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This book is an introduction to health care as a complex adaptive system, a system that feeds back on itself. The first section introduces systems and complexity theory from a science, historical, epistemological, and technical perspective, describing the principles and mathematics. Subsequent sections build on the health applications of systems science theory, from human physiology to medical decision making, population health and health services research. The aim of the book is to introduce and expand on important population health issues from a systems and complexity perspective, highlight current research developments and their implications for health care delivery, consider their ethical implications, and to suggest directions for and potential pitfalls in the future.
Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.
Lead effectively in today's complex health systems! As hospitals and healthcare organizations strive to meet standards to achieve status in the Magnet Hospital Recognition Program and address the issues in the Institute of Medicine’s Nursing Work Force Issues Initiative, they must be able to respond in ways that embrace rapid change. The 3rd Edition of this groundbreaking text addresses the leadership roles advanced practice nurses can assume in this new environment. It defines the concept of complexity and teaches the leadership skills that are best suited for complex adaptive systems, while also enabling you to build the self-awareness you need to learn new ways to lead. Case studies help you apply your new skills and prepare for your advanced practice roles.
This publication is the first book to address complexity science in health care. It represents a revolutionary new way for health care leaders to think about how they engage employees, work with physicians, manage unmanageably complex tasks and plan for an uncertain future. But it's not for health care workers only - this book is useful to anyone interested in how complexity science is changing not only business management, but also how many disciplines of science relate to one another. Complexity science reframes our view of many systems that are only partially understood by traditional scientific methods. Systems as apparently diverse as stock markets, human bodies, ecosystems, immune systems, termite colonies and hospitals seem to share some patterns of behavior. These patterns provide insights into sustainability, viability, and innovation.
Regulation shapes all aspects of America's fragmented health care industry. While the health and lives of patients as well as almost one-sixth of the national economy depend on its effectiveness, health care regulation in America is bewilderingly complex. 'Health Care Regulation in America' is a guide to this regulatory maze.
This unique title explores complex systems in clinical medicine and the subsequent implementation of that knowledge into practice. Written conversationally and as a reflection on the journey of learning about complex systems, the book explores how knowledge of these systems can be applied to four key roles in academic medicine: clinical practice, education, research, and administration. Further, this title emphasizes how gaining an understanding of complex systems can greatly help a physician deal with the many challenges found in academic medicine. Unlike other books on complexity in medicine, which tend to focus on only one aspect of the management of patients, Complex Systems in Medicine deals with the multifaceted roles of a physician. The approach in this book is uniquely qualitative rather than mathematical, and is written to make it not only of interest to physicians, trainees, and allied health providers, but also to make it more accessible to a non-medical audience. The inclusion of personal anecdotes by the author provides concrete examples of the application of knowledge of complex systems in academic medicine. A first-of-its-kind contribution to the literature, Complex Systems in Medicine: A Hedgehog’s Tale of Complexity in Clinical Practice, Research, Education, and Management is not only a novel reference for medical professionals, it is an accessible tool for the non-medical audience hoping to learn more about complex systems and their direct relevance to medicine, a field that deals with the infinite variety of humans and their ills. It illustrates the consequences of the interactive elements of patient care that make medicine both a science and an art.
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
"Many people believe that healthcare is the example par excellence of a complex adaptive system (CAS). It has a daunting range of diverse stakeholders (citizens, taxpayers, politicians, policymakers, providers, managers, clinicians, patients and patient groups), spans the public and private sectors and delivers care across many settings and through varied types of organisations (public health settings, community centres, hospitals, aged-care facilities, and family or general practices, for example). The individuals delivering care, and the groups, teams, networks, bodies and organisations through which they provide services, interact in intricate configurations, longitudinally. Said that way, certain consequences arise. The system, of necessity, will be adapting to circumstances over time, behaviours won't necessarily be predictable, the sum of the parts will be greater and different from the individual elements making up the system, and the inputs and outputs will not match because relationships within the system are not straightforward-they are non-linear. The complexity science approach to understanding, acting on, and researching health systems is becoming increasingly popular. It is therefore timely to release an analysis of complexity and its characteristics, and apply them to healthcare."--Website.
Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.
This book illustrates the relevance of chaos and complexity theory to healthcare organisations, public health, clinical governance and the consultation. It explains the terms and ideas at the heart of complexity, the unfamiliar science behind it, and how it applies to the real world. In healthcare, the NHS is a complex adaptive system. So are hospitals, general practices, diseases and patients. The book describes how insights from complexity can help us better understand how organisations, patients or disease develop over time, in an often unpredictable manner. Contributors set out the benefits of applying complexity to their own particular areas of healthcare. Complexity and Healthcare will be of special interest to clinicians and managers in primary and secondary care, researchers and academics, and in particular, general practitioners and public health professionals.