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Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309132967 Category : Medical Languages : en Pages : 359
Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309132967 Category : Medical Languages : en Pages : 359
Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309068371 Category : Medical Languages : en Pages : 312
Book Description
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
Author: Committee for the Study of the Future of Public Health Publisher: National Academies Press ISBN: 0309581907 Category : Medical Languages : en Pages : 240
Book Description
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309047420 Category : Medical Languages : en Pages : 240
Book Description
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Author: United States. Fort Hood Independent Review Committee Publisher: Independently Published ISBN: Category : Missing persons Languages : en Pages : 148
Book Description
The U. S. Secretary of the Army appointed the Fort Hood Independent Review Committee(FHIRC or Committee) and directed it to "conduct a comprehensive assessment of the Fort Hoodcommand climate and culture, and its impact, if any, on the safety, welfare and readiness of ourSoldiers and units." In addressing this mandate, the FHIRC determined that during the time periodcovered by the Review, the command climate relative to the Sexual Harassment/Assault Responseand Prevention (SHARP) Program at Fort Hood was ineffective, to the extent that there was apermissive environment for sexual assault and sexual harassment.As set forth in this Report, specific Findings demonstrate that the implementation of theSHARP Program was ineffective. During the review period, no Commanding General or subordinateechelon commander chose to intervene proactively and mitigate known risks of high crime, sexualassault and sexual harassment. The result was a pervasive lack of confidence in the SHARP Programand an unacceptable lack of knowledge of core SHARP components regarding reporting and certainvictim services. Under a structurally weak and under-resourced III Corps SHARP Program, theSexual Assault Review Board (SARB) process was primarily utilized to address administrative and notthe actual substantive aspects of the Program. While a powerful tool by design, the SARB processbecame a missed opportunity to develop and implement proactive strategies to create a respectfulculture and prevent and reduce incidents of sexual assault and sexual harassment. From the III Corpslevel and below, the SHARP Program was chronically under-resourced, due to understaffing, lack oftraining, lack of credentialed SHARP professionals, and lack of funding. Most of all, it lackedcommand emphasis where it was needed the most: the enlisted ranks.A resonant symptom of the SHARP Program's ineffective implementation was significantunderreporting of sexual harassment and sexual assault. Without intervention from the NCOs andofficers entrusted with their health and safety, victims feared the inevitable consequences of reporting: ostracism, shunning and shaming, harsh treatment, and indelible damage to their career. Many haveleft the Army or plan to do so at the earliest opportunity.As part of the command climate, the issues of crime and Criminal Investigation Division(CID) operations were examined. The Committee determined that serious crime issues on and offFort Hood were neither identified nor addressed. There was a conspicuous absence of an effectiverisk management approach to crime incident reduction and Soldier victimization. A militaryinstallation is essentially a large, gated community. The Commander of a military installation possessesa wide variety of options to proactively address and mitigate the spectrum of crime incidents. Despitehaving the capability, very few tools were employed at Fort Hood to do so. Both the Directorate ofEmergency Services (DES) and the CID have a mandate and a role to play in crime reduction.Each contributed very little analysis, feedback and general situational awareness to the command towardfacilitating and enabling such actions. This was another missed opportunity.The deficient climate also extended into the missing Soldier scenarios, where no onerecognized the slippage in accountability procedures and unwillingness or lack of ability of noncommissioned officers (NCOs) to keep track of their subordinates. The absence of any formalprotocols for Soldiers who fail to report resulted in an ad hoc approach by units and Military Police(MP) to effectively address instances of missing Soldiers during the critical first 24 hours, again withadverse consequences.Consistent with the FHIRC Charter, this Report sets forth nine Findings and offers seventyRecommendations.
Author: National Institutes of Health (U.S.). Office for Protection from Research Risks Publisher: ISBN: Category : Animal experimentation Languages : en Pages : 40
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309164257 Category : Medical Languages : en Pages : 267
Book Description
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
Author: Institute of Medicine
Author: Institute of Medicine
Author: Institute of Medicine
Author: Committee for the Study of the Future of Public Health
Author: Institute of Medicine
Author: United States. Fort Hood Independent Review Committee
Author: National Institutes of Health (U.S.). Office for Protection from Research Risks
Author: 
Author: Institute of Medicine
Author: United States. Health Resources Administration
Author: Kerm Henriksen