Increased HIV screening may help identify more people with the disease, but there may not be enough resources to provide them with the care they need. The Institute of Medicine's Committee on HIV Screening and Access to Care concludes that more practitioners must be trained in HIV/AIDS care and treatment and their hospitals, clinics, and health departments must receive sufficient funding to meet a growing demand for care.
The effective functioning of a democratic society—including social, business, and political interactions—largely depends on trust. Yet trust remains a fragile and elusive resource in many of the organizations that make up society's building blocks. In their timely volume, Trust and Distrust in Organizations, editors Roderick M. Kramer and Karen S. Cook have compiled the most important research on trust in organizations, illuminating the complex nature of how trust develops, functions, and often is thwarted in organizational settings. With contributions from social psychologists, sociologists, political scientists, economists, and organizational theorists, the volume examines trust and distrust within a variety of settings—from employer-employee and doctor-patient relationships, to geographically dispersed work teams and virtual teams on the internet. Trust and Distrust in Organizations opens with an in-depth examination of hierarchical relationships to determine how trust is established and maintained between people with unequal power. Kurt Dirks and Daniel Skarlicki find that trust between leaders and their followers is established when people perceive a shared background or identity and interact well with their leader. After trust is established, people are willing to assume greater risks and to work harder. In part II, the contributors focus on trust between people in teams and networks. Roxanne Zolin and Pamela Hinds discover that trust is more easily established in geographically dispersed teams when they are able to meet face-to-face initially. Trust and Distrust in Organizations moves on to an examination of how people create and foster trust and of the effects of power and betrayal on trust. Kimberly Elsbach reports that managers achieve trust by demonstrating concern, maintaining open communication, and behaving consistently. The final chapter by Roderick Kramer and Dana Gavrieli includes recently declassified data from secret conversations between President Lyndon Johnson and his advisors that provide a rich window into a leader's struggles with problems of trust and distrust in his administration. Broad in scope, Trust and Distrust in Organizations provides a captivating and insightful look at trust, power, and betrayal, and is essential reading for anyone wishing to understand the underpinnings of trust within a relationship or an organization. A Volume in the Russell Sage Foundation Series on Trust
Does trust still matter in health care and who does it matter to? Have trust relations changed in the 'New' NHS? What does trust mean to patients, clinicians and managers? In the NHS trust has traditionally played an important part in the relationships between its three key actors: the state, health care practitioners and patients. However, in recent years the environments in which these relationships operate have been subject to considerable change as the NHS has been modernised. Patients are now expected to play a more active role, both in self-managing their illness and in choice of care provider and clinicians are expected to work in teams and in partnership with managers. This unique book explores the importance of trust, how it is lost and won and the extent to which trust relationships in health care may have changed. The book combines theoretical and empirical analysis, while also examining the role of policy. Calnan and Rowe analyse data collected from interviews with patients, health care professionals and managers in primary care and acute care settings. Among the issues covered are: The importance of trust to their relationships What constitutes high and low trust behaviour The changing nature of trust relations between patients, clinicians and managers How trust can be built and sustained How interpersonal trust affects institutional trust Trust Matters in Health Care is key reading for policy makers, health care professionals and managers in the public and private sector, and a useful resource for educators and students within health and social care and management studies.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.
This book presents a framework for development, optimization, and evaluation of behavioral, biobehavioral, and biomedical interventions. Behavioral, biobehavioral, and biomedical interventions are programs with the objective of improving and maintaining human health and well-being, broadly defined, in individuals, families, schools, organizations, or communities. These interventions may be aimed at, for example, preventing or treating disease, promoting physical and mental health, preventing violence, or improving academic achievement. This volume introduces the multiphase optimization strategy (MOST), pioneered at The Methodology Center at the Pennsylvania State University, as an alternative to the classical approach of relying solely on the randomized controlled trial (RCT). MOST borrows heavily from perspectives taken and approaches used in engineering, and also integrates concepts from statistics and behavioral science, including the RCT. As described in detail in this book, MOST consists of three phases: preparation, in which the conceptual model underlying the intervention is articulated; optimization, in which experimentation is used to gather the information necessary to identify the optimized intervention; and evaluation, in which the optimized intervention is evaluated in a standard RCT. Through numerous examples, the book demonstrates that MOST can be used to develop interventions that are more effective, efficient, economical, and scalable. Optimization of Behavioral, Biobehavioral, and Biomedical Interventions: The Multiphase Optimization Strategy is the first book to present a comprehensive introduction to MOST. It will be an essential resource for behavioral, biobehavioral, and biomedical scientists; statisticians, biostatisticians, and analysts working in epidemiology and public health; and graduate-level courses in development and evaluation of interventions.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
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.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
