10 Strategies for Improving Quality in Care and Reducing Costs

The Institute of Medicine (IOM) describes themselves as an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863. Nearly 150 years later, the National Academy of Sciences has expanded into what is collectively known as the National Academies, which comprises the National Academy of Sciences, the National Academy of Engineering, the National Research Council, and the IOM.

The IOM’s Roundtable on Value & Science-Driven Health Care is comprised of national healthcare leaders and organized under a charter. The vision is for our health system to provide the most appropriate care drawing on the best evidence based data. The goal is the to have 90% of clinical supported by accurate, timely, and up-to-date clinical information and reflect the best available evidence by 2020.

This month the group released a Discussion Paper, “A CEO Checklist for High-Value Care“. The checklist outlines 10 items identified from their experiences that reflect strategies proven effective and essential to improving quality and reducing costs. Four primary areas comprise the list, foundational elements, infrastructure fundamentals, care delivery priorities, and reliability and feedback.

Foundational elements

• Governance priority—visible and determined leadership by CEO and Board
• Culture of continuous improvement—commitment to ongoing, real-time learning

Infrastructure fundamentals

• IT best practices—automated, reliable information to and from the point of care
• Evidence protocols—effective, efficient, and consistent care
• Resource utilization—optimized use of personnel, physical space, and other resources

Care delivery priorities

• Integrated care—right care, right setting, right providers, right teamwork
• Shared decision making—patient–clinician collaboration on care plans
• Targeted services—tailored community and clinic interventions for resource-intensive patients

Reliability and feedback

• Embedded safeguards—supports and prompts to reduce injury and infection
• Internal transparency—visible progress in performance, outcomes, and costs