Closing The Quality Gap

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.

Improved communication in business means higher profits. Improved communication in government means happier citizens. Improved communication in healthcare means quicker recoveries, fewer lawsuits, and happier nurses and patients.Closing the Communication Gap can help readers improve communication by closing the gap between what the communicator mea

This book offers a novel and proven approach to the retention and success of underrepresented students. It advocates a strategic approach through which an institution sets clear goals and metrics and integrates the identity support work of cultural / diversity centers with skill building through cohort activities, enabling students to successfully navigate college, graduate on time and transition to the world of work. Underlying the process is an intersectional and identity-conscious, rather than identity-centered, framework that addresses the complexity of students’ assets and needs as they encounter the unfamiliar terrain of college.In the current landscape of higher education, colleges and universities normally divide their efforts between departments and programs that explicitly work on developing students’ identities and separate departments or programs that work on retaining and graduating higher-risk students. This book contends that the gap between cultural/diversity centers and institutional retention efforts is both a missed opportunity and one that perpetuates the opportunity gap between students of color and low-income students and their peers.Identity-consciousness, the central framework of this book, differs from an identity-centric approach where the identity itself is the focus of the intervention. For example, a Latino men’s program can be developed as an identity-centered initiative if the outcomes of the program are all tied to a deeper or more complex understanding of one’s Latino-ness and/or masculinity. Alternately, this same program can be an identity-conscious student success program if it is designed from the ground up with the students’ racial and gender identities in mind, but the intended outcomes are tied to student success, such as term-to-term credit completion, yearly persistence, engagement in high-impact practices, or timely graduation.Following the introductory chapter focused on framing how we understand risk and success in the academy, the remaining chapters present programmatic interventions that have been tested and found effective for students of color, working class college students, and first-generation students. Each chapter opens with a student story to frame the problem, outlines the key research that informs the program, and offers sufficient descriptive information for staff or faculty considering implementing a similar identity-conscious intervention on their campus. The chapters conclude with a discussion of assessment, and suggested “Action Items” as starting points.

We have always struggled, as human beings. But our struggle today is exacerbated by a gap between the increasingly complicated world we have created and the default ways we think about it. Twenty-first-century challenges are qualitatively different from the ones that generations of our ancestors faced, yet our thinking has not evolved to keep pace. We need to catch up. To make smarter decisions -- as governments, organizations, families and individuals -- we need more sophisticated mental strategies for interpreting and responding to today's complexity. Best-selling author and business leader Ted Cadsby explores the insights of cognitive psychology, anthropology, biology, neuroscience, physics, and philosophy to reveal the gap between how we typically tackle complex problems and what complexity actually requires of us. In an accessible and engaging style, he outlines ways to close the gap -- the strategic mental shifts that increase decision-making effectiveness. The bottom line? We need greater complexity in our thinking to match the increasing complexity in our world, and Cadsby shows us how.

Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.

This powerful call to arms offers a realistic vision for getting locally produced, healthy food onto everyone’s table, “[blending] a passion for sustainable living with compassion for the poor” (Dr. Jane Goodall) In Closing the Food Gap, food activist and journalist Mark Winne poses questions too often overlooked in our current conversations around food: What about those people who are not financially able to make conscientious choices about where and how to get food? And in a time of rising rates of both diabetes and obesity, what can we do to make healthier foods available for everyone? To address these questions, Winne tells the story of how America’s food gap has widened since the 1960s, when domestic poverty was “rediscovered,” and how communities have responded with a slew of strategies and methods to narrow the gap, including community gardens, food banks, and farmers’ markets. The story, however, is not only about hunger in the land of plenty and the organized efforts to reduce it; it is also about doing that work against a backdrop of ever-growing American food affluence and gastronomical expectations. With the popularity of Whole Foods and increasingly common community-supported agriculture (CSA), wherein subscribers pay a farm so they can have fresh produce regularly, the demand for fresh food is rising in one population as fast as rates of obesity and diabetes are rising in another. Over the last three decades, Winne has found a way to connect impoverished communities experiencing these health problems with the benefits of CSAs and farmers’ markets; in Closing the Food Gap, he explains how he came to his conclusions. With tragically comic stories from his many years running a model food organization, the Hartford Food System in Connecticut, alongside fascinating profiles of activists and organizations in communities across the country, Winne addresses head-on the struggles to improve food access for all of us, regardless of income level.

This review was organized to bring a systematic assessment of different quality improvement strategies & their effects to the process of identifying & managing hypertension. Findings suggest that quality improvement strategies appear, in general, to be associated with the improved identification & control of hypertension. It is not possible to discern with complete confidence which specific quality improvement strategies have the greatest effects, since most of the studies included more than one quality improvement strategy. Illustrations.