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Ten Simple Rules Posted by Marcus Pierson, 5/26/02 at 12:03:45 PM.
The IOM's patient safety report concluded that reducing injuries to patients would require systemic changes; the Chasm report says the same about all six dimensions of needed improvement. Major gains will depend, not on exhorting the health care workforce to try harder, but rather on fundamental changes in the ways in which care is organized, and in the environment (such as finance, regulation, and accreditation), which often constrains the forms of care that are feasible. At the level of care itself, the IOM recommends the adoption of ten "simple rules" to guide design: 1. Care based on continuous healing relationships (not just visits) 2. Customization based on individual patients‚ needs and values 3. The patient as source of control 4. Shared knowledge and the free flow of information (including "unfettered access" by patients to their own medical records) 5. Evidence-based decision-making 6. Safety as a system property 7. The need for transparency 8. Anticipation of needs 9. Continuous decrease in waste 10. Cooperation among clinicians To encourage the emergence of care systems based on these guiding principles, the IOM recommends changes in financing, regulation, information technologies, and other elements of the health care environment, and in the strategies of the organizations that house the "microsystems" of care. Most important, the Committee recommends far greater focus on the proper care of people with chronic diseases, in contrast to the historical focus on acute care.
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