User's manual for the IOM's 'Quality Chasm' report.
Fifteen months after releasing its report on patient safety (To Err Is Human), the Institute of Medicine (IOM) produced a safety report entitled Crossing the Quality Chasm. In this article, Berwick, one of the original architects of the report, provides a condensed synthesis of the instrumental report. The framework is presented in an executive summary fashion, starting with broad areas of interest (experience of patients, functioning of microsystems and organizations, and environmental factors), and ultimately leading to a mandate for improvement in six dimensions of health care performance. These dimensions include safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Berwick emphasizes the importance of defining ''quality'' based on the experiences of our patients and concludes by raising anticipated challenges in moving forward.