Combined with the more traditional employer occupational safety and health protection activities are newer employment-based programs to promote better health through helping workers quit smoking, lose weight, reduce stress, or exercise more regularly. In support of these efforts, some employers have made changes in their policies and facilities to support physical activity and healthier eating, and some employers connect with community resources for health education, health fairs, and other services. This diverse array of activities most typically has been planned, managed, and assessed - to the extent they exist in the workplace at all - by different, often uncoordinated departments within the business entity. Some employers have reconceptualized their safety, prevention, and promotion initiatives and attempted to bring them together into a coherent whole. The National Institute for Occupational Safety and Health (NIOSH) has supported this integration, defining Total Worker Health as "a strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance health and well-being." In May 2014, with support from NIOSH, the Institute of Medicine organized a workshop on Total Worker Health. Rather than a review of published literature, this workshop sought input from a wide variety of on-the-ground stakeholders regarding their experiences with integrating occupational safety and health protection with health promotion in the workplace. Promising and Best Practices in Total Worker Health is the summary of the discussions and presentations of the event. This report identifies prevalent and best practices in programs that integrate occupational safety and health protection with health promotion in small, medium, and large workplaces; employer and employee associations; academia; government agencies; and other stakeholder groups. Table of Contents Front Matter 1 Introduction 2 Total Worker Health in the Real World 3 The Value in Pursuing Total Worker Health 4 Total Worker Health in Large Businesses 5 Total Worker Health for Small- and Medium-Sized Businesses 6 Reactors Panel and Discussion References Appendix A: Workshop Agenda Appendix B: Speaker and Moderator Biographical Sketches

The nurse workforce constitutes the largest sector of health professionals in the United States and includes individuals with varying educational backgrounds and expertise. Like other health professions, nursing includes a large number of specialties and subspecialties. Nurses may seek certification, based on various standards and criteria, from a wide range of organizations. Similarly, organizations may participate in nursing credentialing programs, which typically reflect the attainment of various nursing care standards and outcome measures. It is, however, unclear how this additional training and education affects health care quality and patient health. Future Directions of Credentialing Research in Nursing examines short- and long-term strategies to advance research on nurse certification and organizational credentialing. This report summarizes a workshop convened by the Institute of Medicine in September 2014 to examine a new framework and research priorities to guide future research on the impact of nurse credentialing and certification on outcomes for nurses, organizations, and patients. Over 100 people attended the workshop, which focused on topics such as emergent priorities for research in nursing credentialing; critical knowledge gaps and methodological limitations in the field; promising developments in research methodologies, health metrics, and data infrastructures to better evaluate the impact of nursing credentialing; and short- and long-term strategies to encourage continued activity in nursing credentialing research. Future Directions of Credentialing Research in Nursing is a record of the presentations, discussion, and break-out sessions of this event. Table of Contents Front Matter 1 Introduction 2 A New Framework for Credentialing Research in Nursing 3 Strengthening Data and Health Informatics for Credentialing Research 4 Challenges and Opportunities in Credentialing Research Methodologies 5 Assessing Core Competencies in Nursing Credentialing 6 Nursing Credentialing Within a Complex Health Care Landscape 7 Taking the Temperature: Stakeholder Reactions and Suggestions References Appendix A: Workshop Agenda Appendix B: Glossary

The past several decades have been a time of rapid globalization in the development, manufacture, marketing, and distribution of medical products and technologies. Increasingly, research on the safety and effectiveness of new drugs is being conducted in countries with little experience in regulation of medical product development. Demand has been increasing for globally harmonized, science-based standards for the development and evaluation of the safety, quality, and efficacy of medical products. Consistency of such standards could improve the efficiency and clarity of the drug development and evaluation process and, ultimately, promote and enhance product quality and the public health. To explore the need and prospects for greater international regulatory harmonization for drug development, the IOM Forum on Drug Discovery, Development, and Translation hosted a workshop on February 13-14, 2013. Discussions at the workshop helped identify principles, potential approaches, and strategies to advance the development or evolution of more harmonized regulatory standards. This document summarizes the workshop. Table of Contents Front Matter 1 Introduction 2 Principles and Definitional Considerations 3 Overview of the Current Global Regulatory Landscape 4 Areas of Need for Harmonized Standards and Barriers to Progress in Addressing the Gaps 5 Characteristics of Harmonized Regulations and Regulatory Structures 6 Finding Solutions: Options and Systemic Approaches 7 Tactics and Strategies for a Way Forward References Appendix A: Workshop Agenda Appendix B: Participant Biographies

Clinical trials provide essential information needed to turn basic medical research findings into patient treatments. New treatments must be studied in large numbers of humans to find out whether they are effective and to assess any harm that may arise from treatment. There is growing recognition among many stakeholders that the U.S. clinical trials enterprise is unable to keep pace with the national demand for research results. The IOM, along with the Mount Sinai School of Medicine, held a workshop June 27-28, 2011, to engage stakeholders and experts in a discussion about possible solutions to improve public engagement in clinical trials. Table of Contents Front Matter 1 Introduction 2 Framing the Problem 3 Recruitment Challenges in Clinical Trials for Different Diseases and Conditions 4 Models for Public Engagement 5 Messages and Methods for Public Engagement 6 The Media 7 Novel Clinical Trial Designs 8 The Health System's Structure and Culture 9 Toward a Patient-Centered Strategy for Clinical Trials References Appendix A: Workshop Agenda Appendix B: The Clinical Trials Process Appendix C: Participant Biographies

Individuals with disabilities, chronic conditions, and functional impairments need a range of services and supports to keep living independently. However, there often is not a strong link between medical care provided in the home and the necessary social services and supports for independent living. Home health agencies and others are rising to the challenges of meeting the needs and demands of these populations to stay at home by exploring alternative models of care and payment approaches, the best use of their workforces, and technologies that can enhance independent living. All of these challenges and opportunities lead to the consideration of how home health care fits into the future health care system overall. On September 30 and October 1, 2014, the Institute of Medicine and the National Research Council convened a public workshop on the future of home health care. The workshop brought together a spectrum of public and private stakeholders and thought leaders to improve understanding of the current role of Medicare home health care in supporting aging in place and in helping high-risk, chronically ill, and disabled Americans receive health care in their communities. Through presentations and discussion, participants explored the evolving role of Medicare home health care in caring for Americans in the future, including how to integrate Medicare home health care into new models for the delivery of care and the future health care marketplace. The workshop also considered the key policy reforms and investments in workforces, technologies, and research needed to leverage the value of home health care to support older Americans, and research priorities that can help clarify the value of home health care. This summary captures important points raised by the individual speakers and workshop participants. Table of Contents Front Matter 1 Introduction 2 Home Health Care: Today and Tomorrow 3 Toward Personal Health: Going Home and Beyond 4 Key Issues and Trends 5 The Home Health Care Workforce 6 Models of Care and Approaches to Payment 7 Innovations in Technology 8 Making Connections 9 Reflections and Reactions References Appendix A: Workshop Agenda Appendix B: Speaker and Moderator Biographical Sketches