one of the most important things that happened in that report was it it it gave names to the dimensions of quality if you're buying a car there are dimensions of quality safety fuel efficiency Comfort fun and driving durability and so on we're used to that well what what are the dimensions of goodness in healthcare and The Institute of medicine crossing the quality Chasm report gave us six dimensions and said these should be the areas for healthc care to improve on it also sumarize a lot of the research literature on the current levels of performance for those six areas and here are the six areas the first one is safety back to the report from a year and a half earlier to air as human safety means we're not harming people with our care uh we're not adding to the burden of illness so a safe Health Care System reduces hazards and risks from the care itself safety the second dimension they called Effectiveness and that was a term that sort of was meant too to mean matching science to care so if if if a if science says that this drug can help in this disease then we use that drug and if science says this can't help we don't use it so avoiding overuse of things that don't help and assuring use of things that do help uh avoiding underuse that's Effectiveness lining up science in all other Industries timeliness is an important dimension of quality you don't want to wait everywhere well nor do you in healthcare so timeliness is reduction of needless delay some delay is instrumental you you want to wait to see what happens but there's a lot of non-instrumental very costly delay The Fifth Dimension is efficiency which means avoiding waste we throw out so much in healthcare we we give things that can't help we duplicate procedures and tests we lose records we we we we lose the ideas of the workforce by not inviting them to to join in in invention so efficiency is a big word it means stop wasting stuff we're very very wasteful in healthcare the last Dimension which some people think should be the first is equity and that means closing the Gap in Justice and Healthcare basically right now the biggest predictor of your health status in our country remains your race if you know someone's race you know much more about their future and health than you than almost anything else I could tell you about them a black baby born in inner city Baltimore this year is has a life expectancy of a male that it's uh seven or eight years less than a white baby that that's a quality Dimension too Equity so safety Effectiveness patient- centeredness timeliness efficiency and Equity that those are the names of the dimensions of quality that the Institute of medicine says we should work on uh the in The Institute for healthcare Improvement has taken those aims and put them in our mission statement we exist to improve on those six dimensions and more and more thanks to the Institute of medicine you're seeing Hospitals and Clinics and health orare organizations in our country and by the way other countries adopt that same now rather famous list of goals for improving Healthcare brought to you by the ihi open school for Health Professions an initiative by The Institute for healthcare Improvement that prepares health profession students to lead patient safety and quality improvement in healthcare for more more information visit ihi.org