In its publication, Crossing the Quality Chasm, the National Academy of Medicine (formerly known as the Institute of Medicine) identified six domains of quality in healthcare and described aims for systems of 21st-century healthcare.5
Safe: Avoid harm to patients from the care that is intended to help them.
Effective: Provide services based on scientific knowledge to all who could benefit and refrain from providing services to those not likely to benefit (eg, avoid underusing and misusing services, respectively).
Patient-centered: Provide care that is respectful of and responsive to individual patient preferences, needs, and values and ensure that patient values guide all clinical decisions.
Timely: Reduce waits and sometimes harmful delays for both those who receive and those who give care.
Efficient: Avoid waste, including waste of equipment, supplies, ideas, and energy.
Equitable: Provide care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
5. Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US); 2001.
