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Books, Journals, New Media
February 6, 2002

Quality: Crossing the Quality Chasm: A New Health System for the 21st Century

Author Affiliations

Harriet S.MeyerMD, Contributing EditorDavid H.MorseMS, Journal Review EditorRobertHoganMD, adviser for new media


Not Available

JAMA. 2002;287(5):646-647. doi:10.1001/jama.287.5.646-JBK0206-3-1

In the 19th century, Lister, Koch, and Pasteur defined the biological basis of medical science. Semmelweis and Nightingale showed the beneficial effects of implementing the new science. In the mid-20th century Austin Bradford Hill devised methods of measuring effects of scientific medicine on patients. Avedis Donadebian provided the theory and framework to examine health system quality. Osler Peterson published the first modern measurements of medical practice quality. Yet, implementation of contemporary quality improvement results remains far from ideal in daily medical practice. We need only review, for example, the multiple studies over the past five decades documenting simultaneous overuse of ineffective treatment and underuse of beneficial care.