Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care -- not only in these six programs but also throughout the nation's health care system.

The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (military), and IHS (native Americans). It examines each program's quality enhancement processes -- that is, steps taken to assure and improve safety and quality of care.

The committee proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and includes a proposed research agenda to support quality enhancement.

You can read Leadership by Example: Coordinating Government Roles in Improving Healthcare Quality on the NAP website <http://www.nap.edu/catalog/10537.html>.