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Books > Medicine > General issues > Health systems & services > General
This book is concerned with the complexities of achieving quality in care transitions. The organization and accomplishment of high quality care transitions relies upon the coordination of multiple professionals, working within and across multiple care processes, settings and organizations, each with their own distinct ways of working, profile of resources, and modes of organizing. In short, care transitions might easily be regarded as complex activities that take place within complex systems, which can make accomplishing high quality care challenging. As a subject of enquiry, care transitions are approached from many research, improvement and policy perspectives: from group psychology and human factors to social and political theory; from applied process re-engineering projects to exploratory ethnographic studies; from large-scale policy innovations to local improvements initiatives. This collection will provide a unique cross-disciplinary and multi-level analysis, where each chapter presents a particular depth of insight and analysis, and together offer a holistic and detail understand of care transitions.
The editors are two of the most prominent researchers in this area. Both are at the Center for Urban Epidemiologic Studies. David Vlahov is particularly visible and known as the editor of the Journal of Urban Health. Sandro Galea is very prominent for his research on urban health; in particularly, research done on PTSD and children post-9/11. Thorough analysis of different populations in urban settings and specific health considerations Useful section on methods for the research audience. Applied in nature with section on prevention and interventions There are over 100 urban health centers in North America and there are no thorough, up-to-date ressources.
Edited by a professor at Harvard Medical School who has extensive experience in this field, this important and timely book presents a variety of perspectives on the organization of patient medical records around patient problems, presenting a more effective problem-oriented approach rather than the traditional data-oriented approach. It is comprehensive, covering the history and importance of the electronic health record, the attitudes toward and use of problem lists, strategies to improve the problem list, and applications in practice of the problem list.
This title includes a number of Open Access chapters. In the last several decades, international traffic volume has significantly increased, raising the risk of infectious diseases and their spread. In this important volume, the impact of health issues is explored in connection with travel. Not only does the book explore the risk of diseases such as H1N1 (otherwise known as swine flu), malaria, salmonella, and Legionellosis, it also addresses health regulations for travel to foreign countries, alcohol use and hospitality-related health problems and issues, medical tourism (patients seeking less expensive medical procedures in countries other than their own), and much more.
This book provides an overview of the challenges in electronic health records (EHR) design and implementation along with an introduction to the best practices that have been identified over the past several years. The book examines concerns surrounding EHR use and proposes eight examples of proper EHR use. It discusses the complex strategic planning that accompanies the systemic organizational changes associated with EHR programs and highlights key lessons learned regarding health information-including technology errors and risk management concerns.
Analyzing Form, Function, and Financing of the U.S. Health Care System tells the story of the U.S. health care system by using a narrative approach identifying function rather than the more common data-driven focus on structure. It presents policy decisions we have made about our health care system and analyzes some of their consequences to better understand the choices we have. To facilitate this, the book is divided into four major sections. Section I is mostly "about" the health care system. It describes several theoretical models that provide a foundation for the structure of the U.S. health care system. Section II provides a description of the form, or organization, of the U.S. health care delivery system. It presents a comprehensive overview of the entire health care delivery system, including identifying all levels of care. Section III focuses on financing, beginning with a description of the economic and political values that determine how we finance our system. It describes health insurance, from the perspective of both the consumer and the provider, and discusses how money moves through the system. It concludes with a discussion and analysis of cost and cost control efforts. Section IV describes some of the more important efforts in health care reform, including several targeted programs that are a significant part of the U.S. health care system, such as Medicare and Medicaid. It also describes other targeted programs within the U.S. health care system and explores how other countries with economies similar to that of the United States organize and finance their health care systems.
Why is there a need to 'innovate healthcare'? The basic reason stems from the sheer scale of the challenges now facing healthcare provision in the UK and across many other countries. The aim of this book is to interrogate past and current attempts to innovate in this arena and to draw-out the key lessons. Innovating Healthcare: The Role of Political, Managerial and Clinical Leadership presents the latest state of knowledge based on original data from a series of NIHR-funded research projects set in the context of a review of extensive secondary research. The book draws upon first-person verbatim accounts of change attempts made by doctors and other clinicians as well as upon research findings about the roles played by policy-makers and managers. The analysis draws upon theory and practice in leadership, innovation and institution-building. The mutually-reinforcing contributions of political, managerial and clinical leadership are at the core of the investigative narrative. This book will be of interest to students and researchers, clinicians and managers in the health and care sectors as well as policy-makers. While the focus in on healthcare, the book has wider relevance for students of management, leadership, innovation and organizational studies.
China witnessed an unprecedented economic boom in the past four decades but will soon see the end of "demographic dividend". With shrinking labor, improving the quality of human capital could be one way to maintain China's remarkable growth. The population in rural China accounts for 41% of the total population in China but the human capital development in rural China lags far behind the urban cities. This book selects four major reforms on education and health in rural China and evaluates the impact of these reforms on human capital development. Through rigorous econometric analysis, the book looks at factors of the rural-urban gap in human capital and the causal relationship between the reforms and the human capital development. This book will be a useful reference for developing economies which are facing similar issues in the labor market.
This third edition presents and dissects a wide variety of HIT failures so that the reader can understand in each case what went wrong and why and how to avoid such problems, without focusing on the involvement of specific people, organizations, or vendors. The lessons may be applied to future and existing projects, or used to understand why a previous project failed. The reader also learns how common causes of failure affect different kinds of HIT projects and with different results. Cases are organized by the type of focus (hospital care, ambulatory care, and community). Each case provides analysis by an author who was involved in the project plus the insight of an HIT expert. This book presents a model to discuss HIT failures in a safe and protected manner, providing an opportunity to focus on the lessons offered by a failed initiative as opposed to worrying about potential retribution for exposing a project as having failed. Access expert insight into key obstacles that must be overcome to leverage IT and transform healthcare. Each de-identified case study includes an analysis by a group of industry experts along with a counter analysis. Cases include a list of key words and are categorized by project (e.g. CPOE, business intelligence). Each case study concludes with a lesson learned section. Thought provoking commentary chapters add additional context to the challenges faced during HIT projects, from social and organizational to legal and contractual.
With the use of electronic health records (EHR) transforming the healthcare industry, the use of information technology in the maintenance of personal health records poses a range of issues and opportunities for every medical organization, The Cyber Patient expertly walks readers through the elements required for an efficient, well-run healthcare record management system, while reflecting the U.S. government's goal of achieving widespread adoption of interoperable electronic health records to improve the quality and efficiency of healthcare while maintaining the levels of security and privacy that consumers expect. The author also provides an update as to where the industry stands in their push of interoperability and the increased use of data as an analytic tools. Providing an application readers can adopt as a model, this important book examines the infrastructure of electronic health records and how government criteria have impacted and will continue to impact both private and public marketplaces. This valuable resource also addresses how auditors, controllers, and healthcare providers can keep up with the market's continued move towards an interoperable e-health world, without neglecting clinical and financial accountability in the delivery of healthcare. As e-health continues to develop and transform, The Cyber Patient thoughtfully prepares professionals to plan and implement an effective EHR as wel as internal controls system within any clinical setting.
Healthcare Workforce Transitioning shares with educators and healthcare professionals alike the awareness, integration, and partnership that results from a successful process of framing a Healthcare Management Program around core competencies. To transition toward a successful healthcare career requires proficiencies in communication, leadership, professionalism, knowledge of the healthcare environment, and business skills. Competencies provide context to curriculum construction and build awareness of the role this standard plays in a career-ready workforce. Integrating professional development and service learning into co-curricular activities further strengthens outcomes. Partnering with healthcare professionals through ongoing World Cafe conversations, contributes a touchstone about expectations and accountabilities to be successful in a career. This book draws on the World Cafe methodology, guidelines, and vignettes in developing performance assessment, coaching, training, and performance reviews. The author provides lessons learned throughout the text to illustrate the points made in the chapters. It also provides a proven participatory methodology applied to competency exploration, application, and authentication.
Issues surrounding business complexity plague organizations throughout the world. This situation is particularly true of the numerous complex projects and programs upon which organizations embark on a regular basis. Current project management processes and standards are based on Newtonian/Cartesian principles, such as linearity, reductionism, and single source problem causation. However, complex projects exhibit both Newtonian/Cartesian characteristics and complex systems characteristics, such as emergence, self-organization, non-linearity, non-reductionism, and multi-source problem causation. To conduct successful projects, complementary ways of approaching projects are required, and new competencies for those who manage projects and for those on project teams are required as well. There are a number of books available to help project managers and teams address the issue of systems behavior. However, there are none that approach complex projects from a neuroscience-based approach to human behavior and ambiguity. This book does exactly that in order to reduce project complexity and thereby increase the probability of project success. Cognitive Readiness in Project Teams looks to the concept of cognitive readiness (CR), first developed by the United States Department of Defense to better prepare and manage teams of individuals in complex battlefield situations. Its intent is to make project managers and teams more focused, responsive, resilient and adaptive through self-mastery and the mastering of interpersonal relationships. It introduces a CR framework for project managers and teams. This framework has neuroscience fundamentals and theorems as the foundation for the three pillars of CR: mindfulness, emotional intelligence, and social intelligence. The book is a compendium of chapters written by renowned authors in the fields of project management, neuroscience, mindfulness, and emotional and social intelligence.
Research shows that the importance of patient-reported outcomes, improved decision support, and care coordination is growing rapidly as new payment models transform healthcare delivery. This has led to the use of new measures and communication techniques, including shared decision-making and motivational interviewing. Using patient-reported outcomes at the point of service helps providers identify what matters most to the patient in front of them now. Describing treatment options and deciphering a patient's preferences effectively is a process, which has been likened to arriving at a diagnosis. Providers make a medical diagnosis by discerning a patient's primary complaints, past history, exam findings, and test results. A preference diagnosis can be thought of similarly. Providers work with their patients to identify what matters most to them, discuss the risks and benefits of the available treatment options, and support the patient as needed through the decision-making process. Once informed of their options, patients frequently chose treatments that require modifying their habits. Motivational interviewing helps patients and providers understand what matters most now and design care plans that provide appropriate support. While many healthcare providers and leaders may be familiar with patient-reported outcomes from research articles, and have heard of shared decision-making and motivational interviewing, few have experience using them. Fewer still understand how each relates to the other. This book helps leaders and healthcare providers better understand how to use patient-reported data to their advantage at the point of service. The book provides the background for developing shared knowledge and shared language, along with extensive examples of dialogue between providers and patients. In addition, the book contains personal interviews of subject matter experts who have significant experience using these measures. The result is a comprehensive understanding of how these measures and techniques can help providers, organizations, and patients navigate this modern healthcare management opportunity.
Never before in the healthcare industry has there been such intense emphasis and open debate on the issue of quality. The steady rise in the cost of healthcare coupled with the need for quality have combined to put the healthcare industry at the top of the national agenda. Quality, costs, and service are not just socially provocative ideas. They are critical criteria for decision-making by patients, physicians, and many key constituents of healthcare organizations. The pursuit of improved performance has driven a host of executives and managers in search of techniques for structuring, rehabilitating, redesigning, and reengineering the organizations they serve. Unfortunately, the narrow-mindedness with which programs are implemented and the discontinuity in their application weaken the promise of success. The process of quality improvement can become an undisciplined search for illusions rather than reality. For many years, healthcare managers have embraced the narrow definition of performance solely in the context of financial success. Forward-thinking executives now realize that the road to financial success begins with success in quality and service. Quality and service are no longer separate issues - they are the same. Neither one by itself will bring about lasting success. The ultimate measure of performance is in an organization's ability to create value for its customers, and true performance must be measured in the context of the customers' total experience. This book is about how to manage performance in the context of value to the customer or patient. It brings together the many pieces of the performance improvement puzzle - quality, technology, costs, productivity, and customer service. The author also covers process improvement tools including Lean and Six Sigma, and how to create a culture of continuous improvement as well as how to improve the patient experience and productivity improvement strategies. The book is filled with examples, illustrations, and tools for improving key aspects of a healthcare organization's performance.
Medical practice and research are inconceivable today without electronic computing and communication tools. Digital machines do many tasks orders-of-magnitude better, faster and more accurately than humans. Still, there are functions critical to the healthcare endeavor that people do much better than machines, things like: understanding and using natural language; perceiving what is unexpressed; taking into account values, culture, ethics, and human relationships; touching and healing. For the foreseeable future, the "smartest" computers will be no match for human beings when it comes to performing these most anthropic functions. American healthcare is at a critical juncture. Providers and patients are increasingly frustrated by degradation of the human relationships that lie at the core of the medical practice. Technologies, such as the computerized medical record, get much of the blame for intrusion into the patient-provider relationship. However, it is not technology itself that is to blame. The fault lies with how systems are conceived, designed, and deployed. This book analyzes how to organize the work of healthcare in a way that uses machines to do what they do best, thereby freeing humans to do what we do best. Smart use of electronic technology is crucial to the success of any bid to fulfill the Institute for Healthcare Improvement's triple aim to make healthcare more effective, efficient, and humane.
The CMIO Survival Guide is the handbook for the new Chief Medical Information Officer, as well as for those recruiting or planning to recruit a CMIO. This quick reference is organized by real-world topics that CMIOs need to know, as well as the criteria that the CIO, CMO or CEO should consider in identifying excellence in a CMIO candidate. It is written by pioneering physicians and AMDIS faculty with a wealth of experience in medical informatics who provide guidance, advice and lessons learned for those interested in this relatively new role in healthcare. This second edition updates every chapter in the original work and adds new chapters to address the changes in healthcare delivery, the role of the physician executive, technology, medical education, small and rural hospitals.
Concierge medicine represents a relatively novel health care delivery model that is becoming more appealing both to providers and patients because of its potential to improve quality and value in health care. A gap exists in the current literature regarding the benefits and challenges associated with concierge medicine as well as best practices for developing and sustaining a successful, patient-centered concierge practice. This book aims to close the gap by discussing the role of concierge medicine in the context of the evolving U.S. healthcare system and the changes produced by the Affordable Care Act. It will address questions about affordability, access, quality, value, communication, technology, and patient-centered care, and will include real-world best practice examples from a successful concierge medicine practice.
Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics, 2nd Edition provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation's healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today's healthcare system. The material is presented in two sections. Section 1 focuses on the healthcare access, cost and quality issues that create pressures for change in health policy. The first edition was completed just as the Patient Protection and Affordable Care Act (PPACA) was debated and passed. This new edition updates the information about access, cost, and quality issues. It also discusses the pressure for change that led to the passage of the PPACA, evidence that shaped the construction of the act, evidence on the impacts of the PPACA, and evidence on the pressures for future changes. Section 2 focuses on changes that are underway including: changes in the Medicare payment system; new types of healthcare delivery organizations such as ACOs and patient-centered medical homes. It also discusses the current efforts to help patients build health such as wellness programs and disease management programs. And finally, health information technology will be discussed. The new edition will maintain the current structure; however each chapter will be updated to discuss post-PPACA evidence on each type of type. In addition to the updates previously mentioned, the authors will present a series of data explorations to several chapters. Most of the new data explorations present summarized statistical information based on de-identified data from one hospital electronic data system. These data explorations serve two purposes. First, they illustrate the impacts of the pressures for change - and some of the changes - on healthcare providers. For example, the data illustrates the financial impact of pre-PPACA uncompensated care. Second, explanation of the data will require explanations of standard coding systems that are used nationwide (DRGs, CPT, ICD) codes. Other data explorations provide detail about other sources of data useful for health policy analysis, and for healthcare providers and insurers.
This book reveals and describes the leadership and culture change required to remove waste from healthcare processes and eliminate the root cause of soaring costs, poor quality and safety, and limited access. The book's delivery strategy revolves around personal and organizational stories and case studies told by physician and administrative leaders, all students of the Toyota Production System. This revised edition uniquely blends updated case studies with practical theory to describe how the healthcare value proposition can be changed by reducing waste, variation and complexity in healthcare. New to the book are chapters on clinical standard work and integration of lean and safety.
Winner of a 2016 Shingo Research and Professional Publication Award! A recent article published in the Journal of Patient Safety estimated that more than 400,000 lives are lost each year due to preventable patient events in American hospitals. Preventable patient safety events are the third leading cause of death in the United States. While most health care organizations know they need to improve patient safety, most lack an understanding of the steps required to develop and implement an effective patient safety program. Baylor Scott & White Health has successfully created a strong culture of patient safety. In 2013, Baylor Health Care System published the book Achieving STEEEP Health Care, which describes its quality improvement journey via the STEEEP framework of delivering care that is Safe, Timely, Effective, Efficient, Equitable, and Patient-centered. This book provides a detailed overview of the Baylor Scott & White Health approach to the delivery of safe care, the leading aim of the STEEEP quality and patient safety framework. It presents real-life examples, practical approaches, and tools for improving patient safety. The book is structured around some of the key components of patient safety such as the importance of strategic efforts in categories of culture, processes, and technology. Maintaining a focus on human factors in patient safety and health care, the book explains the need for advanced analytics along with long-term learning and corporate resources. This book describes how to develop appropriate goals, formulate strategies to meet those goals, and implement techniques to improve patient safety based on the experience of Baylor Scott & White Health.
While many health care organizations need to improve health care quality and lower costs, most lack specific strategies and tactics for implementing these changes. Baylor Scott & White Health has established and continues to develop an accountable care organization (ACO) called the Baylor Scott & White Quality Alliance (BSWQA) to improve the quality of care and decrease health care costs through clinical integration. Accountable: The Baylor Scott & White Quality Alliance Accountable Care Journey tells the story of the BSWQA and its clinical network and payers who are committed to delivering accountable, value-based patient care. It describes the need for ACOs in today's health care environment and details the framework and requirements needed to establish one. The book provides readers with essential background information about accountable care, including the Triple Aim and population health management. It outlines the infrastructure and governance framework needed to establish a successful ACO and supplies real-world examples from the ACO owned by Baylor Scott & White Health, the largest not-for-profit health care system in Texas. The book explores the concept of accountability for all stakeholders in today's complex care systems, as well as the role of personal and organizational accountability in managing patient populations. It also includes detailed outlines to guide you in developing your own accountable care organization-from step-by-step details of legal requirements to an outline of the role of payers in this model.
As healthcare moves from volume to value, payment models and delivery systems will need to change their focus from the individual patient to a population orientation. This will move our economic model from that of a "sick system" to a system of care focused on prevention, boosting patient engagement, and reducing medical expenditures. This new focus will shift traditional financial accountability from the payer model to provider directed models. Population Health: An Implementation Guide to Improve Outcomes and Lower Costs covers not only the rationale for this transition, but also outlines successful practice models that are built to thrive in these new market dynamics. Besides the philosophical and the cultural aspects of these new models, it details the implementation and strategic initiatives required to succeed in today's value- and population-oriented healthcare environment. Describing what population health is, the book explains why it represents an opportunity for healthcare delivery systems, public health agencies, community-based organizations, and other entities to work together to improve health outcomes in the communities they serve. The book clarifies how the new models will impact healthcare providers, how to manage populations, and how to handle the risk factors involved. It details new delivery models, such as primary care and medical neighborhoods, and outlines the value proposition of screening and prevention in assigned populations.
Since adapting the principles of the Toyota Production System to health care in 2002, Virginia Mason Health System has made enormous leaps forward in quality, safety, patient experience of care, and affordability. It has achieved world-class levels of patient satisfaction and has been honored as one of the safest hospitals in the country. A Leadership Journey in Health Care: Virginia Mason's Story supplies an inside look at process improvement from the world leader in applying Lean methods to health care. It presents key lessons learned as well as the best practices developed at Virginia Mason during its 12-year process improvement journey. Just as important, Virginia Mason's culture of leadership at all levels sets it apart from others in the health care universe. Describing why it's critical for leadership to be actively involved in any process improvement initiative, the book illustrates exactly what leadership looks like at all levels within Virginia Mason. In the book, bestselling author Charles Kenney introduces breakthrough new work at Virginia Mason that most health care audiences have yet to read about. He details the reasons why governance has played such a big role in Virginia Mason's success and discusses a game-changing initiative concerning respect for people. After reading this book, you will better understand the active leadership style that has propelled Virginia Mason's success. By following the best practices and lessons learned, you will be prepared to teach, coach, and encourage your team to achieve streamlined and standardized work, sustained improvements, and increased patient satisfaction. Foreword by Carolyn Corvi, Virginia Mason Health System/Virginia Mason Medical Center Boards of Directors; Retired Vice President and General Manager, Boeing Commercial Airplanes
The term health technology refers to drugs, devices, and programs that can improve and extend quality of life. As decision-makers struggle to find ways to reduce costs while improving health care delivery, health technology assessments (HTA) provide the evidence required to make better-informed decisions. This is the first book that focuses on the statistical options of HTAs, to fully capture the value of health improvements along with their associated economic consequences. After reading the book, readers will better understand why some health technologies receive regulatory or reimbursement approval while others do not, what can be done to improve the chances of approval, as well as common shortcomings of submissions for drug and device reimbursement. The book begins by contrasting the differences between regulatory approval and reimbursement approval. Next, it reviews the principles and steps for conducting an HTA, including the reasons why different agencies will have a different focus for their scope in the HTA. Supplying an accessible introduction to the various statistical options for different methods in an HTA, the book identifies the links to regulatory and reimbursement decisions for each option. It highlights many of the methodological advances that have occurred since HTA research began, to provide researchers and decision-makers with a cutting-edge framework. It also details the logical basis for the methods along with simple instructions on how to conduct the various techniques. Both authors have considerable experience in generating evidence for submissions and reviewing submissions to decision-makers for funding. One of the authors has also received a nationally recognized lifetime achievement award in this area.
Consumer Health Information Programs and Services: Best Practices presents examples of successful and long-standing library programs and services that provide health information to consumers-the general public, patients, and families or patients - who seek information about health and diseases. This best practices volume brings together library programs and services currently offered in hospital libraries, public libraries, academic health sciences libraries, and standalone consumer health libraries, covering a range of topics and special programs. Advice and best practices provided by these experienced CHI librarians will help readers who are planning a new consumer health information service, or who are looking to upgrade and expand their current program or service. This best practices book will highlight successful library consumer health information programs and services, offering advice and tips about all aspects of providing health information to the general public and patients, from planning and establishing a CHI program, to offering specialized services to special populations. Readers will find both solid, tried-and-true methods for providing these services, as well as guidance on using newer, updated techniques to reach persons needing health information. |
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