An important part of the Fund's work is studying what the innovators are doing and spreading the word. Recently, Fund-supported researchers examined the "culture of safety" created at OSF St. Joseph Medical Center in Illinois, which has realized a 90 percent reduction in adverse drug events. Playing a critical role are nurses, who conduct safety briefings at shift changes to review conditions that could have caused patient harm.

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he Commonwealth Fund is dedicated to improving the quality and efficiency of health care in the United States. Toward that goal, the Fund's Program on Health Care Quality Improvement and Efficiency supports projects that:
promote the development and widespread use of health care performance measures, with a focus on efficiency, care coordination, and patient safety.
enhance the capacity of health care organizations to provide better care more efficiently.
encourage health care purchasers to adopt incentives that spur providers to improve quality and efficiency.
Evidence of shortcomings in the quality of our health care is substantial.(1) (2) (3)  A 1999 Institute of Medicine report estimated that as many as 98,000 Americans die each year as a result of avoidable patient safety errors, while the Centers for Disease Control and Prevention has estimated that 90,000 die as a result of hospital-based infections.(4) (5)  According to the national health system scorecard released by the Commission on a High Performance Health System, anywhere from 100,000 to 150,000 deaths could be prevented each year if the U.S. were able to raise standards of care to benchmark performance levels achieved within this country and abroad. The Commission's scorecard also documented enormous variation in the delivery of care—nationally, regionally, and locally.
The Program on Health Care Quality Improvement and Efficiency is guided by the belief that improvements in health care quality are most likely to occur when the need for change is acknowledged and publicly recognized, when appropriate incentives are in place, and when those who deliver, purchase, and regulate care have the capacity to initiate and sustain change.
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Anthony Shih, M.D.
Senior Program Officer