“First, do no harm”—Hippocratic oath principle

Part of what makes medicine such an engaging career is how the field continuously evolves as we strive to do better for patients. The historic passage of the 2010 Patient Protection and Affordable Care Act, also referred to as the “Accountable” Care Act (ACA), created a renewed focus on quality in health care. With its passage comes an opportunity for individual physicians to redefine their roles within the context of the larger health care system. The six key competency areas expected of a practitioner (http://www.acgme.org/outcome/comp/compmin.asp)—Patient Care, Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice—are each infused with issues relating to quality and value. In particular, the domains of Professionalism, Problem-Based Learning and Improvement, and Systems-Based Care involve applying an increased public health, or population, perspective when approaching patients.

This edition of FOCUS reviews key quality issues in mental health care and provides practical tools to help clinicians evolve their skill sets for the transformations ahead. Articles examine key issues in quality, including Improving the Quality of Psychiatric Care: Aligning Research Policy and Practice (Harding and Pincus) and Promoting Quality Care through Physician Competence: Applying Deliberate Practice to Lifelong Learning (Faulkner). In addition, Laura Roberts reviews Case Studies in Ethics and Carl Greiner discusses Ethical Responses to the Disruptive Physician. Furthermore, John Q. Young examines a major risk factor for preventable errors, Patient Safety During Transitions in Care. Importantly, to better navigate safe passage through suicide risk, Suicide Risk: Navigating the Failure Modes (Jabbarpour and Jayaram) and Physician Practice Assessment Tool for the Assessment and Treatment of Adults at Risk for Suicide and Suicide-Related Behaviors are provided (Duffy et al.). Influential publications in the area of quality, spanning mental health care to the larger health care delivery system, are also included.