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.

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.

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.

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.

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 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.

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.

This completely revised and updated edition of an outstanding text addresses the fundamental knowledge of epidemiological methods and statistics that can be applied to evolving systems, programs, technologies, and policies. This edition presents new chapters on causal thinking, ethics, and web resources, analyzes data on multinational increases in poverty and longevity, details the control of transmissible diseases, and explains quality management, and the evaluation of healthcare system performance.

This text is directed at every student of medicine regardless of level of training or specialty ambitions. Without imparting any education in medicine per se, each chapter teaches the prospective medical trainee the art of being a physician. The reader will be convinced early on, that there is more to being a good doctor than medical school didactics. They will learn what residency admission chiefs, interviewers and faculty are most impressed with in an applicant. The first few chapters speak of the importance of, and being the best student of medicine that one can be. An extensive review of the most current government mandated laws, rules and regulations are in dedicated chapters throughout the text and can be used as a ready reference. The book brings to the reader the very up-to-date and new concepts of the ever confusing and changing realm of managed care. Additionally, one of the main purposes of this book, is to introduce to the student of medicine the use and need of advisors and mentors. This chapter entitled "Mentors" embellishes the age old tradition of true mentoring in medicine, a practice which is just now reviving itself. Medical students, trainees, and practicing physicians at all levels have had an integral part in reviewing and making the chapters more relevant to today's highly competitive and complicated playing field. The Portable Medical Mentor: Training Success addresses every facet of "how to be a good physician" in an easy to read and down to earth, practical fashion. It is intended that once read, the student will be more competitive in residency applications, better thought of as a physician, by peers, and patients, and more comfortable in their chosen specialty.

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.

Leadership and management in the context of healthcare is about improving the quality of medical care delivered at all levels. Doctors frequently lead healthcare teams with responsibility for significant clinical resource which requires management and leadership skills regardless of specialty. A growing body of literature has also argued that medical leadership plays an integral part in the success and effectiveness of organisational change in the health sector. Being an effective medical leader requires a different set of skills from being a good clinician. It is therefore important that future medical graduates are supported and equipped with the high-level skills required for their role (e.g. leading and developing multidisciplinary teams, understanding organizational systems, processes and interdependencies, redesigning services and working collaboratively with a wide range of stakeholders). This growing interest across the globe in preparing medical graduates for the role of medical manager and leader requires a comprehensive approach to education and training which begins at an undergraduate level. As an undergraduate these skills are frequently neglected or not taught well. However, with the correct resources and using a case-based approach the undergraduate program can easily support the development of practical leadership and management skills. The case studies and supporting text will provide an overview of the fundamentals of leadership theory and practice relevant to medical students, junior doctors and specialty trainees. Using internationally recognized competency frameworks this book will support the acquisition of knowledge and skills relevant to medical management and leadership such as project management, intelligent leadership, presentation skills, audit, organizational decision making and engaging relevant stakeholders.

As Dr. Cullen's chapter on information technology points out, what is required is not just a new electronic system that follows the patients, but a new language that creates and defines a system that can appropriately care for the patient. What we design for the complexities of caring for the medically underserved can serve as model for caring for everyone in this country. Many innovative, bold, and wonderful solutions have been developed as local/ regional models. As communities and states we can learn from, and support, each other. But the local models are not, by and large, self-sustaining. Ultimately, so- tions to the lack of medical insurance in this country will require a national persp- tive, and federal funding. That is part of the work we all must do, and Dr. Dalen's chapter points out some of the possibilities and pitfalls other countries have experienced. When I wonder how the system we have hasn't already collapsed from its own weight, I just need to look at the people working within it. Healthcare is a service industry, and we have been blessed with professionals who understand and live the concept of service in their daily lives, who go the extra mile for the patient despite the vagaries, the barriers, and the sometimes mean spiritedness of the organi- tional infrastructure.

This book is designed to provide physicians with the information they need in applying business management skills to their medical practice. It covers management and leadership practices, financial planning and execution, hospital governance, managed care, marketing activities, and medical business law. Written for the physician in easily understandable language, it describes each concept, delineates its applications in various practice environments and provides insight into the future developments in each sector.

This book focuses on the innovative and more critical management approach adopted in the PA (Public Administration) in order to identify and describe the main models and instruments to economically evaluate the decision making process in accordance to the specific conditions such as efficiency, effectiveness, cost and equity. The manuscript pays special attention to this sector by identifying, investigating and applying the main evaluation models (logic and methods) of the decision making process, in particular in terms of investment decisions. In the recent decades, with reference to PA, several managerial approaches have been developed from a business management perspective. These managerial approaches differ in terms of variables analyzed, such as the role of governance or the specific logics and mechanisms applied, but all of them have a common goal, which is the improvement of efficiency, effectiveness, economic and equitable decision making and operations in the PA. This book investigates the different mentioned frameworks adopting a wider and integrated analysis perspective on the evaluation of investments in the health care system.

If you believe that the latest blockbuster medication is worth a premium price over your generic brand, or that doctors have access to all the information they need about a drug's safety and effectiveness each time they write a prescription, Dr. Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In "Powerful Medicines, "he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced.
This is a comprehensive behind-the-scenes look at issues that affect everyone: our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.
In this engagingly written book, Dr. Avorn asks questions that will interest every consumer: How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation's drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?
Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry's own marketing techniques to reduce use of some of the most overprescribed and overpriced products. "Powerful Medicines" offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible.
This is a passionate and provocative call for action as well as a compelling work of clear-headed science.

"From the Hardcover edition."

Many doctors want to know more about the FDA not only so that they might better understand the issues and how they are related to their practice, such as off label-drug usage, but also to enrich their professional lives and allow them to more deeply understand the many FDA related articles written in the popular press. It is further based on the notion that doctors prefer a formal way to learn about FDA. The Agency is a truly vast subject engaging thousands of lawyers, regulators, scientists, physicians, writers, legislators and many others directly and indirectly. This book is an introductory overview written from a physician's perspective for physicians. It is organized along lines that emphasize issues most interesting to physicians. Much of it deals with nomenclature and definitions, since as is true of all fields, one must understand the special concepts and vocabulary of the field.

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.

Thermal harm is one of the most traumatizing assaults on man and his environment. Whether suffered by living beings as burn injury, or sustained by societal structures as fire damage, the resulting physical pain and material loss can be extremely distressing both to the person and to society. The health professions and in particular burn specialists have been continually developing effective means of combating burn disease and promoting rehabili tation of the victims, especially in mass casualty situations. In parallel, various levels of the community have been mobilizing fire prevention and fire-fighting mechanisms that protect society and the environment from the ever-increasing hazards of fire disasters. It is therefore surprising that, while aiming at the same objective, the two sectors have rarely come together; doctor has rarely worked with fire chief. Yet both disciplines have so much to learn from and contribute to each other's efforts. The Mediterranean Burns Club is a professional organization that brings together persons concerned with burn therapy and fire safety in all forms, especially in the countries of the Mediterranean basin. It is honoured to have been identified by the United Nations as a premier scientific body in its field within the programme of the International Decade for Natural Disaster Reduction. It is therefore natural that it should have initiated an international gathering of specialists engaged in burns as a surgical, clinical problem, and of counterparts dealing with fires as a societal, disaster management problem."

While the use of database technology is ubiquitous throughout IT (and health IT in particular), it is not generally appreciated that, as a database increases in scope, certain designs are far superior to others. In biomedical domains, new knowledge is being generated continually, and the databases that must support areas such as clinical care and research must also be able to evolve while requiring minimal or no logical / physical redesign. Appropriately designed metadata, and software designed to utilize it effectively, can provide significant insulation against change. Many of the larger EMR or clinical research database vendors have realized this, but their designs are proprietary and not described in the literature. Consequently, numerous misconceptions abound among individuals who have not had to work with large-scale biomedical systems, and graduates of a health or bioinformatics program may find that they need to unlearn what they were taught in database and software design classes in order to work productively with such systems. A working knowledge of such systems is also important for individuals who are not primarily software developers, such as health informaticians, medical information officers and data analysts. This book is, in a sense, intended to prepare all of the above individuals for the real world.

The first edition of Infection Prevention reviewed evolving areas in infection prevention on topics including contact precautions, technology implementation, specific infections, and care in various settings. It summarized the current data on infection prevention, presents controversies on the various topics, and includes recommendations for patient safety. Addressing hot topics such as MRSA, C. difficile vaccination, mandatory flu vaccines, and CLABSI, this is the only text to include prevention and control overviews across a range of infection issues. Written by experts in the field, this successor edition will update current chapters on the most cutting-edge models of care on emerging and evolving topics in infectious diseases. It will also include new material and chapters on high-level disinfection, diagnostic test stewardship, unique pathogens units, outpatient antibiotic stewardship, outpatient antibiotic therapy, as well as a chapter on infection prevention metrics: how much can we prevent healthcare associated infections and how hard should we try. The second edition of Infection Prevention: New Perspectives and Controversies is a valuable resource for infection prevention professionals, healthcare quality and safety professionals, caring for patients in in- and outpatient settings.

This work aims to deepen our understanding of the role played by technical guidelines and tools for the design, construction and operation of healthcare facilities, ultimately establishing the impact of the physical environment on staff and patient outcomes. Using case studies largely drawn from the UK, Europe, China and Australasia, design approaches such as sustainability (e.g. targets for energy efficiency, carbon neutrality, reduction of waste), evidence-based design (EBD), and Post-Project Evaluation (PPE) are examined in order to identify policies, mechanisms and strategies that can promote an integrated learning environment that in turn supports innovation in healthcare.

The US healthcare system faces numerous difficulties: uncontrolled increases in costs; major access problems; doctor shortages; closing practices; inefficiencies; decreasing revenues; shrinking bottom lines; large numbers of uninsured and underinsured patients; and the upcoming increased demands in service posed by the Affordable Care Act. As a result, many physicians and health care organications are turning to group visits to address these problems. While Dr. Noffsinger's textbook Running Group Visits In Your Practice is the cornerstone reference on designing, implementing and running shared medical appointments (SMAs) in one's practice, it lacks the simplicity and practicality that clinicians are looking for to start their own SMA programs. The ABCs of Group Visits is a practical, streamlined and step-by-step guide focused on the implementation aspects of group visits.Healthcare professionals at every level are looking for alternate ways to deliver high quality care at lower cost, and it is clear to many that group visits provide a care delivery model that will address many of today's critical challenges. The ABCs of Group Visits quickly provides a solution for your busy practice."

Das mitwirkende Verschulden im Zivilrecht wird gemeinhin als spezielle Auspragung des Grundsatzes von Treu und Glauben verstanden. Die Arbeit versucht, den Normbezug des Mitverschuldens am Beispiel der Arzthaftung nachzuweisen. Ausgehend vom versicherungsrechtlichen Begriff der Obliegenheit werden typische Fallgruppen schadensvermeidenden und schadensmindernden Patientenverhaltens entwickelt.