Crossing the Quality Chasm in American Healthcare

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Introduction

Crossing the Quality Chasm is a comprehensive report dwelling upon the quality of health care in the US, which calls for bridging the quality gap through a drastic redesign of the American health care system. The report provides principles for action that policymakers, health care managers, regulators, doctors, nurses, and other people responsible for patients’ well-being must follow in order to achieve the ultimate goal indicated in the document (Likosky, 2014). Moreover, the report not only criticizes the existing system and sets performance expectations for the century ahead but also suggests particular improvements in six dimensions: patient safety (reducing the possibility of harm), care effectiveness (preventing misuse or underuse of resources), patient-centeredness (improvement of customer service and taking into account patients’ preferences in care decisions), timeliness (reducing wait time), care efficiency (minimizing waste), and equity (eliminating racial and social inequality of health care) (Brilli, Allen, & Davis, 2014). Crossing the Quality Chasm analyzes the causes of the quality gap as well as limitations of the present-day system of health care to come out with a totally different framework for care. It claims that services should be performed at four levels: patient experience, care-giving microsystems, organizations that house and support them, and legal, financial, and educational environment – this would promote evidence-based practice and improve quality that is currently impeded by a lot of adverse factors (Inoue, 2016).

Analysis

The Agency for Healthcare Research and Quality’s 2015 National Healthcare Quality and Disparities Report is an official document recording the country’s progress in eliminating various disparities that currently exist in health care. The major assumptions include the following ones (Radwin, Castonguay, Keenan, & Hermann, 2016):

  • there has been a considerable improvement in providing access to health care services to people who did not have any kind of health insurance before;
  • the quality of health care continues to become better;
  • the overall treatment has been improved with the gradual removal of disparities;
  • patient safety has been increased, although gaps remain;
  • care coordination is not given priority;
  • care affordability is still low;
  • racial and social care discrepancies persist.

This important information will render assistance in advocating for a disadvantaged patients population as it clearly shows the areas of health care that do not seem to improve in terms of bridging gaps. Thus, it shows the directions of further development. Besides, the report will guide me in the provision of culturally competent care and help initiate programs and campaigns aimed at increasing affordability of health care service to people of low economic status (Austin, McGlynn, & Pronovost, 2016).

The Institute of Medicine’s 2010 and 2016 Future of Nursing Reports are highly significant for re-evaluating the role of an advanced practice nurse in the health care system. Both documents encourage nurses to be more active, efficient, and decisive in the complex health care system and take an active part in the decision-making process. Such reassessment of an advanced practice nurse’s position implies that I would be able to take a leadership role in improving care provision. The system still has a lot of weak points that have to be addressed. Many recommendations from the documents are already reflected in the unceasing process of advancing the profession that is capable of opening new horizons to its representatives. The evidence-based recommendations provided in the report will be very useful not only in providing high-quality care to patients but also in policy-making (Grossman & Valiga, 2016).

References

Austin, J. M., McGlynn, E. A., & Pronovost, P. J. (2016). Fostering transparency in outcomes, quality, safety, and costs. Jama, 316(16), 1661-1662.

Brilli, R. J., Allen, S., & Davis, J. T. (2014). Revisiting the quality chasm. Pediatrics, 133(5), 763-765.

Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing. Philadelphia, PA: FA Davis.

Inoue, M. (2016). Improving quality of care through primary care research. Journal of General and Family Medicine, 17(4), 267-269.

Likosky, D. S. (2014). Clinical microsystems: A critical framework for crossing the quality chasm. The Journal of Extra-Corporeal Technology, 46(1), 33-37.

Radwin, L. E., Castonguay, D., Keenan, C. B., & Hermann, C. (2016). An expanded theoretical framework of care coordination across transitions in care settings. Journal of Nursing Care Quality, 31(3), 269-274.

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