This unique collection of chapters from world experts on person-centered outcome (PCO) measures addresses the following critical questions: Can individual experiences be represented in measurements that do not reduce unique differences to meaningless uniformity? How person-centric are PCO measures? Are PCO measurements capable of delivering the kind of quality assured quantification required for high-stakes decision making? Are PCO measures likely to support improved health care delivery? Have pivotal clinical studies failed to deliver treatments for diseases because of shortcomings in the PCO measures used? Are these shortcomings primarily matters of precision and meaningfulness? Or is the lack of common languages for communicating outcomes also debilitating to quality improvement, research, and the health care economy? Three key issues form an urgent basis for further investigation. First, the numbers generated by PCO measures are increasingly used as the central dependent variables upon which high stakes decisions are made. The rising profile of PCO measures places new demands for higher quality information from scale and test construction, evaluation, selection, and interpretation. Second, PCO measurement science has well-established lessons to be learned from those who have built and established the science over many decades. Finally, the goal in making a PCO measurement is to inform outcome management. As such, it is vitally important that key stakeholders understand that, over the last half century, developments in psychometrics have refocused measurement on illuminating clinically important individual differences in the context of widely reproduced patterns of variation in health and functioning, comparable scale values for quality improvement, and practical explanatory models. This book's audience includes anyone interested in person-centered care, including healthcare researchers and practitioners, policy makers, pharmaceutical industry representatives, clinicians, patient advocates, and metrologists. This is an open access book.

This book provides a basic introduction to geriatric telepsychiatry, including potential benefits and drawbacks of utilizing this treatment modality. The text discusses applications in academic, public, federal, and educational settings and suggests practical guidelines for implementing and maintaining a telepsychiatry program. As the elder population continues to grow over the next several decades, digital tools, including videoconferencing, will play a large role in meeting the needs of the elderly. Written by the leaders in geriatric telepsychiatry, this text is the first to focus on the psychiatric application of these digital tools, lay out the policies and guidelines for treating patients who can benefit from this service, and outline the most cutting-edge research on the topic. Geriatric Telepsychiatry is the ultimate guide for psychiatrists, geriatricians, social workers, geriatric nurses, students, long-term care facilitators, and all medical professionals who work with the elderly psychiatric patient.

This practical resource provides hospitalists of all levels a comprehensive foundation for understanding the critical elements of hospital medicine. Beginning with an overview of the healthcare system, chapters provide relevant insights on management, regulations, evidence-based approaches, an awareness of safety and economic concerns and professional development skills. Perspectives on how hospitalist and hospital medicine teams can effectively engage this system to provide cost-effective, high-quality care are offered throughout this volume. With real-world guidance on the major tenets of hospital medicine, Hospital Medicine will serve as the definitive guide to a successful career in this rapidly evolving specialty.

"Nathan Tierney's powerful storytelling is rarely seen in today's health care business environment. We must redesign the health care delivery system---a team sport in service of patients, hold it accountable with measurement to improve outcomes, and quantify the resource costs over the full cycle of care. Value-based health care is a framework through which these goals are achieved, and Tierney provides a detailed playbook to get your organization there. Outlined in incredible detail and clarity, he presents core concepts and dives into the key metrics needed to build, maintain, and scale a successful value-based health care organization. Nathan shares a realistic vision of what any CEO should expect when developing their own Value Management Office. Nothing is more important to me than improving the lives of those I love. My personal mission is to create systemic change with an impact on the global stage. This playbook needs to be on the desk of every executive, clinician, and patient today." -Mahek Shah, MD, Senior Researcher and Senior Project Leader, Harvard Business School Our current healthcare system's broken. The Organization for Economic Co-Operation and Development (OECD) predicts health care costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients; all of which raises the demand for healthcare. In 2006, Michael Porter and Elizabeth Teisberg authored the book 'Redefining Health Care: Creating Value-Based Competition on Results.' In it, they present their analysis of the root causes plaguing the health care industry and make the case for why providers, suppliers, consumers, and employers should move towards a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Since 2006, Professor Porter, accompanied by his esteemed Harvard colleague, Profesor Robert Kaplan, have worked tirelessly to promote this new approach and pilot it with leading healthcare delivery organizations like Cleveland Clinic, Mayo Clinic, MD Anderson, and U.S. Department of Veteran Affairs. Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice. This book defines the practice of value-based health care as Value Management. The book explores Profesor Porter's Value Equation (Value = Outcomes/ Cost), which is central to Value Management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the Value Realization Framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery. The Value Realization Framework is based on Professor Kaplan's ground-breaking Balanced Scorecard approach, but specific to healthcare organizations. On the costs side, the book details the Harvard endorsed time-driven activity based costing (TDABC) methodology, which has proven to be a modern catalyst for defining HDO costs. Finally, this book covers the need and a plan to establish a Value Management Office to lead the delivery transformation and govern operations. This book is designed in a format where any organization can read it and acquire the fundamentals and methodologies of Value Management. It is intended for healthcare delivery organizations in need of learning the specifics of achieving the implementation of value-based healthcare.

Imagine: You are a hospital Chief Executive Officer, Chief Financial Officer, medical or nursing director, patient safety specialist, quality improvement professional, or a doctor or nurse on the front lines of patient care. Every day you're aware that patients and families should be more engaged in their care so they would fare better both in the hospital and after discharge; their care could be safer and more seamlessly coordinated; patients should be ready for discharge sooner and readmitted less often; your bottom line stronger; your staff more fulfilled. You enter into new payment models such as bundling with an uneasy awareness that your organization is at risk because you don't know what the care you deliver actually costs. Like most healthcare leaders, you are also still searching for a way to deliver care that will help you to achieve the Triple Aim: care that leads to improved clinical outcomes, better patient and family care experiences, and reduced costs. Sound familiar? If so, then it's time to read The Patient Centered Value System: Transforming Healthcare through Co-Design. This book explains how to introduce the Patient Centered Value System in your organization to go from the current state to the ideal. The Patient Centered Value System is a three-part approach to co-designing improvements in healthcare delivery-collaborating with patients, families, and frontline providers to design the ideal state of care after listening to their wants and needs. Central to the Patient Centered Value System is seeing every care experience through the eyes of patients and families. The Patient Centered Value System is a process and performance improvement technique that consists of 1) Shadowing, 2) the Patient and Family Centered Care Methodology, and 3) Time-Driven Activity-Based Costing. Shadowing is the essential tool in the Patient Centered Value System that helps you to see every care experience from the point of view of patients and families and enables you to calculate the true costs of healthcare over the full cycle of care. Fundamental to the Patient Centered Value System is the building of teams to take you from the currents state of care delivery to the ideal. Healthcare transformation depends not on individual providers working to fix broken systems, but on teams of providers working together while breaking down silos. The results of using the Patient Centered Value System are patients and families who are actively engaged in their care, which also improves their outcomes; providers who see the care experience from the patient's and family's point of view and co-design care delivery as a result; the tight integration of clinical and financial performance; and the realization of the Triple Aim.

This book is about being mindful in clinical practice and how mindfulness enhances the quality of patient care while adding depth and meaning to a clinicians' work. Chapters include narratives from clinicians who consciously apply mindfulness in real life settings. Authors from various settings provide examples that capture how emergent mindfulness is. Mindful Medical Practice demonstrates to physicians, residents and students how mindfulness enriches both their practices and lives.

The Health Care Data Guide is designed to help students and professionals build a skill set specific to using data for improvement of health care processes and systems. Even experienced data users will find valuable resources among the tools and cases that enrich The Health Care Data Guide. Practical and step-by-step, this book spotlights statistical process control (SPC) and develops a philosophy, a strategy, and a set of methods for ongoing improvement to yield better outcomes.

Provost and Murray reveal how to put SPC into practice for a wide range of applications including evaluating current process performance, searching for ideas for and determining evidence of improvement, and tracking and documenting sustainability of improvement. A comprehensive overview of graphical methods in SPC includes Shewhart charts, run charts, frequency plots, Pareto analysis, and scatter diagrams. Other topics include stratification and rational sub-grouping of data and methods to help predict performance of processes.

Illustrative examples and case studies encourage users to evaluate their knowledge and skills interactively and provide opportunity to develop additional skills and confidence in displaying and interpreting data.

Companion Web site: www.josseybass.com/go/provost

Evidence Synthesis in Healthcare - a Practical Handbook for Clinicians is the first book to reveal the field of Evidence Synthesis, by combining multiple sources of quantitative/qualitative data to derive the best evidence for use in healthcare. Through the use of clearly explained examples and practical explanations, Evidence Synthesis in Healthcare - a Practical Handbook for Clinicians describes the practical tools, techniques, uses and policy considerations of evidence synthesis techniques in modern healthcare practice.

Despite effective approaches to prevention, STD and HIV infection rates remain fairly constant. Targeting, implementation, and monitoring of interventions have posed widespread problems, and the recent spate of cuts to prevention budgets has made these roadblocks even more challenging. It is clear that working in sexual health requires both a deeper understanding of STI/HIV epidemiology and an ongoing quest for up-to-date, realistic prevention strategies. The New Public Health and STD/HIV Prevention offers readers leading-edge access to both. Focusing on social determinants of sexual health, at-risk populations, critical factors in approaches to prevention, and reviews of new research, this authoritative volume explores areas as varied as HPV prevention, technology-based interventions, migration as a factor in disease transmission, and competencies key to effective leadership in the field. Dispatches from the frontlines of theory, research, and practice in the U.S. and abroad include: Personal risk, public impact: balancing individual rights and STD/HIV prevention. Distribution of prevention resources and its impact on sexual health. Prevention measures in diverse populations of women. Toward a better approach to preventive interventions with men who have sex with men. Adolescent sexual health and STIs. Reducing disparities in sexual health: lessons from the campaign to eliminate infectious syphilis. Public health professionals of all backgrounds interested in or working in improving sexual health will find The New Public Health and STD/HIV Prevention an indispensable guide to conceptualizing the problems and clarifying possible solutions.

Oncofertility integrates the two previously distinct fields of cancer treatment and fertility research and aims to explore and expand the reproductive future of cancer survivors. In order to achieve the goal of fertility preservation, the Oncofertility community must focus on communication and the way data is provided and received. Concomitant with the rapidly changing technology of Oncofertility, there have been radical shifts and advances in the way health educators and clinicians can produce and share information. As success rates of reproductive techniques such as egg freezing and banking continue to rise, providing increasing opportunities for young cancer patients to preserve their fertility prior to the onset of cancer treatments, communication among professionals in oncology, reproductive medicine, and psychosocial work, among others, becomes crucial, and clinical demand for Oncofertility information is expected to rise considerably. Oncofertility Communication describes and addresses the myriad channels through which the multiple audiences involved in Oncofertility can be served with appropriate and accurate information about cancer-related fertility issues. The text answers frequently asked questions and provides invaluable insights to scientific and health care professionals about communication among the diverse Oncofertility audiences. It incorporates timely discussions about traditional and emerging electronic communication tools and discusses the impact of health care policy changes on the Oncofertility field.

Focusing on practical, patient related issues, this volume provides the basic concepts of Evidence Based Medicine (EBM) as they relate to Pathology and Laboratory Medicine and presents various practical applications. It includes EBM concepts for use in the identification of cost-effective panels of immunostains and other laboratory tests and for improvement of diagnostic accuracy based on the identification of selected diagnostic features for particular differential diagnosis. EBM concepts are also put forth for use in Meta-analysis to integrate the results of conflicting literature reports and use of novel analytical tools such as Bayesian belief networks, neural networks, multivariate statistics and decision tree analysis for the development of new diagnostic and prognostic models for the evaluation of patients. This volume will be of great value to pathologists who will benefit from the concepts being promoted by EBM, such as levels of evidence, use of Bayesian statistics to develop diagnostic and other rules and stronger reliance on "hard data" to support therapeutic and diagnostic modalities.

Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting is a landmark title in the field, offering a clear, detailed, and cohesive call by leading experts for coordinated care for patients with concurrent psychiatric and medical conditions. The renowned editors and authors argue that what is slowly occurring, and greatly needed at a faster pace, is nothing less than a sea change in the way that psychiatric care will be delivered. The current, mostly segregated, medical and psychiatric model of care has led to the development of competing medical and psychiatric subcultures that have resulted in a lack of dialog among health providers, administrators, and payers - and thus in less than optimal patient outcomes. To remedy this problem, the book offers a practical, insightful road map to achieving the central tenet of health reform - truly coordinated, patient-centered care where the care experience for the patient, the medical care itself, and the cost outcomes improve as the system changes from fee-for-service to population-based health. An invaluable reference for all clinicians, policy makers, payers, administrators, and others interested in the debate surrounding healthcare systems, Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting is a major contribution to the literature and a gold standard resource.

The gap between a rising demand for health care services on the one side and scarce resources on the other, is leading to a growing pressure on decision-making processes. Hence, prioritization in medicine has become an increasingly important issue for assuring stability of health systems and improving the capability of health care. The present volume addresses normative dimensions of methodological and theoretical approaches, the legal basis behind priority setting as well as international experiences concerning the normative framework and the process of priority setting. It also examines specific criteria for prioritization and discusses economic evaluations. Contributing authors from a broad range of scientific disciplines discuss prioritization within an international dialogue.

This concise and practical book is the first of its kind to examine the use of assisted reproductive technologies (ART) in relation to blood-borne infectious diseases: human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV). The book opens with a discussion of the impact of these viruses on male and female fertility, followed by specific chapters of each of them, including ART with HIV and HCV serodiscordant couples (where either the male or female is positive) and the detection and impact of HBV and HCV in human gametes and embryos. An important character on laboratory safety when performing ART with blood-borne viruses follows, and the book concludes with a discussion of ART in austere and resource-poor settings, where these infections are often dominant due to lack of treatment and access to vaccines. Written and edited by an international array of experts in reproductive medicine, Assisted Reproductive Technologies and Infectious Diseases explores questions, techniques, and related issues with the aim of effectively helping clinicians working with serodiscordant couples wishing to have children.

Globally, the health sector faces significant demands for reform and improvement to meet the needs of the 21st Century. To achieve that goal, highly sophisticated and capable leaders are required across all dimensions of the health system. This book describes the key challenges that demand reform, why better leadership is the source code for better system performance, and the issues that stand in the way of getting that leadership. It includes substantive treatment of the modern democratic challenges that healthcare leaders face; and the essence of what it means to be a leader in today's world. The essence of leadership itself is described, and the case made for the need for people to use the workplace as the place to develop leadership rather than relying solely on formal programs. It will also outline a self-directed learning process that any individual leader-citizen, clinician, or senior executive-can use to develop their own leadership capability, and thus become more active as a leader of change. This book addresses the need for leaders to think on a system-wide scale. A second part of the book focuses primarily on the Canadian Health system and LEADS in a Caring Environment capabilities framework, and the link between LEADS and frameworks in Australia and the UK. LEADS was developed through a partnership between members of the Healthcare Leaders Association of British Columbia and the Canadian College of Health Leaders, the Canadian Health Leadership Network and Royal Roads University. Currently it is stewarded by a not-for-profit collaboration that has endorsed LEADS as an evidence-informed set of national expectations for Canadian health leaders. LEADS has been endorsed by many health organizations in almost all provinces in Canada as a foundation for their talent management programs in leadership (development and succession planning). The book will address the research foundations for the LEADS framework; how it was developed; the framework's contents; its congruence with other national frameworks, and how LEADS can be used as a model to envisage and plan change.

This revised edition covers all aspects of public health informatics and discusses the creation and management of an information technology infrastructure that is essential in linking state and local organizations in their efforts to gather data for the surveillance and prevention. Public health officials will have to understand basic principles of information resource management in order to make the appropriate technology choices that will guide the future of their organizations. Public health continues to be at the forefront of modern medicine, given the importance of implementing a population-based health approach and to addressing chronic health conditions. This book provides informatics principles and examples of practice in a public health context. In doing so, it clarifies the ways in which newer information technologies will improve individual and community health status. This book's primary purpose is to consolidate key information and promote a strategic approach to information systems and development, making it a resource for use by faculty and students of public health, as well as the practicing public health professional. Chapter highlights include: The Governmental and Legislative Context of Informatics; Assessing the Value of Information Systems; Ethics, Information Technology, and Public Health; and Privacy, Confidentiality, and Security. Review questions are featured at the end of every chapter. Aside from its use for public health professionals, the book will be used by schools of public health, clinical and public health nurses and students, schools of social work, allied health, and environmental sciences.

This book introduces the concepts contributing to healthcare organizational excellence and is designed to aid organizations seeking to embed a culture of excellence through a variety of established programs. The book focuses on identifying organizational excellence as derived from the literature, high reliability organizations (HROs), and nationally recognized programs, including the ANCC Magnet Recognition Program®, ANCC Pathway to Excellence® Program, and Accreditation programs. The authors explore concepts that are relevant to achieving organizational excellence and provide tools to help analyze gaps and determine steps forward in the pursuit of organizational excellence.

This book is one of the first to comprehensively summarise the latest thinking and research in the rapidly evolving field of quality management in intensive care. Quality indicators and outcome measures are discussed with a practical focus on patient-centred, evidence-based implementation for safer and more effective clinical practice. Chapters on topics such as teambuilding, patient satisfaction, mortality and morbidity, and electronic management systems are organised into three sections, covering quality management at the scale of the individual patient, the intensive care unit, and the national and international level. Written by a team of over forty international experts in the specialty, with editors who have been heavily involved for many years with the European Society of Intensive Care Medicine, the book reflects commonly accepted goals and guidelines for best practice, and will be valuable for practitioners worldwide. The ideal one-stop resource for intensive care physicians as well as ICU and hospital managers.

"Understanding ICD-9-CM Coding: A Worktext, 3rd Edition" will help your students gain confidence in ICD-9-CM diagnostic and procedural coding. This text, updated with the 2010 coding changes and ICD-9-CM Official Guidelines for Coding and Reporting, is a comprehensive, hands-on worktext. It contains practice exercises throughout that help your students test themselves and illustrations of human anatomy and surgical procedures that clarify concepts, as well as medical abbreviations relating to body systems. When used in conjunction with a coding manual, this worktext will help your students master ICD-9-CM coding for all medical specialties.

Healthcare faces unprecedented global challenges. Rapid advances in genomics, computational sciences, and technology - as well as the new focus on value-based care and an increased trend toward healthcare commercialization - represent disruptive changes to an already-fragmented delivery system. The healthcare establishment has been slow to adapt, and now faces rising cancer-care costs and lags in outcome improvement and genomically informed interventions. Managing Disruptive Change in Healthcare codifies the US National Cancer Institute's lessons from utilizing a public-private partnership with community hospitals to navigate the change needed to increase patient access to high-quality cancer care, and enhance hospitals' capacity to conduct and support research initiatives. The treatment of complex diseases requires a delivery system capable of translating scientific advances into care that is coordinated across the full continuum; this book offers a blueprint to just such an infrastructure.

Choose the book designed by coders for coders! Buck's 2020 ICD-10-PCS includes all the ICD-10-PCS codes you need to know to ensure the most accurate billing and reimbursement for in-patient medical procedure coding. As coders need extensive knowledge to code with ICD-10-PCS - and to choose from the thousands of possible codes - this edition provides colorful Netter's Anatomy illustrations and tables organized to simplify the process of choosing and building procedure codes. It comes with durable spiral binding and includes a companion website with the latest coding news and updates. ICD-10-PCS Official Guidelines for Coding and Reporting (OGCR) provide easier reference to coding rules when they are needed most. Convenient Guide to the Updates in the front of the book lists all new, revised, and deleted codes, providing at-a-glance lookup of the coding changes. Unique! Full-color Netter's Anatomy art is included in the front of the book to help you understand complex anatomic information and how it may affect choosing codes. American Hospital Association's Coding Clinic (R) citations include official ICD-10-PCS coding advice relating to specific codes and their usage. Hospital Acquired Condition (HAC) symbol notes procedures related to HACs as outlined in the MS-DRG. Symbols for Non-covered and Limited-Coverage procedures indicate related material outlined in the Definitions of Medicare Code Edits. Sex edits from the Definition of Medicare Code Edits denote codes that are used only with patients of a specific sex. Non-Operating Room Procedure symbols identify procedures that do and do not affect MS-DRG assignment. Combinations symbol identifies procedures that can affect MS-DRG assignment. Online Appendix E: Procedure combination table, displays each procedure cluster and the corresponding DRG, as well as a few procedure combinations that are designated as non-OR. NEW! Updated 2020 Official Code set reflects the latest ICD-10 codes needed for procedural coding.

Despite all the jokes about the poor quality of physician handwriting, physician adoption of computerized provider order entry (CPOE) in hospitals still lags behind other industries' use of technology. As of the end of 2010, less than 22% of hospitals had deployed CPOE. Yet experts claim that this technology reduces over 80% of medication errors and could prevent an estimated 522,000 serious medication errors annually in the US. Even though the federal government has offered $20 billion dollars in incentives to hospitals and health systems through the 2009 stimulus (the ARRA HITECH section of the American Recovery and Reinvestment Act of 2009), many organizations are struggling to implement advanced clinical information systems including CPOE. In addition, industry experts estimate that the healthcare industry is lacking as many as 40,000 persons with expertise in clinical informatics necessary to make it all happen by the 2016 deadline for these incentives. While the scientific literature contains numerous studies and stories about CPOE, no one has written a comprehensive, practical guide like Making CPOE Work. While early adopters of CPOE were mainly academic hospitals, community hospitals are now proceeding with CPOE projects and need a comprehensive guide. Making CPOE Work is a book that will provide a concise guide to help both new and experienced health informatics teams successfully plan and implement CPOE. The book, in a narrative style, draws on the author's decade-long experiences of implementing CPOE at a variety of academic, pediatric and community hospitals across the United States.