Institute of Medicine Committee on Quality of Health Care in America

Institute of Medicine Committee on Quality of Health Care in America
Name	Institute of Medicine Committee on Quality of Health Care in America
Formation	1998
Parent organization	National Academy of Sciences
Jurisdiction	United States
Headquarters	Washington, D.C.
Key people	Donald Berwick, Linda T. Kohn, Institute of Medicine

Institute of Medicine Committee on Quality of Health Care in America was a blue‑ribbon panel convened by the Institute of Medicine of the National Academy of Sciences to assess safety and quality in United States health care. The Committee produced influential analyses that affected federal agencies such as the Department of Health and Human Services, private organizations including the American Medical Association and American Hospital Association, and academic centers such as Harvard University and Johns Hopkins University.

History and formation

The committee was appointed by the Institute of Medicine under the auspices of the National Research Council and chaired by Kurt D. Peterson and later by Donald Berwick with participation from leaders at Harvard Medical School, Stanford University School of Medicine, Mayo Clinic, Cleveland Clinic, and Johns Hopkins University School of Medicine. Its formation followed high‑profile patient safety incidents in United States hospitals and attention from policymakers in the Clinton administration and the United States Congress. Members included representatives from Agency for Healthcare Research and Quality, Centers for Medicare & Medicaid Services, Joint Commission, World Health Organization, and advocacy organizations such as Consumers Union and AARP. The committee worked with technical advisors from Institute for Healthcare Improvement, National Quality Forum, Robert Wood Johnson Foundation, and Gates Foundation.

Key publications and reports

The committee’s landmark report "To Err Is Human" (1999) and follow‑on "Crossing the Quality Chasm" (2001) were published under the Institute of Medicine imprint and cited by President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry, Senate Committee on Health, Education, Labor, and Pensions, House Committee on Energy and Commerce, Centers for Disease Control and Prevention, and World Health Organization. Subsequent convenings produced themed papers on health information technology with contributors from Microsoft, IBM, Epic Systems Corporation, and Cerner Corporation, reports on measurement with input from National Quality Forum and Agency for Healthcare Research and Quality, and workforce analyses engaging American Nurses Association and Association of American Physicians and Surgeons. The committee’s publications were disseminated through venues including New England Journal of Medicine, The Lancet, Journal of the American Medical Association, and presentations at conferences hosted by American Public Health Association.

Major findings and recommendations

The committee concluded that medical errors were a leading source of preventable morbidity and mortality in United States hospitals and recommended system‑level changes emphasizing safe design, reporting, and measurement. It called for adoption of health information technology systems, standardized clinical practice guidelines, enhanced reporting to bodies like the Joint Commission and National Quality Forum, and payer incentives from Centers for Medicare & Medicaid Services. Recommendations included establishing transparency practices akin to those promoted by Consumer Reports, strengthening professional credentialing through American Board of Medical Specialties, promoting patient engagement as advanced by Institute for Healthcare Improvement, and increasing federal research funding from National Institutes of Health and Agency for Healthcare Research and Quality.

Impact on healthcare policy and practice

The committee’s reports catalyzed policy actions by Centers for Medicare & Medicaid Services, regulatory shifts at the Joint Commission, funding priorities at the Robert Wood Johnson Foundation, and legislative initiatives debated in the United States Congress. Health systems such as Mayo Clinic, Cleveland Clinic, Kaiser Permanente, and academic centers at University of California, San Francisco adopted many recommendations, accelerating implementation of electronic health record systems by vendors like Epic Systems Corporation and standards bodies including Health Level Seven International. The committee influenced quality measurement programs used by Medicare and quality improvement campaigns run by Institute for Healthcare Improvement and professional societies such as the American College of Physicians.

Criticisms and controversies

Critics from think tanks such as the Heritage Foundation and commentators in Wall Street Journal argued the committee overstated error rates and advocated costly interventions that advantaged vendors like Cerner Corporation and Epic Systems Corporation. Some professional groups including the American Medical Association and specialty societies raised concerns about mandated reporting burdens and unintended consequences tied to Centers for Medicare & Medicaid Services pay‑for‑performance experiments. Legal scholars at Yale Law School and Harvard Law School debated implications for malpractice litigation, while privacy advocates at ACLU and Electronic Frontier Foundation warned about risks from rapid health information technology adoption.

Membership and organizational structure

The committee comprised clinicians, patient safety experts, health services researchers, administrators, and consumers drawn from institutions such as Johns Hopkins University, Harvard Medical School, Stanford University, Yale School of Medicine, University of Pennsylvania, Columbia University, University of Chicago, Northwestern University, Duke University School of Medicine, Brown University, University of Michigan, University of Washington, Vanderbilt University Medical Center, Mount Sinai Health System, Massachusetts Institute of Technology, and leaders from Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, and professional groups like the American Nurses Association and American Academy of Pediatrics. Organizational oversight rested with the Institute of Medicine Board and reporting channels to the National Academy of Sciences and National Academy of Medicine.

Category:United States healthcare