This book is part of a series of titles that are a spin-off of the Shingo Prize-winning book Leveraging Lean in Healthcare: Transforming Your Enterprise into a High Quality Patient Care Delivery System. Each book in the series focuses on a specific aspect of healthcare that has demonstrated significant process and quality improvements after a Lean implementation. There are many departments within a hospital that support the primary function of caregiving and each can benefit from implementing Lean methodologies. Leveraging Lean in Ancillary Hospital Services: Creating a Cost Effective, Standardized, High Quality, Patient-Focused Operation provides a functional understanding of Lean processes and quality improvement techniques in nutritional services, inpatient floors, pharmacy, and radiology. This book is ideal for healthcare executives, leaders, process improvement team members, and inquisitive frontline workers who want to implement and leverage Lean. Supplying detailed descriptions of Lean tools and methodologies, it identifies powerful Lean solutions specific to the needs of ancillary hospital services. The first section provides an overview of Lean concepts, tools, methodologies, and applications. The second section focuses on the application of Lean in the ancillary hospital services environment. Presenting numerous examples, stories, case studies, and lessons learned, it examines the normal operation of each area in radiology, pharmacy, and nutritional services and highlights the areas where typical problems occur. The case studies walk readers through various Lean initiatives and demonstrate how Lean tools and concepts have been used to achieve lasting improvements to processes and quality of care. It also introduces actionable blueprints that readers can duplicate or modify for use in their own institutions. Illustrating leadership's role in achieving departmental goals, this book will provide you with a well-rounded understanding of how Lean can be applied to achieve significant improvements throughout the entire continuum of care.

Achieving health care that is safe, timely, effective, efficient, equitable, and patient-centered (STEEEP) is not an endpoint, but a journey. This journey requires a commitment to quality improvement (QI) from the highest levels of leadership combined with the interdependent development of several key components of health care delivery: administration and governance, clinical leadership, quality programs and expertise, data analytics, and accreditation. As each organization travels along its journey, these components must evolve at a common pace. With each component of a given phase of the quality journey firmly developed, the organization can expect to advance to the next phase knowing that the requisite factors are aligned. Winner of a 2015 Shingo Research and Professional Publication AwardBaylor Scott & White Health (BSWH) has formalized its commitment to quality with the adoption of the STEEEP framework supporting the Institute of Medicine's call for health care that is safe, timely, effective, efficient, equitable, and patient centered. This Shingo Prize-winning guide book is a companion to BSWH's recent book Achieving STEEEP Health Care. It presents practical approaches and tools, including sample workflows, forms, charters, and checklists, that health care delivery organizations can use to organize, lead, execute, and measure the impact of their own improvement efforts. BSWH has traveled the QI journey during its 100 years as the largest not-for-profit health care system in Texas and one of the largest in the U.S. With a history of visionary care, its aim is to help others achieve the highest levels of quality and safety for their patients. To learn more about the BSWH quality journey and to find additional case studies and tools, please visit www.steeepglobalinstitute.com.

David M. Craig traveled across the United States to assess health care access, delivery and finance in this country. He interviewed religious hospital administrators and interfaith activists, learning how they balance the values of economic efficiency and community accountability. He met with conservatives, liberals, and moderates, reviewing their ideas for market reform or support for the Affordable Care Act. He discovered that health care in the US is not a private good or a public good. Decades of public policy and philanthropic service have made health care a shared social good.

"Health Care as a Social Good: Religious Values and the American Democracy" argues that as escalating health costs absorb more and more of family income and government budgets, we need to take stock of the full range of health care values to create a different and more affordable community-based health care system. Transformation of that system is a national priority but Americans have failed to find a way to work together that bypasses our differences. Craig insists that community engagement around the common religious conviction that healing is a shared responsibility can help us achieve this transformation -- one that will not only help us realize a new and better system, but one that reflects the ideals of American democracy and the common good.

Updated and thoroughly revised, the second edition of this foundational text continues to cover all major topics of organization, financing, workforce, goals, initiatives, accountability, and metrics from the perspectives of academicians and officials in public health. This second edition is the only public health text to encompass the new legislation implemented by the Affordable Care Act, with its focus on prevention and increase in funding for prevention research. It also examines resulting job opportunities and expanded interest in the public health field.

Comprehensive and accessible, the text discusses a variety of new trends in public health, particularly regarding primary care and public health partnerships. The second edition also includes information about new accountability initiatives and workforce requirements to contribute to "public health services and systems research," better known as health services research and clinical outcomes research in medical care. The text stresses the increasing emphasis on efficiency, effectiveness, and equity in achieving population health improvements, and goes beyond merely presenting information to analyze the question of whether the practice of public health achieves its promise. Each chapter includes objectives, review questions, and case studies. Also included are an instructor's manual (containing every major public health improvement initiative and introducing every major data system sponsored by the U.S. public health system), PowerPoint slides, and a test bank.

New to the Second Edition: Completely updated and revised Addresses changes wrought by Obamacare Focuses on the workforce, job opportunities, and job training Discusses building healthy communities and the determinants of health Covers new developments in treating Lyme disease, West Nile virus, and other illnesses Considers variation in public health-globally and nationally by state Investigates intentional injuries such as suicide, homicide, and war

Key Features: Provides information that is holistic, comprehensive, and accessible Covers all major topics of organization, financing, leadership, goals, initiatives, accountability, and metrics Relates current public health practice to the field's history and mission Includes a global health component Analyzes successful and unsuccessful aspects of health care delivery

This book presents the theory of integrating implification and it provides a profound evidence based study of Buurtzorg Nederland. The case itself, forming the building block of the theory, has received tremendous interest in the Netherlands and abroad. This is the first international book on Buurtzorg Nederland and the first one departing from a management multidisciplinary perspective. The book demonstrates theory building by using the Grounded Theory Methodology as a way to contribute to management theory. Integrating simplification gives room for context specific implementation of organizational innovation to different industries.

Academics and practitioners working in the field of healthcare management need to effectively manage knowledge and KM. KM places value on the tacit knowledge that individuals hold within an institution and often makes use of IT to free up the collective wisdom of individuals within an organization. Clinical Knowledge Management: Opportunities and Challenges establishes a convergence in thinking between KM and knowledge engineering healthcare applications. This book assembles original and innovative contributions in the area of KM and knowledge engineering applications for healthcare systems and clinical engineering applications. Clinical Knowledge Management: Opportunities and Challenges reinforces the implicit contention that the healthcare industry is calling for KM frameworks that can marry these two perspectives. This book has appeal in both camps and is the first to genuinely examine KM for healthcare in the necessary holistic manner.

This highly original book is an ethnographic noir of how Big Data profits from patient private health information. The book follows personal health data as it is collected from inside healthcare and beyond to create patient consumer profiles that are sold to marketers. Primarily told through a first-person noir narrative, Ebeling as a sociologist-hard-boiled-detective, investigates Big Data and the trade in private health information by examining the information networks that patient data traverses. The noir narrative reveals the processes that the data broker industry uses to create data commodities-data phantoms or the marketing profiles of patients that are bought by advertisers to directly market to consumers. Healthcare and Big Data considers the implications these "data phantoms" have for patient privacy as well as the very real harm that they can cause.

Increasing costs and higher utilization of resources make the role of process improvement more important than ever in the health care industry. Management Engineering: A Guide to Best Practices for Industrial Engineering in Health Care provides an overview of the practice of industrial engineering (management engineering) in the health care industry. Explaining how to maximize the unique skills of management engineers in a health care setting, the book provides guidance on tried and true techniques that can be implemented easily in most organizations. Filled with tools and documents to help readers communicate more effectively, it includes many examples and case studies that illustrate the proper application of these tools and techniques. Containing the contributions of accomplished healthcare process engineers and process improvement professionals, the book examines Lean, Six Sigma, and other process improvement methodologies utilized by management engineers. Illustrating the various roles an industrial engineer might take on in health care, it provides readers with the practical understanding required to make the most of time-tested performance improvement tools in the health care industry. Suitable for IE students and practicing industrial engineers considering a move into the health care industry, or current healthcare industrial engineers wishing to expand their practice, the text can be used as a reference to explore individual topics, as each of the chapters stands on its own. Also, senior healthcare executives will find that the book provides insights into how the practice of management engineering can provide sustainable improvements in their organizations. To get a good overview of how your organization can best benefit from the efforts of industrial engineers, this book is a must-read.

Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have concepts and methods that are able to cope with this complexity. Resilience engineering provides that capacity because its focus is on a system's overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. Resilience engineering's unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering. Whereas current safety approaches primarily aim to reduce or eliminate the number of things that go wrong, Resilient Health Care aims to increase and improve the number of things that go right. Just as the WHO argues that health is more than the absence of illness, so does Resilient Health Care argue that safety is more than the absence of risk and accidents. This can be achieved by making use of the concrete experiences of resilience engineering, both conceptually (ways of thinking) and practically (ways of acting).

Although all primary care organisations have to develop business plans at every level, for many this is a new experience. This book will show the reader how., The Business Planning Tool Kit is a practical, comprehensive book that contains all the reader needs to know about business planning in primary care. The book includes topics on what to include in a business plan, personnel, finances, premises and information management. It is an interactive guide including links to websites that have practical templates for the reader to download and use. It takes general practitioners, practice managers, and managers in primary care groups, trusts, and health authorities through the business planning process in a clear, straightforward way., This book provides a whole new way of looking at how general practice can be managed and it does so in the form of a manual which gives whoever takes on the task the tools to do so. The layout of the book is a joy. Every section has sheets on which staff members can write their comments on the issue in hand. Users of this book are likely to find themselves in a healthier practice because of it.' Andrew Polmear, in the Foreword

"As one who is involved in the culture change movement and is trying to review the huge volume of available resources, I find it refreshing to have a book that draws it all together....I highly recommend this book to administrators who are overwhelmed at the thought of implementing change in their environment. The author has done an excellent job of making it seem quite possible to make culture change a reality."--Doody's Medical Reviews

"The publication of "Implementing Culture Change in Long-Term Care" marks the beginning of a new era in the aging services profession. This book is the Rosetta Stone of the culture change movement. Dr. Jurkowski's skillful blend of theory, research, and practice addresses the movement's most urgent needs and makes the work of culture change advocates accessible to a broader and more influential audience....This book is the future in paper and ink."

From the Foreword by Bill Thomas, MD
Founder of the Eden Alternative and the Green House Project

This text offers a strategic approach for promoting an active culture of change in long-term care facilities for older adults and people with disabilities. It discusses the philosophical framework for the delivery of care in these settings and addresses the changing landscape of our long-term care population. With the aim of transforming these facilities from institutional settings to person-centered, homelike environments, the book offers administrators and practitioners numerous strategies and benchmarks for culture change, and addresses tools and resources to support the culture change process. The text describes how these benchmarks have been met and provides ways to address not just knowledge, but also attitudes and behavior, important components of a culture change strategy.

The book compares and contrasts current long-term care paradigms-the medical model, the rehabilitation paradigm, the independence and dignity model, and strength-based approaches-in order to see how they facilitate or impede culture change. It provides best practice examples of benchmarks to be attained along with strategies to promote this process. These benchmarks and strategies are based upon the Artifacts for Culture Change Assessment Tool developed by the Centers for Medicare and Medicaid. The text describes ways to build a blueprint and strategic processes for integrating these benchmarks into a long-term care setting, addressing the entire process from assessment through evaluation. It also provides tools enabling readers to learn from their own process via a feedback loop, and includes strategies to facilitate partnerships with family, staff, and community. Key Features:

Elucidates benchmarks that can be implemented in long-term care settings, using the Centers for Medicare/Medicaid's "Long Term Care Artifacts" assessment tool as an intervention Focuses on care practices, the environment, the inclusion and integration of family and community, leadership benchmarks, and workplace practices Includes robust examples of best practices within each of the main artifact arenas Incorporates tools and strategies for assessing the philosophical paradigm of a long- term facility that can help or hinder the culture change process Provides discussion and reflection questions and websites for additional resources

Utilizing the 3Ms of Process Improvement in Healthcare supplies step-by-step guidance on how to use the 3Ms of change leadership to improve healthcare processes. Complete with forms, templates, and healthcare case studies, it illustrates the proper application of the 3Ms. It weaves stories throughout the book of role models who have succeeded, as well as some who have failed. It identifies the specific elements that were missing or defective in the failed attempts to teach readers about how the three elements work together. Arming you with a culture change method that is based on changing behaviors, it provides a leadership and management guide to achieving your objectives. The 3Ms have worked for Ben Franklin, Abraham Lincoln, and the author's teams across the globe. Now, with this book, you can put the power of the 3Ms to work for you in your quest towards improving processes, providing better care, and reducing costly errors. The author encourages reader interaction and feedback on his website: www.rpmexec.com. He also provides you with access to the forms and templates described in the book.

Serious scholarly analyses of the types and roles of accountability in health care first appeared in the late 1980s. That issue, along with the related issue of responsibility in health care, has continued to interest policymakers, analysts and scholars ever since. Indeed, there has been a renewed surge of interest in recent years, with growing attention to the notion of accountable care organizations in the US, clinical audits in the UK, and governance as stewardship in many other countries. Accountability and responsibility in health care was also the theme of a major international conference organized by the Israel National Institute for Health Policy Research, which was held in Jerusalem in 2009.This book is a collection of scholarly articles on the themes of accountability and responsibility in health care and seeks to be the premier book in that field. It includes selected papers from the 2009 Jerusalem Conference, analytic essays on how accountability and responsibility are playing out in eight different countries, and reprints of some of the classic articles in the field.The book will interest policymakers, managers, researchers and students, and many of the ideas presented here will help shape the development of this field in the years ahead. Some of these ideas have appeared in other forums; the unique contribution of this volume is that it is the first to bring together so many different perspectives on accountability and responsibility in health care. This volume will both acquaint readers with some of the latest thinking on accountability and responsibility in health care, and will serve as a catalyst for future reflection, research and writing in this area.

David Samuels, a leading authority on financial models in healthcare, draws on his multidisciplinary background in all aspects of managed care to provide an expansive yet detailed perspective of this complex field. Grounded in evidence-based modeling, the book's multidisciplinary focus puts the spotlight on core concepts from the standpoints of health plans, hospitals, physician practice, and their respective integrated network models. You'll learn what happened when a country's national health care plan is developed with problematic underwriting, why hospitals will always be victimized at their payer's bargaining table, and even how to improve the current primary care shortage at both 50% less provider costs as well as with triple their members' compliance in wellness care. The book gives you the critical tools to stay ahead of the learning curve, engage patients to take responsibility for their own and their family's health status, and improve your differentiation in a RAPIDLY changing marketplace.

The definitive guide to clinical leadership, by Dickon Weir-Hughes, the Chief Executive of the NMC.

Dickon takes a unique slant on the teaching of Leadership and Management through an A-Z format, making this subject very accessible. The book provides a helpful and practical summary of the key leadership principles within healthcare.

Dickon has drawn on his personal experience of the 'sharp end' of clinical leadership in a number of organisations. Utilising his experience as a leadership programme facilitator, mentor and coach. he understands the need for students and practitionners to grasp leadership concepts and terminology, to assess their competence against such a framework and to have some suggestions for taking forward personal development. This book fulfils that in and accessible and novel way.

Health professionals often take on managerial roles at short notice and with little or no preparation. Although they may be highly clinically qualified and accomplished, the practicalities and relationships involved in management - helping staff to feel motivated and valued, building and leading teams, managing meetings and presentations, writing reports and managing change, to name but a few - present new challenges and pitfalls for which they are unprepared. This book is for managers and prospective managers who want to approach their new responsibilities professionally from the very beginning. Based on the authors' successful "Vital Signs" education programme, it identifies the critical skills needed to hit the ground running as a manager. It is an accessible, easily comprehensible guide to gaining the self-confidence and the respect of staff, and to creating a steady platform for acquiring and mastering a wide range of skills in the future. 'This book is dedicated to helping leaders and managers prepare for people responsibilities. It also addresses three areas which usually make leaders and managers uncomfortable - running meetings successfully, making presentations and writing reports. [It] gives accessible and practical examples and I have no hesitation in commending it to a wide readership.' - From the Foreword by John Edmonstone

Although many books have been published on the application of GIS in emergency management and disaster response, this is the first one to bring together a comprehensive discussion of the critical role GIS plays in hospital and healthcare emergency management and disaster response.

Illustrating a wide range of practical applications, GIS in Hospital and Healthcare Emergency Management explores how GIS data is being used to assess need, determine surge capacity, and improve logistics in emergency or disaster scenarios. Leading experts in the field provide authoritative coverage of all areas of emergency management involving GIS and related technologies.

Making this complex subject accessible for professionals who want to improve their preparedness and response capabilities, this complete resource provides numerous examples, case studies, and proven simulation and modeling tools to aid in the development of effective and efficient emergency response plans. It also includes a CD-ROM with a user interface that supplies access to helpful forms, exercises, color versions of the figures in the book, hundreds of valuable resources, as well as a composite bibliography of all references included in the text.

In today s technology driven environment, failure to plan is planning to fail. This accessible resource provides emergency planners, operations managers, and hospital and healthcare administrators with the understanding and the tools needed to create emergency management and disaster preparedness systems that will help hospitals save lives, time, and money when the next emergency strikes.

Typically entrenched and systemic, healthcare problems require the sort of comprehensive solutions that can only be addressed by a change in culture and a shift in thinking. Applying Lean in Healthcare: A Collection of International Case Studies demonstrates how honest appraisal, intelligent planning, and vigilant follow-up have led to dramatic improvements in a variety of healthcare settings across the world. It teaches us how innovative organizations can find sustainable solutions to seemingly intractable problems by following a path guided by Lean Thinking. Lean methods may not solve every healthcare problem, but as these cases prove, changing a culture rather than personnel results in more effective sustainable change.

Clinical training and background are not synonymous with leadership. So where does a potential clinical leader turn to for advice? This small handy volume is specifically written for this purpose with information about the softer skills of leadership. It is not linked to any particular healthcare system or clinical discipline. Focus on leadership as a means to influence healthcare culture is attracting attention internationally currently. There is a lack of published material aimed at clinical leadership and the time is ripe to channel and develop formal pathways to support this unmet need. There is an appetite for understanding what leadership involves and the book is aimed at that. It provides useful information presented in a highly readable style. Readers will find the style a refreshing change from the usual academic material. Accounts of hands-on experience with non-pedantic pragmatic advice are reflected strongly in the book. It draws heavily on the concept that perceptions may not be shared. This may be the basis for fruitful communication and mutual understanding, if not necessarily agreement. Clinical leadership is an evolving discipline and seldom do currently practicing individuals have an accredited qualification. They rather build up 'on -the -job' experience. This compendium of real life experiences and educational facts attempts to bridge the gap and prepare healthcare professionals to hit the ground running in their leadership roles. The book's narrative pace will make it a good holiday or long journey read. The subject matter is neither dry, trivial nor trite.

While there are a growing number of books based on the Toyota Production System, or lean, focused on healthcare, there are very few that detail the tools that make lean more than just a way of thinking and put the methodology into practice. Based on Hiroyuki Hirano's classic 5 Pillars of the Visual Workplace and modeled after the Shingo Prize-winning Shopfloor Series for Lean Manufacturers, 5S for Healthcare adopts a proven reader-friendly format to impart all the information needed to understand and implement this essential lean methodology. It provides examples and cased studies based on the experiences of the principals involved with the Rona Consulting Group, who were responsible for the groundbreaking implementation of the Toyota Production System at the Virginia Mason Medical Center. Written to readily assist with hands-on implementation efforts, this volume offers innovative features designed to improve understanding and support application. This includes helpful how-to-steps and practical examples taken directly from the healthcare industry.

Applies the Principles of Informatics to the Pharmacy Profession Emphasizes Evidence-Based Practice and Quality Improvement Approaches Leading the way in the integration of information technology with healthcare, Pharmacy Informatics reflects some of the rapid changes that have developed in the pharmacy profession. Written by educators and professionals at the forefront in this field, the book shows how informatics plays a central role in providing productive and efficient healthcare services. After defining pharmacy informatics, the text explores the information and biomedical technologies that are the drivers of change. It then discusses the basics of maintaining the reliability and security of computers in a connected world, the need for standardization in the healthcare industry, and effective strategies for searching, evaluating, and managing the wide variety of information resources available today. The next section covers the types of information systems that exist in hospitals and pharmacies, including bar coding. The book then presents tools for evidence-based practice, computerized clinical pharmacokinetics methods, clinical decision support, and data mining methods to improve therapy, reduce adverse outcomes, and cut costs. The final section examines various developments driven by the Internet and how current informatics solutions must evolve to maximize their potential. The continual growth and increasing complexity of therapeutic information necessitate new ways for effectively handling medical data and ultimately providing better patient care. This book discusses how these changes affect pharmacy students and practicing pharmacists, preparing them for what lies ahead in this evolving field.

The U.S. health care system faces well-known problems: 47 million people without health insurance, rapidly rising costs that consume 16 percent of the country's economic output, and widely uneven quality of care. Even many people with coverage are experiencing serious problems paying for the rapidly rising costs of health care and insurance.This book - a joint product of the National Academy of Public Administration and the National Academy of Social Science - undertakes a sweeping analysis of the management and administrative issues that arise in expanding health care coverage. The book identifies the core administrative functions that need to be performed in assuring access to health coverage, describes how these functions are performed at present and under proposed alternatives, draws lessons from experience in the U.S. and abroad, and assesses suggested administrative approaches designed to facilitate the improvement and expansion of health care coverage.Adequate health care is one of today's most crucial domestic policy concerns. "Expanding Access to Health Care" is designed to bring together in one place some of the best thinking on the subject, not as an exercise in advocacy, but rather to lay out the issues in a balanced way so that policymakers, researchers, and citizens can better understand the complex details of health care reform.

Quality care of patients requires evaluating large amounts of data at the right time and place and in the correct context. With the advent of electronic health records, data warehouses now provide information at the point of care and facilitate a continuous learning environment in which lessons learned can provide updates to clinical, administrative, and financial processes. Given the advancement of the information tools and techniques of today's knowledge economy, utilizing these resources are imperative for effective healthcare. Thus, the principles of Knowledge Management (KM) are now essential for quality healthcare management.

The Healthcare Knowledge Management Primer explores and explains essential KM principles in healthcare settings in an introductory and easy to understand fashion. This concise book is ideal for both students and professionals who need to learn more about key aspects of the KM field as it pertains to effecting superior healthcare delivery. It provides readers with an understanding of approaches to KM by examining the purpose and nature of its key components and demystifies the KM field by explaining in an accessible manner the key concepts of KM tools, strategies and techniques, and their benefits to contemporary healthcare organizations.

Quality care of patients requires evaluating large amounts of data at the right time and place and in the correct context. With the advent of electronic health records, data warehouses now provide information at the point of care and facilitate a continuous learning environment in which lessons learned can provide updates to clinical, administrative, and financial processes. Given the advancement of the information tools and techniques of today s knowledge economy, utilizing these resources are imperative for effective healthcare. Thus, the principles of Knowledge Management (KM) are now essential for quality healthcare management.

The Healthcare Knowledge Management Primer explores and explains essential KM principles in healthcare settings in an introductory and easy to understand fashion. This concise book is ideal for both students and professionals who need to learn more about key aspects of the KM field as it pertains to effecting superior healthcare delivery. It provides readers with an understanding of approaches to KM by examining the purpose and nature of its key components and demystifies the KM field by explaining in an accessible manner the key concepts of KM tools, strategies and techniques, and their benefits to contemporary healthcare organizations.

The U.S. health care system faces well-known problems: 47 million people without health insurance, rapidly rising costs that consume 16 percent of the country's economic output, and widely uneven quality of care. Even many people with coverage are experiencing serious problems paying for the rapidly rising costs of health care and insurance.This book - a joint product of the National Academy of Public Administration and the National Academy of Social Science - undertakes a sweeping analysis of the management and administrative issues that arise in expanding health care coverage. The book identifies the core administrative functions that need to be performed in assuring access to health coverage, describes how these functions are performed at present and under proposed alternatives, draws lessons from experience in the U.S. and abroad, and assesses suggested administrative approaches designed to facilitate the improvement and expansion of health care coverage.Adequate health care is one of today's most crucial domestic policy concerns. "Expanding Access to Health Care" is designed to bring together in one place some of the best thinking on the subject, not as an exercise in advocacy, but rather to lay out the issues in a balanced way so that policymakers, researchers, and citizens can better understand the complex details of health care reform.