This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the "macro system." A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects.

Within the international discussion on the structure of healthcare systems, managed care is an increasingly important topic. Over more than twenty years managed care approaches have fundamentally influenced healthcare systems in terms of patient orientation, efficiency, and quality. Experts assume that up to 20% of healthcare expenses can be saved by applying high-quality managed care approaches. By using suitable organisational forms and management principles, not only can costs be reduced, but the quality of medical service provision can be augmented. Managed care is therefore much more than a cost-cutting strategy. The goal of this book is to offer a systematic overview of the organisational forms and management instruments implemented in managed care. Advocates consider managed care to be a logical and necessary developmental step in modern healthcare systems. An increase in quality and at the same time a reduction of costs is not seen as contradictory but rather as consistent. Therefore, managed care is a response to changed challenges in the provision of healthcare.

This text provides physicians with the basic business skills in order for them to become involved in the financial aspect of their practices. The text will help the physician decide what kind of practice they would like to join (i.e. private practice, small group practice, solo practice, hospital employment, large group practice, academic medicine, or institutional\government practice) as well as understand the basics of contracting, restrictive covenants and how to navigate the road to partnership. Additional topics covered include, monthly balance sheets, productivity, overhead costs and profits, trend analysis and benchmarking. Finally, the book provides advice on advisors that doctors will need to help with the business of their professional and personal lives. These include accountants, bankers, lawyers, insurance agents and other financial advisors. The Complete Business Guide for a Successful Medical Practice provides a roadmap for physicians to be not only good clinical doctors but also good businessmen and businesswomen. It will help doctors make a difference in the lives of their patients as well as sound financial decisions for their practice.

This book provides an organizational model of the common ground needed to improve patient care and adapt to today's healthcare environment. The relationship between a hospital CEO and a general surgeon and how they aligned, motivated and partnered with physicians to change the culture of a hospital and implement patient oriented systems is the essential element of this text. Sustainable transformation processes will also be presented for the various roles and contributions of the healthcare team. Written from a team perspective, Transforming the Patient Experience is a practical guide for healthcare team members and leaders to follow.

This is the first book to offer a comprehensive yet concise overview of the challenges and opportunities presented by the use of big data in healthcare. The respective chapters address a range of aspects: from health management to patient safety; from the human factor perspective to ethical and economic considerations, and many more. By providing a historical background on the use of big data, and critically analyzing current approaches together with issues and challenges related to their applications, the book not only sheds light on the problems entailed by big data, but also paves the way for possible solutions and future research directions. Accordingly, it offers an insightful reference guide for health information technology professionals, healthcare managers, healthcare practitioners, and patients alike, aiding them in their decision-making processes; and for students and researchers whose work involves data science-related research issues in healthcare.

This book collects several contributions, written both by statisticians and medical doctors, which focus on the identification of new diagnostic, therapeutic and organizational strategies in order to improve the occurrence of clinical outcomes for Acute Coronary Syndromes (ACS) patients. The work is structured in two different parts: the first one is focused on cooperative project mainly on statistical analysis of large clinical and administrative databases; the second one faces the development of innovative diagnostic techniques, with specific reference to genetic and proteomic, and the evolution of new imaging techniques for the early identification of patients at major risk of thrombotic, arrhythmic complications and at risk of poor revascularization.

This book presents some recent systems engineering and mathematical tools for health care along with their real-world applications by health care practitioners and engineers. Advanced approaches, tools, and algorithms used in operating room scheduling and patient flow are covered. State-of-the-art results from applications of data mining, business process modeling, and simulation in healthcare, together with optimization methods, form the core of the volume. Systems Analysis Tools for Better Health Care Delivery illustrates the increased need of partnership between engineers and health care professionals. This book will benefit researchers and practitioners in health care delivery institutions, staff members and professionals of specialized hospital units, and lecturers and graduate students in engineering, applied mathematics, business administration and health care.

A COMPLETE UPDATE AND REVISION OF THE CLASSIC TEXT "At last, a manual of operations for comparing the cost-effectiveness of a preventive service with a treatment intervention." -American Journal of Preventive Medicine Twenty years after the first edition of COST-EFFECTIVENESS IN HEALTH AND MEDICINE established the practical benchmark for cost-effectiveness analysis, this completely revised edition of the classic text provides an essential resource to a new generation of practitioners, students, researchers, and policymakers. Produced by the Second Panel on Cost-Effectiveness in Health and Medicine-a team of 13 experts from fields including decision science, economics, ethics, psychology, and medicine-this new edition is a comprehensive guide to the use of cost-effectiveness analysis as an evaluative tool at the institutional and policy levels. As health care systems face increasing pressure to derive maximum value from expenditures, the guidelines in this new text represent not just the best information available, but a vital guide to health care decision-making in a challenging new era. Completely revised and enriched with examples and expanded coverage, this second edition of COST-EFFECTIVENESS IN HEALTH AND MEDICINE builds on its predecessor's excellence, offering required reading for both analysts and decision makers.

Recent research in health decision making has shown that many patients, even those with a college education, have difficulties grasping a host of numerical concepts, including percentages and probabilities. Yet, basic numeracy and graph literacy are essential for understanding information relevant to making decisions about health, such as the incidence and prevalence of different diseases, risk reductions from medical screenings and treatments, and risk increases from side effects of treatments and unhealthy behaviors. Patients who have problems understanding such numerical concepts are often prone to errors in risk perception and medical choices. Importantly, informed medical decision making, heavily reinforced these days by the legal requirement for informed consent, depends critically on communication of quantitative medical information. Meeting the challenge of effectively communicating medical information to patients with different levels of numeracy and graph literacy has become more important than ever. Transparent Communication of Health Risks describes a series of cross-cultural studies investigating how people in countries with different medical and educational systems understand numerical and graphical information, what they know about existing medical treatments and screenings, which presentation formats help them better understand the relevant information, and how they use the data to make medical decisions. Focusing on the careful measurement of necessary knowledge and skills, the book also includes validated numeracy and graph literacy scales in English, Spanish, and German. Some of the topics covered in the book are: numeracy and graph literacy for health; measuring risk comprehension in educated samples; communicating information about medical treatment and screening; reducing the effect of framed messages about health; the effect of individual differences on shared decision making; and transparent health information in the media. Transparent Communication of Health Risks emphasizes the importance and value of working toward the development of tailored risk communication interventions and clarifies the tasks ahead for health psychologists, public health professionals, pharmaceutical and medical education companies, medical physicists, and nurses.

The present book aims to assist and guide medical doctors in any specialty to manage his/her own clinic or office, allowing a higher and better development of its team/staff and providing tools for a high quality service to patients and customers. It is devoted to be the background for any medical doctor's success in personal career, serving as a foundation for professional growth. In last instance, Medical Office Management is intended to be a practical manual for easy day to day application in medical clinics.

Operations research tools are ideally suited to providing solutions and insights for the many problems health policy-maker's face. Indeed, a growing body of literature on health policy analysis, based on operations research methods, has emerged to address the problems mentioned above and several others. The research in this field is often multi-disciplinary, being conducted by teams that include not only operations researchers but also clinicians, economists and policy analysts. The research is also often very applied, focusing on a specific question driven by a decision-maker and many times yielding a tool to assist in future decisions. The goal of this volume was to bring together a group of papers by leading experts that could showcase the current state of the field of operations research applied to health-care policy. There are 18 chapters that illustrate the breadth of this field. The chapters use a variety of techniques, including classical operations research tools, such as optimization, queuing theory, and discrete event simulation, as well as statistics, epidemic models and decision-analytic models. The book spans the field and includes work that ranges from highly conceptual to highly applied. An example of the former is the chapter by Kimmel and Schackman on building policy models, and an example of the latter is the chapter by Coyle and colleagues on developing a Markov model for use by an organization in Ontario that makes recommendations about the funding of new drugs. The book also includes a mix of review chapters, such as the chapter by Hutton on public health response to influenza outbreaks, and original research, such as the paper by Blake and colleagues analyzing a decision by Canadian Blood Services to consolidate services. This volume could provide an excellent introduction to the field of operations research applied to health-care policy, and it could also serve as an introduction to new areas for researchers already familiar with the topic. The book is divided into six sections. The first section contains two chapters that describe several different applications of operations research in health policy and provide an excellent overview of the field. Sections 2 to 4 present policy models in three focused areas. Section 5 contains two chapters on conceptualizing and building policy models. The book concludes in Section 6 with two chapters describing work that was done with policy-makers and presenting insights gained from working directly with policy-makers.

Das Werk kommentiert die Musterberufsordnung, also das Berufsrecht der AErztinnen und AErzte in Deutschland. Die Neuauflage arbeitet die AEnderungen, die der 125. Deutsche AErztetag beschlossen hat, ein. Die Berufsordnung fur AErztinnen und AErzte bleibt auch nach den AEnderungen im Burgerlichen Gesetzbuch (Behandlungsvertrag) und im StGB (Korruption im Gesundheitswesen) aktuelles Berufsrecht, weil diese Normen teilweise andere Regelungsziele verfolgen. Des Weiteren oeffnet sich das Berufsrecht auch neuen Entwicklungen wie der Digitalisierung (Stichwort Fernbehandlung). Das Urteil des BVerfG zur Sterbehilfe treibt die AErzteschaft nach wie vor um. Im Berufsrecht wurde die entsprechende Vorschrift 16 geandert. Der Einfluss berufsfremder Investorinnen und Investoren (private equity) auf Einrichtungen im Gesundheitswesen wachst dynamisch. Das Berufsrecht muss sich dieser Entwicklung stellen. Der Kommentar entwickelt hierzu Loesungsansatze. Der Kommentar will der Praxis - AErzten und Juristen - auch in der Neuauflage ein zuverlassiger und kompetenter Begleiter im Umgang mit der Berufsordnung fur AErztinnen und AErzte sein.

The world's problems are indeed world problems: social and environmental crises, global trade and politics, and major epidemics are making public health a pressing global concern. From this constantly changing scenario, global health diplomacy has evolved, at the intersection of public health, international relations, law, economics, and management-a new discipline with transformative potential. Global Health Diplomacy situates this concept firmly within the human rights dialogue and provides a solid framework for understanding global health issues and their negotiation. This up-to-the-minute guide sets out defining principles and the current agenda of the field, and examines key relationships such as between trade and health diplomacy, and between global health and environmental issues. The processes of global governance are detailed as the UN, WHO, and other multinational actors work to address health inequalities among the world's peoples. And to ensure maximum usefulness, the text includes plentiful examples, discussion questions, reading lists, and a glossary. Featured topics include: The legal basis of global health agreements and negotiations. Global public goods as a foundation for global health diplomacy. Global health: a human security perspective. Health issues and foreign policy at the UN. National strategies for global health. South-south cooperation and other new models of development. A volume of immediate utility with a potent vision for the future, Global Health Diplomacy is an essential text for public health experts and diplomats as well as schools of public health and international affairs.

From the Preface: Collectively, the chapters in this book address application domains including inpatient and outpatient services, public health networks, supply chain management, and resource constrained settings in developing countries. Many of the chapters provide specific examples or case studies illustrating the applications of operations research methods across the globe, including Africa, Australia, Belgium, Canada, the United Kingdom, and the United States. Chapters 1-4 review operations research methods that are most commonly applied to health care operations management including: queuing, simulation, and mathematical programming. Chapters 5-7 address challenges related to inpatient services in hospitals such as surgery, intensive care units, and hospital wards. Chapters 8-10 cover outpatient services, the fastest growing part of many health systems, and describe operations research models for primary and specialty care services, and how to plan for patient no-shows. Chapters 12 - 16 cover topics related to the broader integration of health services in the context of public health, including optimizing the location of emergency vehicles, planning for mass vaccination events, and the coordination among different parts of a health system. Chapters 17-18 address supply chain management within hospitals, with a focus on pharmaceutical supply management, and the challenges of managing inventory for nursing units. Finally, Chapters 19-20 provide examples of important and emerging research in the realm of humanitarian logistics.

This book disentangles the issues in connection with the advancement of Health Technology Assessment (HTA) and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose. A wealth of documents dealing with HTA have been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, counter vailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement. Given our social preferences, cherry-picking HTA's features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consolidation as an efficient tool for regulation and decision making are as follows: insufficient resources, delays in assessment, inadequate priority setting, regulatory capture, public distrust, actual influence on regulatory decisions, the need for strengthening international cooperation and harmony, the lack of sound and consistent assessments of diagnostic tests, medical devices and surgical innovations and limited dissemination. Time has come for HTA to take a renewed stand. There is a pressing need to submit HTA to in-depth critical scrutiny.

Why did President Clinton's efforts to reform the financing of American health care fail? For years to come, politicians and scholars of public policy will revisit the debate over Clinton's health care plan. What did planners do right? And what did they do wrong? How can the mistakes of that experience be avoided in the future? What steps can now be taken to achieve some measure of reform in smaller pieces? In The Problem That Won't Go Away, economists, political scientists, sociologists, public opinion experts, and government staff offer answers to these and other crucial questions. They recount the history of the Clinton health care plan, present several alternative strategies the administration might have pursued, and conclude that none was likely to achieve the administration's goals of universal coverage and cost containment. Many support the view that the administration, Congress, and the nation lacked the political consensus and the information to credibly describe the effects of any single bill to reform the U.S. health care system. In that case, was the only option available to the administration to reach for goals far more modest than those it sought? Health care financing as a national political issue will not go away. Pressure to cut public spending to balance the budget means that medicare and medicaid will stay in the legislative spotlight; the retirement of the baby-boom generation in the beginning of the next century promises large increases in the cost of medicare; and a flood of new and costly medical technologies will continue to put financial pressure on everyone responsible for paying for health insurance. But, as this book illustrates, the nature of the debate inthe years after the demise of the Clinton plan will be altogether different from that of the past several decades.

This timely guide to communication in patient-centered medicine argues for greater clarity in explaining health risks versus benefits of an array of screening tests, procedures, and drug regimens. It reviews the growing trend toward patients' involvement in their own care, particularly in terms of chronic conditions, and details approaches physicians can use to prepare patients (and themselves) for collaborative decision-making based on informed choices and clear, meaningful knowledge. Chapters apply this lens to a wide range of common interventions as contentious as estrogen replacement therapy and antibiotics, and as widely prescribed as the daily aspirin and the annual physical. With this goal in mind, the authors also introduce an innovative decision-making tool that translates risks and benefits into a clear graphic format for fewer chances of miscommunication or misunderstanding. Among the topics covered: Involving the patient in decision making. Towards a universal decision aid. BRCT: the Benefit/Risk Characterization Theater. Breast Cancer Screening-Mammograms. Prostate Cancer Screening. Colon cancer screening with colonoscopy. Screening for and treating dementia. Statins, cholesterol, and coronary heart disease. Physicians in family and internal medicine will find Interpreting Health Benefits and Risks: A Practical Guide to Facilitate Doctor- Patient Communication a valuable resource for communicating with patients and new possibilities for working toward their better health and health education. This book considers several common and important situations where faulty decision-making makes overtreatment a serious risk. Clear, fair, referenced, and useful information is provided. And a powerful intuitive technique is introduced which allows patient and doctor to talk as equals as they work together in the exam room. The authors emphasize that some patients who have been fully educated will still accept high risks of harm for a small chance of avoiding premature death. But as this book is accepted and its ideas and technique are extended, I feel sure that net harm to patients will be curtailed. And what is more, the integrity of the decision-making process will be improved. -Thomas Finucane, MD, Professor of Medicine, Division of Gerontology and Geriatric Medicine, The Johns Hopkins University School of Medicine

This book covers the new field of healthcare organization ethics from theory to practical application. It can be used as a text for courses on the subject, as a reference for those interested in the present status of the field, and as a practical guide for healthcare executives, clinicians and committee members who are beginning to develop an organizational ethics program for their institution.

IT in Pharmacy: An Integrated Approach aims to describe and discuss the major areas of pharmacy IT innovation (e-prescribing, drug databases, electronic patient records, clinical decision support, pharmacy management systems, robots and automation etc) from a systems and a professional perspective. It will also consider how the areas of pharmacy IT link together and can be used to enable and develop pharmacy professional practice. The book will examine pharmacy IT from an international perspective, taking into account all parts of the world where IT systems are used in pharmacy practice - namely - North America, the UK, Western Europe and Australia - and will compare pharmacy IT in the different regions. This book is from the author of Principles of Electronic Prescribing (Springer, 2008)

The book examines applications in two disparate fields linked by the importance of valuing information: public health and space. Researchers in the health field have developed some of the most innovative methodologies for valuing information, used to help determine, for example, the value of diagnostics in informing patient treatment decisions. In the field of space, recent applications of value-of-information methods are critical for informing decisions on investment in satellites that collect data about air quality, fresh water supplies, climate and other natural and environmental resources affecting global health and quality of life.

This book is an introduction to health care as a complex adaptive system, a system that feeds back on itself. The first section introduces systems and complexity theory from a science, historical, epistemological, and technical perspective, describing the principles and mathematics. Subsequent sections build on the health applications of systems science theory, from human physiology to medical decision making, population health and health services research. The aim of the book is to introduce and expand on important population health issues from a systems and complexity perspective, highlight current research developments and their implications for health care delivery, consider their ethical implications, and to suggest directions for and potential pitfalls in the future.

Health has been conceptualized by world and national health organizations (WHO, CDC, Healthy People 2010) as more than the absence of disease. It involves a focus on physical, psychosocial, and functional aspects of life as well as the prevention of future illnesses. At this point in the development of quality health care for cancer survivors, there is sufficient knowledge and expert opinion to push efforts forward to improve the health of cancer survivors. Clearly there is more research in the most prevalent forms of cancers (e.g., breast cancer) than others that provide us with guidance on how to optimize their health, but there are data on other forms of cancers that can also better inform practice. There may also be general care practices that can cut across cancer types. There has been an emergence of epidemiological and clinical research in cancer survivors that can form the basis for a revolution in the quality and nature of health care that survivors receive. This book not only provides the reader with diverse perspectives and data but also integrates this information so it can serve as the foundation necessary to improve and maintain the health of cancer survivors. Reporting of symptoms to health care providers is a complex, multi-determined problem influenced not only by the pathophysiology but also, as we have learned over the years through pain research, by societal, cultural, and biobehavioral factors. This book will consider this important aspect of follow-up for millions of cancer survivors because of the strong reliance on symptom reporting for clinical decision making. In order for us to generate meaningful and effective treatment, we need to better understand the symptom experience in cancer survivors. This book provides much information that will assist us to better understand and manage this complicated end point. The presenting problems need to be articulated and "conceptualized" as clearly as possible by both parties so appropriate actions can be taken. Since health care costs are a major concern for patients, payers, and providers, this area will also be addressed in all the relevant sections. In taking an interdisciplinary perspective, this book illustrates the importance of a team approach to the improvement of health care and associated health, well-being, and functioning in cancer survivors. The 17 chapters cover critical topics of which physicians and providers of all types must be aware in order to provide the most comprehensive and responsive care for cancer survivors. All of the clinical care chapters include case studies to illustrate the real-world application of these approaches in cancer survivors. Information about sources of referral both within and outside the traditional health care communities will be provided in tabular form. There is no other text that provides both an overview of the problems and their challenges, case illustrations of direct application, and the reality of reimbursement for such care. The editors hope that there may be no need for the clinician or the survivor to adapt to a "new normal" if the presenting problems are understood and handled from an interdisciplinary perspective as outlined here.

What are the possibilities for process mining in hospitals? In this book the authors provide an answer to this question by presenting a healthcare reference model that outlines all the different classes of data that are potentially available for process mining in healthcare and the relationships between them. Subsequently, based on this reference model, they explain the application opportunities for process mining in this domain and discuss the various kinds of analyses that can be performed. They focus on organizational healthcare processes rather than medical treatment processes. The combination of event data and process mining techniques allows them to analyze the operational processes within a hospital based on facts, thus providing a solid basis for managing and improving processes within hospitals. To this end, they also explicitly elaborate on data quality issues that are relevant for the data aspects of the healthcare reference model. This book mainly targets advanced professionals involved in areas related to business process management, business intelligence, data mining, and business process redesign for healthcare systems as well as graduate students specializing in healthcare information systems and process analysis.