Crossing the Quality Chasm

Crossing the Quality Chasm

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2001-07-19

Total Pages: 359

ISBN-13: 0309132967

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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.


Clinical Practice Guidelines

Clinical Practice Guidelines

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1990-02-01

Total Pages: 169

ISBN-13: 0309043468

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The Alberta clinical practice guidelines program is supporting appropriate, effective and quality medical care in Alberta through promotion, development and implementation of evidence-based clinical practice guidelines.


Our Common Journey

Our Common Journey

Author: National Research Council

Publisher: National Academies Press

Published: 1999-12-09

Total Pages: 380

ISBN-13: 0309086388

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World human population is expected to reach upwards of 9 billion by 2050 and then level off over the next half-century. How can the transition to a stabilizing population also be a transition to sustainability? How can science and technology help to ensure that human needs are met while the planet's environment is nurtured and restored? Our Common Journey examines these momentous questions to draw strategic connections between scientific research, technological development, and societies' efforts to achieve environmentally sustainable improvements in human well being. The book argues that societies should approach sustainable development not as a destination but as an ongoing, adaptive learning process. Speaking to the next two generations, it proposes a strategy for using scientific and technical knowledge to better inform future action in the areas of fertility reduction, urban systems, agricultural production, energy and materials use, ecosystem restoration and biodiversity conservation, and suggests an approach for building a new research agenda for sustainability science. Our Common Journey documents large-scale historical currents of social and environmental change and reviews methods for "what if" analysis of possible future development pathways and their implications for sustainability. The book also identifies the greatest threats to sustainabilityâ€"in areas such as human settlements, agriculture, industry, and energyâ€"and explores the most promising opportunities for circumventing or mitigating these threats. It goes on to discuss what indicators of change, from children's birth-weights to atmosphere chemistry, will be most useful in monitoring a transition to sustainability.


Reducing the Threat of Improvised Explosive Device Attacks by Restricting Access to Explosive Precursor Chemicals

Reducing the Threat of Improvised Explosive Device Attacks by Restricting Access to Explosive Precursor Chemicals

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-05-19

Total Pages: 215

ISBN-13: 0309464072

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Improvised explosive devices (IEDs) are a type of unconventional explosive weapon that can be deployed in a variety of ways, and can cause loss of life, injury, and property damage in both military and civilian environments. Terrorists, violent extremists, and criminals often choose IEDs because the ingredients, components, and instructions required to make IEDs are highly accessible. In many cases, precursor chemicals enable this criminal use of IEDs because they are used in the manufacture of homemade explosives (HMEs), which are often used as a component of IEDs. Many precursor chemicals are frequently used in industrial manufacturing and may be available as commercial products for personal use. Guides for making HMEs and instructions for constructing IEDs are widely available and can be easily found on the internet. Other countries restrict access to precursor chemicals in an effort to reduce the opportunity for HMEs to be used in IEDs. Although IED attacks have been less frequent in the United States than in other countries, IEDs remain a persistent domestic threat. Restricting access to precursor chemicals might contribute to reducing the threat of IED attacks and in turn prevent potentially devastating bombings, save lives, and reduce financial impacts. Reducing the Threat of Improvised Explosive Device Attacks by Restricting Access to Explosive Precursor Chemicals prioritizes precursor chemicals that can be used to make HMEs and analyzes the movement of those chemicals through United States commercial supply chains and identifies potential vulnerabilities. This report examines current United States and international regulation of the chemicals, and compares the economic, security, and other tradeoffs among potential control strategies.


Mississippi River Water Quality and the Clean Water Act

Mississippi River Water Quality and the Clean Water Act

Author: National Research Council

Publisher: National Academies Press

Published: 2008-02-08

Total Pages: 252

ISBN-13: 0309177812

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The Mississippi River is, in many ways, the nation's best known and most important river system. Mississippi River water quality is of paramount importance for sustaining the many uses of the river including drinking water, recreational and commercial activities, and support for the river's ecosystems and the environmental goods and services they provide. The Clean Water Act, passed by Congress in 1972, is the cornerstone of surface water quality protection in the United States, employing regulatory and nonregulatory measures designed to reduce direct pollutant discharges into waterways. The Clean Water Act has reduced much pollution in the Mississippi River from "point sources" such as industries and water treatment plants, but problems stemming from urban runoff, agriculture, and other "non-point sources" have proven more difficult to address. This book concludes that too little coordination among the 10 states along the river has left the Mississippi River an "orphan" from a water quality monitoring and assessment perspective. Stronger leadership from the U.S. Environmental Protection Agency (EPA) is needed to address these problems. Specifically, the EPA should establish a water quality data-sharing system for the length of the river, and work with the states to establish and achieve water quality standards. The Mississippi River corridor states also should be more proactive and cooperative in their water quality programs. For this effort, the EPA and the Mississippi River states should draw upon the lengthy experience of federal-interstate cooperation in managing water quality in the Chesapeake Bay.


Evaluation of the Multifunction Phased Array Radar Planning Process

Evaluation of the Multifunction Phased Array Radar Planning Process

Author: National Research Council

Publisher: National Academies Press

Published: 2008-08-14

Total Pages: 91

ISBN-13: 0309178444

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The Multifunction Phased Array Radar (MPAR) is one potentially cost-effective solution to meet the surveillance needs and of several agencies currently using decades-old radar networks. These agencies including the National Oceanic and Atmospheric Administration s (NOAA) National Weather Service (NWS), the Federal Aviation Administration (FAA), the Department of Defense (DOD) and the Department of Homeland Security (DHS) have many and varied requirements and possible applications of modern radar technology. This book analyzes what is lacking in the current system, the relevant capabilities of phased array technology, technical challenges, cost issues, and compares possible alternatives. Both specific and overarching recommendations are outlined.


The American Business Cycle

The American Business Cycle

Author: Robert J. Gordon

Publisher: University of Chicago Press

Published: 2007-11-01

Total Pages: 882

ISBN-13: 0226304590

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In recent decades the American economy has experienced the worst peace-time inflation in its history and the highest unemployment rate since the Great Depression. These circumstances have prompted renewed interest in the concept of business cycles, which Joseph Schumpeter suggested are "like the beat of the heart, of the essence of the organism that displays them." In The American Business Cycle, some of the most prominent macroeconomics in the United States focuses on the questions, To what extent are business cycles propelled by external shocks? How have post-1946 cycles differed from earlier cycles? And, what are the major factors that contribute to business cycles? They extend their investigation in some areas as far back as 1875 to afford a deeper understanding of both economic history and the most recent economic fluctuations. Seven papers address specific aspects of economic activity: consumption, investment, inventory change, fiscal policy, monetary behavior, open economy, and the labor market. Five papers focus on aggregate economic activity. In a number of cases, the papers present findings that challenge widely accepted models and assumptions. In addition to its substantive findings, The American Business Cycle includes an appendix containing both the first published history of the NBER business-cycle dating chronology and many previously unpublished historical data series.


Realizing the Information Future

Realizing the Information Future

Author: National Research Council

Publisher: National Academies Press

Published: 1994-02-01

Total Pages: 320

ISBN-13: 0309050448

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The potential impact of the information superhighwayâ€"what it will mean to daily work, shopping, and entertainmentâ€"is of concern to nearly everyone. In the rush to put the world on-line, special issues have emerged for researchers, educators and students, and library specialists. At the same time, the research and education communities have a valuable head start when it comes to understanding computer communications networks, particularly Internet. With its roots in the research community, the Internet computer network now links tens of millions of people and extends well into the commercial world. Realizing the Information Future is written by key players in the development of Internet and other data networks. The volume highlights what we can learn from Internet and how the research, education, and library communities can take full advantage of the information highway's promised reach through time and space. This book presents a vision for the proposed national information infrastructure (NII): an open data network sending information services of all kinds, from suppliers of all kinds, to customers of all kinds, across network providers of all kinds. Realizing the Information Future examines deployment issues for the NII in light of the proposed system architecture, with specific discussion of the needs of the research and education communities. What is the role of the "institution" when everyone is online in their homes and offices? What are the consequences when citizens can easily access legal, medical, educational, and government services information from a single system? These and many other important questions are explored. The committee also looks at the development of principles to address the potential for abuse and misuse of the information highway, covering: Equitable and affordable access to the network. Reasonable approaches to controlling the rising tide of electronic information. Rights and responsibilities relating to freedom of expression, intellectual property, individual privacy, and data security. Realizing the Information Future includes a wide-ranging discussion of costs, pricing, and federal funding for network development and a discussion of the federal role in making the best technical choices to ensure that the expected social and economic benefits of the NII are realized. The time for the research and education communities to have their say about the information highway is before the ribbon is cut. Realizing the Information Future provides a timely, readable, and comprehensive exploration of key issuesâ€"important to computer scientists and engineers, researchers, librarians and their administrators, educators, and individuals interested in the shape of the information network that will soon link us all.


Model Rules of Professional Conduct

Model Rules of Professional Conduct

Author: American Bar Association. House of Delegates

Publisher: American Bar Association

Published: 2007

Total Pages: 216

ISBN-13: 9781590318737

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The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.