101 Deficiencies Which Lead to the Demise of a Healthcare Organization by Sunil Kadakia MD, FACC, FSCAI, CPE [--------------------------------------------]
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
With headlines focused on human suffering-civil wars, refugee flows, the spread of disease due to hunger and poor sanitation, population growth, climate change-it is easy to dive into despair. What is needed, instead, is a radical rethinking of global policy to realize the potential for improving the human condition. This book provides hope by examining the basic needs for a fundamental shift in thinking about development and human security for both practical and ethical reasons. Kenneth A. Reinert calls for a basic goods approach that focuses on the provision of nutritious food, clean water, sanitation, health services, education services, housing, electricity, and human security services. This approach bridges two perspectives: that of standard growth, which emphasizes increasing GDP per capita, and that of capabilities/human development, which puts priority on the realization of human potential. Reinert argues that only when growth leads to an increase in the broad-based provision of basic goods and services will the hoped-for expansion of human capabilities and development be achieved. No Small Hope places the basic goods approach on the firm foundation of objective human needs and subsistence rights. It offers a practical agenda for making progress towards human development by focusing on the real determinants of human well-being in an ethical system of moral minimalism. In a world of climate change, increased risk of natural disasters and increased refugee flows, the basic goods approach promises to help alleviate ongoing suffering and address vast deprivations in basic needs fulfillment.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.