Pharmacists’ role in improving quality of care

A cross the United States, there is an extensive desire to transform health care quality and improve patient safety. In 1996, the Institute of Medicine (IOM), which was chartered in 1970 as part of the National Academy of Sciences, launched an ongoing effort to assess and improve the quality of care in the United States.1 The mission of IOM is to “serve as adviser to the nation to improve health.” To date, three landmark reports have resulted from this effort and detail the nature of the problems as well as a call for change.2,–4 To Err Is Human: Building a Safer Health System examined the issue of medical errors and served to further spotlight issues of patient safety and quality.3 This report also caught the attention of the country with the estimation that 44,000–98,000 deaths occur annually in the United States due to medical care. Crossing the Quality Chasm: A New Health System for the 21st Century built a compelling case for a major restructuring of the American health care system, concluding that “the burden of harm conveyed by the collective impact of all of our health care quality problems is staggering.”4 It proposed six aims for improvement, which address key dimensions of health care delivery. The report stated that health care should be safe, effective, patient centered, timely, efficient, and equitable.4 To achieve these six aims, the report called for fundamental changes in payment methodologies, public reporting, and transparency of quality-improvement data. Since the release of these reports, the health care environment has changed rapidly, as providers, purchasers, payers, consumers, policymakers, and others have responded in ways that are beginning to transform our health care delivery system. As a result, several different organizations began to develop their own definitions and measures of quality improvement in health care.