The national focus on improving the quality of health care and a growing body of research on quality methods and outcomes have produced both momentum and urgency for action. In a relatively short time, the science of quality methods and outcomes has made substantial strides. Advances in theory development, increasing use of large datasets, and focused studies of major system problems set the stage for change. What we have learned suggests that improving quality will require a complex blend of short-term and long-term action in many areas: building public awareness, improving the science, changing delivery systems, and altering incentives. This paper highlights conclusions and recommendations from the April 2002 Conference on Measuring and Improving Health Care Quality convened by the American Academy of Nursing Expert Panel on Quality Health Care. Strategic priorities for a unified practice, research, and policy agenda to improve quality of health care are identified. Based on critical analysis of research and dialogue among experts and innovators, priorities for action clustered in five areas: (1) The context for the quality agenda; (2) database issues; (3) advancing research; (4) development of clinical information systems; and (5) public visibility. Attention is needed in each of these areas to stimulate ongoing debate and a meaningful agenda for change.
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