly from medical mistakes. Even though that number was drawn from earlier research, it was an attention-grabber -- perhaps too much so. It somewhat overshadowed the rest of the report's message on patient safety.

Links

This time out of the gate, headlines and sound bites with an accent on the negative again appear to have done a disservice to the IOM. The headline in USA Today was typical: "Report: Health system broken."

There's a limited audience for a recap on the health system's day-to-day failings, from irritations to far worse, when they have been experienced by so many patients and doctors already. It's a wonder if many bothered to read beyond the headlines.

That's a shame because perhaps the IOM report's greatest strength is that it does a good job of articulating the positive values of what American health care should aspire to be -- safe, effective, patient-centered, timely, efficient and equitable. There is room for debate on details and the practicality of the IOM's specific recommendations, but at least that's a solution-centered discussion well worth having if it leads to better patient care.

The AMA and several other leading physician organizations immediately voiced their support for the IOM's overarching goals and the spirit of innovation called for in the report. Indeed, organized medicine is already active in initiatives essential to achieve those goals, including evidence-based clinical guidelines, standardized performance measures and promoting systemic solutions for patient safety. Organized medicine has also demonstrated leadership in other key areas ranging from the high-tech of patient-doctor e-mail to the high-touch of patient-centered care.

However, the medical community is only one part of a health care system in which all participants must work in synch to achieve the goals the IOM has set out. That will require the willingness to act (and often, to spend) on the part of all the participants in health care -- doctor, health plan, government, patient, employer.

Until that happens, it won't matter how big a splash any grand plan for improving quality makes -- they'll all be destined to sink out of sight.

ADDITIONAL INFORMATION:

Weblink

Crossing the Quality Chasm, IOM report on quality in health care (http://www.nap.edu/books/0309072808/html/)

Joint response to the IOM report by the AAFP, AMA, the American College of Physicians-American Society of Internal Medicine and the American College of Surgeons (no longer available)