Series Editors: Moira Stewart, Judith Belle Brown and Thomas R Freeman The application of the patient-centered clinical method has received international recognition. This book introduces and fully examines the patient-centered clinical method and illustrates how it can be applied in primary care. It presents case examples of the many problems encountered in patient-doctor interactions and provides ideas for dealing with these more effectively. It covers a wide range of topics and issues including palliative care, abuse, dying patients, ethical challenges and the role of self-awareness. Many narratives originate from patients' and family members' experiences, providing perspectives of great power and value. The Patient-Centered Care series is of great value to all health professionals, teachers and students in primary care.
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.
The evidence is undeniable. By any measure, the US spends more on healthcare than any other country in the world, yet its health outcomes as measure by longevity are in the bottom half among developed countries, and its health-related quality of life has remained constant or declined since 1998. In addition to high costs and lower than expected outcomes, the healthcare delivery system is plagues by treatment delays as it can take weeks to see a specialist, and many people have limited or no access to care. Part of the challenge is that the healthcare delivery system is a large, complex, and sophisticated value creation chain. Successfully changing this highly interconnected system is difficult and time consuming because the underlying problems are hard to comprehend, the root causes are many, the solution is unclear, and the relationships among problems, causes, and solution are multifaceted. To address these issues, the book carefully explains the underlying problems, examines their root causes using information, data, and logic, and presents a comprehensive and integrated solution that addresses these causes. These three steps are the methodological backbone of this book. A solution depends on understanding and applying the principles of patient-centered care (PCC) and resource management. PCC puts patients, supported by their primary care physicians, back in the role as decision makers and depends on patients being responsible for their health including making good life-style choices. After all, the best way to reduce healthcare costs and increase quality of life is to improve our health and wellness and as a result need less care. In addition, health insurance must be rethought and redesigned so it is less likely to lead to overuse. For many people with health insurance, the out-of-pocket cost of healthcare are small, so healthcare decision making is often biased toward consumption. Effective resource management means that healthcare providers must do a better job of acquiring and using resources in order to provide care quickly, productively, and correctly. This means improving healthcare strategy and management, accelerating the use of information technology, making drug costs affordable and fair, reducing the incidence of malpractice, and rebuilding the provider network. In addition, implementation is difficult because there are many participants in the healthcare delivery value chain, such as physicians, nurses, and medical technicians, as well as many provider organizations, such as hospitals, clinics, physician offices, and labs. Further up the value chain there are pharmaceutical companies, equipment providers, and other suppliers. These participants have diverse and sometimes conflicting goals, but each must be willing to accept change and work in a coordinated manner to improve healthcare. To overcome these problems, strong national leadership is needed to get the attention and support from the people and organizations involved in healthcare and to make the comprehensive changes that will lower healthcare costs, improve healthcare quality, eliminate delays, increase access, and enhance patient satisfaction.
The winner of the prestigious Walt Whitman award for her book "The Hocus Pocus of the Universe" completed her second book of poetry "The Weight of a Soul" while living in Fairhope, Alabama, just before her death. It reflects the values she embraced while working as a registered nurse.
Sponsored by the Picker/Commonwealth Program for Patient-Centered Care In this comprehensive, research-based look at the experiences and needs of patients, the authors explore models of care that can make hospitalization more humane. Through the Patient's Eyes provides insights into why some hospitals are more patient-centered than others; how physicians can become more involved in patient-centered quality efforts; and how patient-centered quality can be integrated into health care policy, standards, and regulations. The authors show how, by bringing the patient's perspective to the design and delivery of health services, providers can improve their ability to meet patient's needs and enhance the quality of care.
Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
In its first edition, Practice Development in Nursing made an important contribution to understanding practice development and its core components. Now fully updated to take into account the many developments in the field, the second edition continues to fill an important gap in the market for an accessible, practical text on what remains a key issue for all members of the healthcare team globally. Practice Development in Nursing and Healthcare explores the basis of practice development and its aims, implementation and impact on healthcare, to enable readers to be confident in their approaches to practice development. It is aimed at healthcare professionals in a variety of roles (for example clinical practice, education, research and quality improvement) and students, as well as those with a primary practice development role, in order to enable them to effectively and knowledgeably develop practice and the practice of others. Key features: New updated edition of a seminal text in the field, including significant new material Relevance to the entire healthcare team Accessible and practical in style, with case studies, scenarios and examples throughout Edited by and with contributions from experts in the field Fully updated to include the latest research Supported by a strong evidence base
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.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
The aging and evolving racial and ethnic composition of the U.S. population has the United States in the midst of a profound demographic shift and health care organizations face many issues as they move to address and adapt to this change. In their drive to adequately serve increasingly diverse communities, health care organizations are searching for approaches that will enable them to provide information and service to all persons, regardless of age, race, cultural background, or language skills, in a manner that facilitates understanding and use of that information to make appropriate health decisions. To better understand how the dynamic forces operating in health care today impact the delivery of services in a way that is health literate, culturally competent, and in an appropriate language for patients and their families, the National Academies of Sciences, Engineering, and Medicine conducted a public workshop on the integration of health literacy, cultural competency, and language access services. Participants discussed skills and competencies needed for effective health communication, including health literacy, cultural competency, and language access services; interventions and strategies for integration; and differing perspectives such as providers and systems, patients and families, communities, and payers. This report summarizes the presentations and discussions from the workshop.
