Table 1.

Institute of Medicine's Six Specific Aims for Quality Helath Care⁶ and Pediatric Obesity Treatment^*

Aim	Description	Brenner FIT's quality improvement
Safe	Avoid injury to patients from care that is intended to help them.	Engage local programs, including camps, community-based obesity programs, and schools to encourage these local programs to shift their focus from weight loss and restrictive diets to behavior change.
Effective	Provide services based on scientific knowledge to all who could benefit and refrain from providing services to those unlikely to benefit.	Maintain clinical database with twice-yearly review of clinic population and outcomes.
Patient centered	Provide care that is respectful of and responsive to individual patient preferences, needs, and values. Ensure patient values guide all clinical decisions.	Utilize Motivational Interviewing in all treatment processes, and provide family-based programming through community center.
Timely	Reduce wait time and sometimes harmful delays for both those who receive and those who give care.	A family support specialist with a background in social work engages families on referral, assist in overcoming delays and barriers to treatment, and prepare families for clinic.
Efficient	Avoid waste, including waste of ideas and energy.	Allow families to stop treatment if necessary, analyze missed and cancelled appointments to identify patterns and obstacles to treatment, develope telemedicine program to assist families living far from clinic, schedule majority of visits before and after school, and have parent-only appointments to minimize missed school.
Equitable	Provide care that does not vary in quality because of personal characteristics, such as gender, ethnicity, geographic location, and sociodemographic status.	Twice-yearly review of outcomes to identify patterns of failure or dropout, development of culturally competent Spanish-language program.

^*Adapted from the Institute of Medicine Committee on Quality of Health Care in America.⁶