Improving Health Care for Mental and Substance Use Conditions: A Framework for Bridging the Quality Chasm

This article highlights selected findings of the 2005 Institute of Medicine (IOM) report on quality problems in health care for mental and substance use (M/SU) conditions and proposes a new framework for organizing and implementing recommendations of the IOM or any organization that would study and report on significant issues in health care administration, delivery, financing, policy, and research. The model, depicted as a "Quality Cube," proposes three essential axes of consideration for implementing broad-scale improvements in health care for M/SU and other health conditions: (a) quality-improvement aims (what goals need to be accomplished), (b) agents (who should take responsibility for their achievement), and (c) actions (how quality aims should be pursued).