NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

Support for this project was provided by the Department of Health and Human Services, the Commonwealth Fund, and the California Healthcare Foundation. The views presented in this report are those of the Institute of Medicine Committee on Enhancing Federal Health Care Quality Programs, and are not necessarily those of the funding agencies.

Library of Congress Cataloging-in-Publication Data

Institute of Medicine (U.S.). Committee on Enhancing Federal Healthcare Quality Programs.

Leadership by example : coordinating government roles in improving healthcare quality / Committee on Enhancing Federal Healthcare Quality Programs ; Janet M. Corrigan, Jill Eden, and Barbara M. Smith, Editors.

p. ; cm.

Includes bibliographical references and index.

1. Medical policy—United States. 2. National health services—United States.

[DNLM: 1. Health Care Reform—United States. 2. Government Programs—United States. 3. Quality Assurance, Health Care—United States. WA 540 AA1 I455L 2003] I. Corrigan, Janet. II. Eden, Jill. III. Smith, Barbara M. IV. Title.

RA395.A3I4935 2003

362.1’0973—dc21

2003001324

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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.