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Synthesizes the empirical literature on organizationalstructuring to answer the question of how organizations structure themselves --how they resolve needed coordination and division of labor. Organizationalstructuring is defined as the sum total of the ways in which an organizationdivides and coordinates its labor into distinct tasks. Further analysis of theresearch literature is neededin order to builda conceptualframework that will fill in the significant gap left by not connecting adescription of structure to its context: how an organization actuallyfunctions. The results of the synthesis are five basic configurations (the SimpleStructure, the Machine Bureaucracy, the Professional Bureaucracy, theDivisionalized Form, and the Adhocracy) that serve as the fundamental elementsof structure in an organization. Five basic parts of the contemporaryorganization (the operating core, the strategic apex, the middle line, thetechnostructure, and the support staff), and five theories of how it functions(i.e., as a system characterized by formal authority, regulated flows, informalcommunication, work constellations, and ad hoc decision processes) aretheorized. Organizations function in complex and varying ways, due to differing flows -including flows of authority, work material, information, and decisionprocesses. These flows depend on the age, size, and environment of theorganization; additionally, technology plays a key role because of itsimportance in structuring the operating core. Finally, design parameters aredescribed - based on the above five basic parts and five theories - that areused as a means of coordination and division of labor in designingorganizational structures, in order to establish stable patterns of behavior.(CJC).
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
Emergency Medical Services (EMS) agencies regardless of service delivery model have sought guidance on how to better integrate their emergency preparedness and response activities into similar processes occurring at the local, regional, State, tribal, and Federal levels. This primary purpose of this project is to begin the process of providing that guidance as it relates to mass care incident deployment.

The Belmont Report

United States. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research

Published: 1978

Total Pages: 614


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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.
Source of the debate on how much competition and regulation are necessary in the health care industry. This is a reprint of proceedings from a 1977 conference.