A major report, “Crossing the Quality Chasm”, published in 2001 by the Institute of Medicine (IOM), focuses on closing the quality gap between what we know to be good health care and the health care that people actually receive.

The report set forth six aims for a quality health care system patient safety [1]:

  • Safe: Avoid harm to patients from the care that is intended to help them. It means safety must be a property of the healthcare system. No one should ever be harmed by health care again [2].
  • Effective: Provide services based on scientific knowledge to all who could benefit and refrain from providing services to those not likely to benefit ( i.e. avoid underuse and misuse of services, respectively).
  • Patient-centered: Provide care that is respectful of and responsive to individual patient preferences, needs, and values and ensure that patient values guide all clinical decisions.
  • Timely: Reduce waits and sometimes harmful delays for both those who receive and those who give care.
  • Efficient: Avoid waste, including waste of equipment, supplies, ideas, and energy.
  • Equitable: Provide care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.


[1] Institute of Medicine Committee on Quality of Health Care in, A. (2001). In Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US) Copyright 2001 by the National Academy of Sciences. All rights reserved.

[2] Institute for Healthcare Improvement. (2020). Across the Chasm: Six Aims for Changing the Health Care System. Improvement Stories. Retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasmSixAimsforChangingtheHealthCareSystem.aspx

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