IOM in the News

June 2002
IOM Issues Tools For Measuing Response System Preparedness-- The National Academies' Institute of Medicine today released a report providing a set of measurement tools and a process for evaluating the extent to which communities have implemented the disaster preparedness plans required by the Department of Health and Human Services' Metropolitan Medical Response System program. The report identifies 23 essential capabilities that form the basis for preparedness and provides a set of preparedness indicators for judging community preparedness in each area. The report, "Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program," is online. Click here to see full-text of press release.

March 2002
(3/6/02) Anthrax Vaccine is Useful, but Shortcomings Underscore Need for Replacement -- The current anthrax vaccine is safe and effective, but certain drawbacks - including reliance on older vaccine technology and a six-dose vaccination schedule over 18 months - underscore the need for a better vaccine, says a new report from the National Academies' Institute of Medicine. The current vaccine can continue to be used, but the U.S. Department of Defense should vigorously support research efforts not only to improve the way it is administered, but also to develop an alternative. Click here to see full-text of press release.

February 2002
JCAHO has accepted an invitation from The Leapfrog Group to become a formal partner. This new partnering arrangement relationship cements a previously informal relationship with the health care purchaser group and means that The Leapfrog Group will seek JCAHO's input on its patient safety initiatives. In the first major collaboration effort between the two parties, the Joint Commission has begun work with Leapfrog leaders to pursue the identification of a specific set of ICU-related outcome and process measures. Click here for same text in JCAHO Online newsletter.

December 2001
(12/19/01) Klausner Accepts Position as National Academies' Adviser on Counterterrorism -- Beginning Jan. 1, 2002, Richard D. Klausner will assume the post of senior fellow and special adviser to the presidents for counterterrorism at the National Academies. The Academies are actively engaged in facilitating a more focused and coordinated involvement of the science and technology community in assessing threats, developing countermeasures, and designing responses to terrorist attacks. As former director of the National Cancer Institute and a member of both the National Academy of Sciences and the Institute of Medicine, Klausner will use his extensive ties to both the U.S. government and the scientific community to help the Academies bring the best science and technology expertise to bear on increasing homeland security. In this connection, he will serve as the liaison between John Marburger, the director of the White House Office of Science and Technology Policy, and the many new counterterrorism efforts of the National Academies -- helping to coordinate these activities with those of the government. Click here to see full-text of press release.

November 2001
(11/5/01) Click here to go to statement from the IOM Council on Vaccine Development.

October 2001
(10/29/01) Click here to go to statement from the Presidents of the IOM, NAS, and NAE on Bioterrorism.

July 2001
Most recently, a July 25, 2001 JAMA article titled, Estimating Hospital Deaths Due to Medical Errors: Preventability is in the Eye of the Reviewer challenged the medical error findings of IOM Report I. Click here to see full-text JAMA article on the JAMA site (for a fee).

As a result of the article's release, a July 24, 2000 Associated Press article in the Wall Street Journal (WSJ) notes that "Dr. Rodney A. Hayward, who led the new study as Director of the VA Center for Practice Management and Outcomes Research in Ann Arbor, Mich., estimates that between 5,000 and 15,000 deaths annually are due to errors". The WSJ article went on to say that, "Dr. Lucian L. Leape of the Harvard School for Public Health, co-author of the Institute of Medicine report, defended his findings and said Dr. Hayward's conclusions were based on too small of a sample and were derived by way of "statistical torturing." He said that some medical professionals have argued that his study actually underestimated the number of medical errors that caused deaths." Click here for access to story in WSJ archive (for a fee).

March 2001
(3/19/01) New IOM report says doctors are trying but system needs work -- Leaders of several key physician groups voiced support for a new Institute of Medicine report that recommends overhauling the health care delivery system. They called on the federal government to take action. "Crossing the Quality Chasm" says that physicians, nurses and other health care professionals are doing their best to provide good care but are swimming upstream in an inefficient system that does not reward innovation and communication. Click here for full-text of American Medical News article.

Click here to listen (requires RealPlayer) to a March 1, 2001 public briefing on release of Crossing the Quality Chasm. The following paragraph is an excerpt from the webcast of panelist Don Berwick, M.D., president and chief executive officer, Institute for Healthcare Improvement, Boston MA:

Dr. Don Berwick: "I want to make sure that the message to the medical community is very clear. We are saying that the care is not satisfactory. We are saying that the care the American population gets is not the care they should get. We are saying that major improvements are needed, they're urgent, they're important, we're saying they're achievable. We're also saying that it's not a matter of the effort or the will or the skill or the dedication of the American clinical community. They're wonderful. If the doctors and nurses weren't trying as hard as they are, we'd be in a lot worse shape. What we're saying is that they need help. The American physician and nurse cannot now, alone without redesign of the system, give the care they want to give. The games over. It's time for a new system in which they can do their work better. This is not about blame, it's about change."

Also in March 2001, a Joint Commission on Accreditation of Healthcare Organizations (JCAHO) press release "applauded the Institute of Medicine's newest quality report, Crossing the Quality Chasm...The IOM provides an excellent synthesis of available knowledge about the analysis of health care quality." It includes Dennis S. O'Leary's comment that, "For those of us who have long labored toward the goals articulated in the IOM report, the challenges represented by continuous quality improvement are all too real. We have come a long way, and we have a long way to go." Click here to read JCAHO press release.

IOM Reports Background

Recognizing that health care costs were spiraling out of control and that quality indicators were reflecting deteriorating quality, the U.S. Congress commissioned the Institute of Medicine (IOM), www.iom.edu, of the National Academy of Sciences (NAS) to prepare a series of reports. The release of To Err is Human: Building a Safer Health System in November 1999 and Crossing the Quality Chasm: A New Health System for the 21st Centry in March 2001 has attracted media attention and public concern, been widely debated, and spurred action in the health care, business, and government sectors. A report titled, Envisioning the National Health Care Quality report, released in March 2001 has not received as much fanfare, but it is setting the stage for making yearly progress toward the improvement of health care.

IOM Report I: To Err is Human specifically addressed patient safety as the most critical issue in American healthcare. It recognized that as many as 44,000 to 98,000 preventable deaths occur in U.S. hospitals each year. This report quickly generated considerable media attention and prompted major employers to become more active, as evidenced by the formation of the Leapfrog Group, described below. Perhaps even more importantly, JCAHO was also prompted into action. There continues to be considerable fallout over the report's demand for major changes. Click here to read IOM Report I online for free at NAS website.

IOM Report II: Crossing the Quality Chasm made the case that patient safety is just “the tip of the iceberg” of a major quality problem. The report cites the requirements for redesign of the healthcare system. It proposes that the redesigned system be based on three principles and six aims. The principles include the requirements that the redesign apply evidence-based medicine, have a patient-centered focus, and take a systems approach. It defines six major aims, the first of which is patient safety. The other five aims are effectiveness, patient-centeredness, timeliness, efficiency, and equity. The report clearly leaves the impression that the concept of “no outcome – no income” may be on the horizon. A huge proportion of the report concentrated on the use of information technology (IT) innovations to provide critical information and knowledge to caregivers. It recommended development of a $1 billion innovation fund to assist in the transfer of such innovations. Click here to read IOM Report II online for free at NAS website.

IOM Report III: The inside story of Envisioning the National Health Care Quality report is that the intention was to get it to Congress without overtly generating resistance from providers. The report request made by the Agency for Healthcare Research and Quality (AHRQ) was made on the basis of the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry. The essence of the report is that it is to define the vision for a National Health Care Quality Report. This Quality Report would be an annual report to the President and Congress. It should serve as a yardstick or barometer by which to measure the quality of health care and gauge the progress in performance improvement. The report addresses the six Aims addressed in IOM II and focuses on specific disease examples. The framework of the report addresses two dimensions: Quality and Consumer Perspectives on needs. It also calls for greater attention to evidence-based approaches. A future purpose the health information infrastructure described in the report would be to enable payers to tie outcome to income. The U.S. Healthcare Finance Administration (HCFA) has been meeting on just these issues. Click here to read IOM Report III online for free at NAS website.

About IOM: The mission of the Institute of Medicine is to advance and disseminate scientific knowledge to improve human health. The Institute provides objective, timely, authoritative information and advice concerning health and science policy to government, the corporate sector, the professions and the public. For more information see: www.iom.edu.