Evaluate the outcomes for nursing care of older people.
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Assignment 1: Changing the System


Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century (Report Brief).Institute of Medicine of the National Academies [Web page]. Retrieved from

The IOM Report Brief, published in 2001, begins by stating: “The U.S. health care delivery system does not provide consistent, high-quality medical care to all people” (p. 1). The report discusses the problems with the U.S. healthcare system and outlines recommendations for achieving a high quality healthcare system in the future.

Since this report was written, how has progress been made? Provide four specific examples that are evidence of whether or not progress has been made in moving toward “a new health system for the 21st century.” Two of the examples must be from your personal experience and two examples from documented references.

The examples may relate to the Six Aims for Improvement, Ten Rules for Redesign, or the four main areas in regard to changing the environment. Some possible areas to consider:

  • One of the six aims is timely care. Do you know a hospital that has a significant problem with patient waiting time in the emergency department? What has the hospital done to solve the problem and what is the result.
  • The first rule for redesign is: Care is based on continuous healing relationships. Do you know an HCO that has implemented a system of electronic communication between the patient and the provider?
  • One of the four main changes discussed is: Applying evidence to health care delivery. Do you know of a treatment process that is governed by specific practice guidelines in many HCOs, but where physicians continue to use an outdated treatment process?

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