In 2001, the Institute of Medicine released the landmark report, Crossing the Quality Chasm: A New Health System for the 21^st Century. This report concluded that the U.S. health care system is in need of fundamental change and recommended a framework and strategies for achieving substantial improvements in the quality of health care.

The Quality Chasm's framework consisted of:

• six aims for improving health care: i.e., making healthcare more safe, effective, patient-centered, timely, efficient, and equitable;
• ten rules to guide the redesign of healthcare; including:

1. Care based on continuous healing relationships.
2. Customization based on patient needs and values.
3. The patient as the source of control.
4. Shared knowledge and the free-flow of information.
5. Evidence-based decision-making.
6. Safety as a system property.
7. The need for transparency.
8. Anticipation of needs.
9. Continuous decrease in waste.
10. Cooperation among clinicians.

• specific internal organizational supports needed to achieve the aims and the rules; e.g., information technology, knowledge management strategies to support evidence-based practice, and   
• organizational supports from the external environment; e.g., public and private payment and purchasing strategies or regulatory actions to support and encourage healthcare organizations in undertaking change.

The formal charge to the Committee on Crossing the Quality Chasm - Adaptation to Mental Health and Addictive Disorders was to explore the implications of the Chasm report for the field of mental health and addictive disorders and to develop an agenda for change. The committee examined both "environmental factors" such as payment, benefits coverage and regulatory issues, as well as, health care organization and delivery issues.