Quality and Safety in Health Care

A 1998 Institute of Medicine publication, “Statement on Quality of Care,” concluded that serious and widespread quality problems exist in the U.S. health care system, which can be classified into one of three categories: overuse, underuse, and misuse. Research has also noted significant variations in the quality of care across geographic areas. For example, hospital discharge rates vary across geographic regions, as does adherence to recommended screenings for people with diabetes. Low-quality care is costly—in both financial and human terms—and lowers consumer confidence in the health care industry.

The Institute of Medicine report states that the delivery of health care is often overly complex and requires too many steps for the patient. These extra steps can waste time and money and risk patient health and safety.

The academy has recommended a national vision for improving the quality of care and fostering innovation within the health care system built upon six quality domains. Health care should be safe, effective, patient-centered, timely, efficient, and equitable. These elements were subsequently incorporated into the National Quality Strategy’s six priorities.