医療安全の３大基本書（２）医療の質

“Knowing is not enough; we must apply. Willing is not enough; we must do.”-Goethe

　受けている医療と受けられるはずの医療との間には、小さなすき間というよりは深い谷間（chasm）が横たわっている。

　いい治療は、向こう側にあるのに、深い溝を降りて登らなければ、ジャーンプっしなければ、もしくは気づかぬうちに、連れて行ってもらえなければ享受できない。そして、誰でも簡単に深い溝に落ちてもどってこれなくなる絶大なリスク。

　自治医大の先生が絶対に読めよ、といっていた３冊のうちの２冊目。

Crossing the Quality Chasm: A New Health System for the 21st Century

• 作者: Institute of Medicine (U. S.),Institute of Medicine
• 出版社/メーカー: Natl Academy Pr
• 発売日: 2001/07
• メディア: ハードカバー
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The National Academies Press: Home より、前文。真水のようにそのままがいい。

This is the second and final report of the Committee on the Quality of Health Care in America, which was appointed in 1998 to identify strategies for achieving a substantial improvement in the quality of health care delivered to Americans. The committee’s first report, To Err Is Human: Building a Safer Health System, was released in 1999 and focused on a specific quality concern—patient safety. This second report focuses more broadly on how the health care delivery system can be designed to innovate and improve care.

This report does not recommend specific organizational approaches to achieve the aims set forth. Rather than being an organizational construct, redesign refers to a new perspective on the purpose and aims of the health care system, how patients and their clinicians should relate, and how care processes can be designed to optimize responsiveness to patient needs. The principles and guidance for redesign that are offered in this report represent fundamental changes in the way the system meets the needs of the people it serves.

Redesign is not aimed only at the health care organizations and professionals that comprise the delivery system. Change is also required in the structures and processes of the environment in which those organizations and professionals function. Such change includes setting national priorities for improvement, creating better methods for disseminating and applying knowledge to practice, fostering the use of information technology in clinical care, creating payment policies that encourage innovation and reward improvement in performance, and enhancing educational programs to strengthen the health care workforce.