Crossing the Quality Chasm: 10 Simple Rules for the 21st Century Health Care System

Crossing the Quality Chasm put forth “10 Simple Rules for the 21st Century Health Care System” to guide the redesign of the health care system. These rules underlie PPC and describe a system different from most health care today.

1. Care based on continuous healing relationships. Patients should receive care whenever they need it and in many forms, not just face-to-face visits.

2. Customization based on patient needs and values. The system of care should meet the most common types of needs, but have the capability to respond to individual patient choices and preferences.

3. The patient as the source of control. Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over health care decisions that affect them.

4. Shared knowledge and the free flow of information. Patients should have unfettered access to their own medical information and to clinical knowledge.

5. Evidence-based decision making. Patients should receive care based on the best available scientific knowledge.

6. Safety as a system property. Patients should be safe from injury caused by the care system.

7. The need for transparency. The health care system should make information available to patients and their families that allows them to make informed decisions when selecting a health plan, hospital, or clinical practice, or choosing among alternative treatments. This should include information describing the system’s performance on safety, evidence-based practice and patient satisfaction.

8. Anticipation of needs. The health system should anticipate patient needs, rather than simply reacting to events.

9. Continuous decrease in waste. The health system should not waste resources or patient time.

10. Cooperation among clinicians. Clinicians and institutions should actively collaborate and communicate to ensure an appropriate exchange of information and coordination of care.