In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMITTEE ON IMPROVING THE QUALITY OF HEALTH CARE GLOBALLY
• Reviewers
• Preface
• Acknowledgments
• Acronyms and Abbreviations
• Summary
  • THE DIRE STATE OF HEALTH CARE QUALITY
  • BUILDING ON HISTORY
  • LEVERAGING UNIVERSAL HEALTH COVERAGE TO IMPROVE THE QUALITY OF CARE
  • EMBEDDING SYSTEMS THINKING AND MEASUREMENT
  • THE FUTURE OF HEALTH CARE
  • HIGH QUALITY FOR EVERYONE: MAKING INFORMAL CARE VISIBLE AND ADDRESSING CARE UNDER EXTREME ADVERSITY
  • THE ADVERSE IMPACTS OF CORRUPTION
  • CREATING A CULTURE OF LEARNING
  • THE CRUCIAL NEED FOR MORE EVIDENCE
  • A FINAL WORD
• 1. Introduction
  • THE SUSTAINABLE DEVELOPMENT GOALS AND THE UNIVERSAL HEALTH COVERAGE AGENDA
  • CHALLENGES FOR HEALTH CARE QUALITY
  • A POOR PATIENT JOURNEY
  • CHARGE, APPROACH, AND SCOPE OF THIS STUDY
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. The Path to a High-Quality Future: The Need for a Systems Approach and a Person-Centered System
  • THE NEED TO REDOUBLE EFFORTS FOR A SYSTEMS APPROACH
  • REDESIGN FOR A PERSON-CENTERED HEALTH SYSTEM
  • SUMMARY AND RECOMMENDATION
  • REFERENCES
• 3. Optimizing the Patient Journey by Leveraging Advances in Health Care
  • GLOBAL TRENDS IN HEALTH CARE
  • IMPLICATIONS FOR QUALITY: PERSON-CENTEREDNESS, ACCESSIBILITY, AND EQUITY
  • MOVING FROM REACTIVE TO PREDICTIVE CARE
  • NEEDED ORGANIZATIONAL AND CARE DELIVERY CHANGES
  • CAUTIONS FOR QUALITY IN THE FUTURE SYSTEM
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 4. The Current State of Global Health Care Quality
  • Mansah's Story: The Consequences of Poor Quality
  • THE STATE OF QUALITY ACROSS DOMAINS
  • THE BURDEN OF LOW-QUALITY CARE
  • DATA SOURCES AND LIMITATIONS
  • VARIABILITY IN QUALITY: WHERE ARE THE GAPS?
  • TRACKING PROGRESS IN QUALITY: WHERE ARE THE METRICS?
  • SUMMARY AND RECOMMENDATION
  • REFERENCES
• 5. High-Quality Care for Everyone: Making Informal Care Visible and Addressing Care Under Extreme Adversity
  • INFORMAL HEALTH CARE PROVIDERS: OVERVIEW
  • HEALTH CARE QUALITY IN SETTINGS OF EXTREME ADVERSITY
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 6. The Critical Health Impacts of Corruption
  • THE IMPACT OF CORRUPTION ON THE HEALTH OF POPULATIONS
  • TYPES OF CORRUPTION IN HEALTH CARE
  • CHALLENGES TO EFFECTIVE UNIVERSAL HEALTH COVERAGE POSED BY CORRUPTION
  • STRATEGIES FOR REDUCING CORRUPTION IN HEALTH CARE
  • SUMMARY AND RECOMMENDATION
  • REFERENCES
• 7. Embedding Quality Within Universal Health Coverage
  • THE NECESSARY LINK BETWEEN UNIVERSAL HEALTH COVERAGE AND QUALITY
  • UNIVERSAL HEALTH COVERAGE AS AN OPPORTUNITY FOR QUALITY IMPROVEMENT
  • THE NEED FOR GOVERNMENT COMMITMENT TO QUALITY WITHIN UNIVERSAL HEALTH COVERAGE
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 8. Establishing a Culture of Continual Learning
  • WHAT IS A LEARNING HEALTH CARE SYSTEM?
  • THE COMPONENTS OF A LEARNING HEALTH CARE SYSTEM
  • A RESEARCH AND DEVELOPMENT AGENDA
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• APPENDIXES
  • A. Public Meeting Agendas
  • B. Methods for Rapid Review
  • C. Committee Member Biosketches
  • D. Methods for Chapter 4

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the global quality chasm: Improving health care worldwide. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25152.