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A groundbreaking history of aging in the US and an innovative
blueprint for revolutionizing geriatric care from Northwell Health,
New York's largest health care system. The New York Times described
Dr. Robert Butler as "the man who saw old age anew." In his 1975
book Why Survive: Being Old in America, Butler argued that for far
too many people old age was "a period of quiet despair . . . and
muted rage" and he set out to mitigate it. Nearly five decades
since he penned his book, a devoted band of brilliant physicians
and others in the healthcare field have realized at least a portion
of Butler's dream: to recognize and alleviate suffering among the
aging. The Aging Revolution is the story of Butler and his
disciples: women and men who saw older distressed adults in
hospitals and homes, and worse: being ignored by most of the
medical establishment. These revolutionaries could not ignore the
suffering, and they set out--individually and collectively--to
create entirely new ways of caring for aging adults to ease their
suffering and improve their quality and length of life. This
revelatory book tells a story never-before told in its entirety,
recounting the one of the most significant periods of improvement
in American medical history. Readers will learn about pioneering
individuals, concepts, and ideas that have improved the lives of
millions, including: the women who placed the spotlight on delirium
and falls--major issues for older adults; the campaign to build and
spread Geriatric and Palliative Care; the small bands of doctors
who worked the halls of Congress to create a new program that
provides primary care along with home visits from healthcare
professionals; and the New York-based foundation that has devoted
its mission and millions exclusively to improving care and quality
of life for aging adults. Today, as a result, chronic conditions
that almost always accompany old age are far more manageable. Older
people enjoy more options for work and professional development,
for education, for leisure and travel, for sports and maintaining
physical strength and mobility. For increasing numbers of
Americans, life is healthier and richer in the experiences that
matter most. Yet, aging in America can still be a challenge and,
too often, particularly for the poor, a painful struggle. The range
of mental and physical well-being has almost infinite variations:
ninety-year-olds running marathons; sixty-five-year-olds
incapacitated by stroke. While this book celebrates the incredible
progress and strides made in this field, it also highlights areas
that need improvement. The authors lay out specific steps that, if
implemented, could super-charge the aging revolution and
drastically diminish the total volume of older adults suffering in
America.
The moving story of an Irish immigrant's life, from a
poverty-stricken childhood in Ireland to becoming a captain of
industry, After the Roof Caved In is a powerful,
poignant look at how hard work and education enabled one young man
to change his life and circumstances completely. Today,
Michael J. Dowling is president and CEO of Northwell Health, New
York state's largest healthcare provider and private employer, with
over 68,000 employees and over 700 facilities. But he grew up in
deep poverty in the village of Knockaderry in rural Ireland, in a
small home without running water or a stable roof, in a family with
little hope for improvement and a place with little
opportunity—and he overcame it all to become wildly
successful. After the Roof Caved In is Dowling's
rags-to-riches story of his life and journey from his destitute
youth to his realization of the power of education and his eventual
departure from his home to attend university in Cork, and onward
through his life as he gradually improved himself and his
circumstances. Full of memories both fond and painful, this
powerful memoir examines the family dynamics of his
childhood—including the lives of his deaf mother and arthritic
father—as well as the social systems of the time, the politics
and concerns of the day, and the way a variety of disparate events
came together to help Dowling change his life completely. Most
importantly, it chronicles his lifelong effort to rise above the
circumstances into which he was born and to create the sort of life
he dreamed possible. For anyone interested in the stories of
immigrants, the experiences of the Irish in the mid-20th century,
or the value of hard work and education in changing one's
life, After the Roof Caved In is an essential read, and
a heartfelt, deeply moving meditation on an extraordinary
life.Â
We are in the midst of what may well be the most confusing,
turbulent period in the history of modern medicine. This book seeks
to cut through the fog and confusion that enshrouds the health care
industry to provide clarity on where the industry stands today and
where it is headed. The book defines the major challenges in health
care through the journey of Northwell Health, one of the largest
provider organizations in the country. The central issues in what
is nearly one-fifth of the United States economy are played out
daily within this not-for-profit organization. Northwell is New
York state's largest workers, and $11 billion in annual revenue.
The book candidly portrays key leaders within Northwell on the most
vexing challenges in health care: How to provide primary and
specialty care spending; how to create and sustain an internal
system of continuous learning to enable employees at all levels to
stay current in an industry that is changing at warp speed; how to
provide emergency services in a world where natural disasters and
acts of terrorism are inevitable; how to identify new revenue
streams to offset reductions from Medicare and Medicaid; and how to
push outside the walls of hospitals and clinics to improve the
overall health of individuals and communities by working on
determinants of health beyond the typical medical practice. The
book exists at the intersection of medicine, business, social and
public policy. Harvard's Michael Porter has written widely on
health care arguing that it is time "for a fundamentally new
strategy," but what, exactly? Where is the industry headed? What do
the changes and the turbulence mean for patients, doctors, nurses?
This book is the product of a learning journey both humbling and
rewarding. Over time, lessons learned, improvements made,
innovations conceived, have advanced Northwell Health in ways that,
some years ago, might not have seemed possible. Northwell has
become a national leader not because it is perfect, but because it
remains steadfast in its journey to remain humble enough to know
that whatever success may be achieved, the journey is about
continuous learning and improvement. The goal of the book is to
provide a deeper, clearer understanding of what is happening in
health care and why; to help illuminate a pathway forward for
patients and caregivers most of all, but also for policy-makers and
the employers and others who pay for care.
Since adapting the principles of the Toyota Production System to
health care in 2002, Virginia Mason Health System has made enormous
leaps forward in quality, safety, patient experience of care, and
affordability. It has achieved world-class levels of patient
satisfaction and has been honored as one of the safest hospitals in
the country. A Leadership Journey in Health Care: Virginia Mason's
Story supplies an inside look at process improvement from the world
leader in applying Lean methods to health care. It presents key
lessons learned as well as the best practices developed at Virginia
Mason during its 12-year process improvement journey. Just as
important, Virginia Mason's culture of leadership at all levels
sets it apart from others in the health care universe. Describing
why it's critical for leadership to be actively involved in any
process improvement initiative, the book illustrates exactly what
leadership looks like at all levels within Virginia Mason. In the
book, bestselling author Charles Kenney introduces breakthrough new
work at Virginia Mason that most health care audiences have yet to
read about. He details the reasons why governance has played such a
big role in Virginia Mason's success and discusses a game-changing
initiative concerning respect for people. After reading this book,
you will better understand the active leadership style that has
propelled Virginia Mason's success. By following the best practices
and lessons learned, you will be prepared to teach, coach, and
encourage your team to achieve streamlined and standardized work,
sustained improvements, and increased patient satisfaction.
Foreword by Carolyn Corvi, Virginia Mason Health System/Virginia
Mason Medical Center Boards of Directors; Retired Vice President
and General Manager, Boeing Commercial Airplanes
The moving story of an Irish immigrant's life, from a
poverty-stricken childhood in Ireland to becoming a captain of
industry, After the Roof Caved In is a powerful, poignant look at
how hard work and education enabled one young man to change his
life and circumstances completely. Today, Michael J. Dowling is
president and CEO of Northwell Health, New York state's largest
healthcare provider and private employer, with over 68,000
employees and over 700 facilities. But he grew up in deep poverty
in the village of Knockaderry in rural Ireland, in a small home
without running water or a stable roof, in a family with little
hope for improvement and a place with little opportunity-and he
overcame it all to become wildly successful. After the Roof Caved
In is Dowling's rags-to-riches story of his life and journey from
his destitute youth to his realization of the power of education
and his eventual departure from his home to attend university in
Cork, and onward through his life as he gradually improved himself
and his circumstances. Full of memories both fond and painful, this
powerful memoir examines the family dynamics of his
childhood-including the lives of his deaf mother and arthritic
father-as well as the social systems of the time, the politics and
concerns of the day, and the way a variety of disparate events came
together to help Dowling change his life completely. Most
importantly, it chronicles his lifelong effort to rise above the
circumstances into which he was born and to create the sort of life
he dreamed possible. For anyone interested in the stories of
immigrants, the experiences of the Irish in the mid-20th century,
or the value of hard work and education in changing one's life,
After the Roof Caved In is an essential read, and a heartfelt,
deeply moving meditation on an extraordinary life.
Since adapting the principles of the Toyota Production System to
health care in 2002, Virginia Mason Health System has made enormous
leaps forward in quality, safety, patient experience of care, and
affordability. It has achieved world-class levels of patient
satisfaction and has been honored as one of the safest hospitals in
the country. A Leadership Journey in Health Care: Virginia Mason's
Story supplies an inside look at process improvement from the world
leader in applying Lean methods to health care. It presents key
lessons learned as well as the best practices developed at Virginia
Mason during its 12-year process improvement journey. Just as
important, Virginia Mason's culture of leadership at all levels
sets it apart from others in the health care universe. Describing
why it's critical for leadership to be actively involved in any
process improvement initiative, the book illustrates exactly what
leadership looks like at all levels within Virginia Mason. In the
book, bestselling author Charles Kenney introduces breakthrough new
work at Virginia Mason that most health care audiences have yet to
read about. He details the reasons why governance has played such a
big role in Virginia Mason's success and discusses a game-changing
initiative concerning respect for people. After reading this book,
you will better understand the active leadership style that has
propelled Virginia Mason's success. By following the best practices
and lessons learned, you will be prepared to teach, coach, and
encourage your team to achieve streamlined and standardized work,
sustained improvements, and increased patient satisfaction.
Foreword by Carolyn Corvi, Virginia Mason Health System/Virginia
Mason Medical Center Boards of Directors; Retired Vice President
and General Manager, Boeing Commercial Airplanes
For decades, the manufacturing industry has employed the Toyota
Production System - the most powerful production method in the
world - to reduce waste, improve quality, reduce defects and
increase worker productivity. In 2001, Virginia Mason Medical
Center, an integrated healthcare delivery system in Seattle,
Washington set out to achieve its compelling vision to become The
Quality Leader and to fulfill that vision, adopted the Toyota
Production System as its management method. Transforming Health
Care: Virginia Mason Medical Center's Pursuit of the Perfect
Patient Experience takes you on the journey of of Virginia Mason
Medical Center's pursuit of the perfect patient experience through
the application of lean principles, tools, and methodology. Over
the last several years Virginia Mason has become internationally
known for its journey towards perfection by applying the Toyota
Production System to healthcare. The book takes readers step by
step through Virginia Mason's journey as it seeks to provide
perfection to its customer - the patient. This book shows you how
you use this system to transform your own organization.
We are in the midst of what may well be the most confusing,
turbulent period in the history of modern medicine. This book seeks
to cut through the fog and confusion that enshrouds the health care
industry to provide clarity on where the industry stands today and
where it is headed. The book defines the major challenges in health
care through the journey of Northwell Health, one of the largest
provider organizations in the country. The central issues in what
is nearly one-fifth of the United States economy are played out
daily within this not-for-profit organization. Northwell is New
York state's largest workers, and $11 billion in annual revenue.
The book candidly portrays key leaders within Northwell on the most
vexing challenges in health care: How to provide primary and
specialty care spending; how to create and sustain an internal
system of continuous learning to enable employees at all levels to
stay current in an industry that is changing at warp speed; how to
provide emergency services in a world where natural disasters and
acts of terrorism are inevitable; how to identify new revenue
streams to offset reductions from Medicare and Medicaid; and how to
push outside the walls of hospitals and clinics to improve the
overall health of individuals and communities by working on
determinants of health beyond the typical medical practice. The
book exists at the intersection of medicine, business, social and
public policy. Harvard's Michael Porter has written widely on
health care arguing that it is time "for a fundamentally new
strategy," but what, exactly? Where is the industry headed? What do
the changes and the turbulence mean for patients, doctors, nurses?
This book is the product of a learning journey both humbling and
rewarding. Over time, lessons learned, improvements made,
innovations conceived, have advanced Northwell Health in ways that,
some years ago, might not have seemed possible. Northwell has
become a national leader not because it is perfect, but because it
remains steadfast in its journey to remain humble enough to know
that whatever success may be achieved, the journey is about
continuous learning and improvement. The goal of the book is to
provide a deeper, clearer understanding of what is happening in
health care and why; to help illuminate a pathway forward for
patients and caregivers most of all, but also for policy-makers and
the employers and others who pay for care.
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