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This book provides a comprehensive framework for developing heart teams to manage a variety of cardiovascular diseases. Management of cardiovascular diseases has changed dramatically in recent years due to developments in evidence-based practices and treatments as well as the introduction of new devices. The sequential method of referring patients from doctor to doctor is becoming an antiquated model. The future of cardiac care lies in developing multidisciplinary "Heart Teams" to provide patient-focused treatment for complex cardiovascular problems. This volume examines the history and evolution of cardiovascular care and technology and explains why the implementation of heart teams is absolutely necessary to the future of cardiac care. It analyzes the role of heart teams for heart failure, complex coronary revascularization, mitral valve disease, cardiac imaging, aortic valve disease, cardiac arrhythmias, and women's heart health. Finally, the book explores how heart teams work with hospital administration and the broader healthcare industry. Heart Teams for Treatment of Cardiovascular Disease: A Guide for Advancing Patient-Centered Cardiac Care is an essential resource for physicians and related professionals, residents, fellows, and graduate students in cardiology, cardiac surgery, critical care medicine, and radiology.
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.
This study explores the parallel histories of the Mayo Clinic, the care of patients with heart disease, and specialization in cardiology during the twentieth century. Chapters are devoted to such technologies as open-heart surgery, coronary angiography, and echocardiography, and to the key individuals, instituions, and innovations that played vital roles in the technologies that transformed heart care.--From publisher description.
A history illustrating the complexity of medical decision making and risk. Still the leading cause of death worldwide, heart disease challenges researchers, clinicians, and patients alike. Each day, thousands of patients and their doctors make decisions about coronary angioplasty and bypass surgery. In Broken Hearts David S. Jones sheds light on the nature and quality of those decisions. He describes the debates over what causes heart attacks and the efforts to understand such unforeseen complications of cardiac surgery as depression, mental fog, and stroke. Why do doctors and patients overestimate the effectiveness and underestimate the dangers of medical interventions, especially when doing so may lead to the overuse of medical therapies? To answer this question, Jones explores the history of cardiology and cardiac surgery in the United States and probes the ambiguities and inconsistencies in medical decision making. Based on extensive reviews of medical literature and archives, this historical perspective on medical decision making and risk highlights personal, professional, and community outcomes.
The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
While the healthcare system continues to shift towards more emphasis on quality metrics, there remains a substantial gap between the expectations of healthcare policies and standards of hospital administrations vs. the realistic care provided by the average healthcare provider. This book offers the perspective of the healthcare provider and aims to fulfill the unmet need to educate other healthcare providers on recognizing quality measures and understanding how to achieve them to meet standards of quality care. This book covers the historical perspective of quality measures, the context of their existence, their utility, and the contemporary issues related to their use. Simultaneously, it critically addresses the quality of these quality metrics and presents the evidence available to date on the efficacy and the limitations of these quality measures. This text is all-inclusive and is organized into chapters that include the evolution of quality metrics in healthcare, the practical role of hospitals, as well as the practical role of individual healthcare providers in addressing quality metrics. The chapters also include assessment of quality metrics that uniquely pertain to medical and surgical practices, as well as non-clinical quality metrics that specifically target undergraduate and graduate medical training. Finally, the book reflects on the use of contemporary quality metrics and their impact on outcomes, patient care, and public health and policy making. In these chapters, tables and illustrations, including algorithms, will be used to provide systematic approaches to common issues related to quality metrics. In addition, historical anecdotes and case presentations will be used to address pearls in contemporary practice of quality metrics. Quality Measures is the definitive reference on quality metrics in healthcare and is a valuable resource for healthcare providers, trainees, administrators and public health agencies.
Part of the European Society of Cardiology series, the ESC Textbook of Cardiovascular Nursing provides in depth learning for nurses specialising in caring for patients with coronary heart disease, heart failure, valvular disease, arrhythmias, congenital heart disease and inherited cardiovascular conditions. The textbook builds on the ESC Core Curriculum for the Continuing Professional Development of Nurses Working in Cardiovascular Care. There are fifteen chapters written by experts in the field. The pathology of coronary heart disease, heart failure, valvular disease, arrhythmias, congenital heart disease and inherited cardiovascular conditions are all discussed in great detail. Whilst tailoring nursing assessment and interventions to the care of patients with heart disease, the textbook emphasises high quality holistic care taking account of the needs of patients with complex comorbidities, as well as their families. The imperative of prevention and rehabilitation in terms of both primary and secondary prevention is described as well as educational, behavioural and therapeutic interventions. The epidemiology of cardiovascular disease is covered including disease burden and inequalities across European regions. Chapters devoted to education and communication and pharmacology are also included and the book concludes with a chapter which discusses the future challenges and opportunities for nurses in addition to the evolution of nursing in cardiovascular care. The target readership of the textbook are nurses entering cardiovascular specialisation and university students undertaking specialist courses in cardiovascular care. The hope of the editors is that the textbook inspires readers to ask questions, search for answers and become the best cardiovascular nurses they can be. There is a strong body of evidence showing that educational provision for nurses increases patient safety and saves lives, the ESC Textbook of Cardiovascular Nursing aims to be an essential part of this provision.
Telemedicineâ€"the use of information and telecommunications technologies to provide and support health care when distance separates the participantsâ€"is receiving increasing attention not only in remote areas where health care access is troublesome but also in urban and suburban locations. Yet the benefits and costs of this blend of medicine and digital technologies must be better demonstrated before today's cautious decision-makers invest significant funds in its development. Telemedicine presents a framework for evaluating patient care applications of telemedicine. The book identifies managerial, technical, policy, legal, and human factors that must be taken into account in evaluating a telemedicine program. The committee reviews previous efforts to establish evaluation frameworks and reports on results from several completed studies of image transmission, consulting from remote locations, and other telemedicine programs. The committee also examines basic elements of an evaluation and considers relevant issues of quality, accessibility, and cost of health care. Telemedicine will be of immediate interest to anyone with interest in the clinical application of telemedicine.
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.
The ESC Textbook of Intensive and Acute Cardiovascular Care is the official textbook of the Acute Cardiovascular Care Association (ACVC) of the ESC. Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and a cause of loss of disability-adjusted life years. For most types of CVD early diagnosis and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients. This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. The chapters cover the various acute cardiovascular diseases that need high quality intensive treatment as well as organisational issues, cooperation among professionals, and interaction with other specialities in medicine. SECTION 1 focusses on the definition, structure, organisation and function of ICCU's, ethical issues and quality of care. SECTION 2 addresses the pre-hospital and immediate in-hospital (ED) emergency cardiac care. SECTIONS 3-5 discuss patient monitoring, diagnosis and specific procedures. Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. The main other cardiovascular acute conditions are grouped in SECTION 9. Finally SECTION 10 is dedicated to the many concomitant acute non-cardiovascular conditions that contribute to the patients' case mix in ICCU. This edition includes new chapters such as low cardiac output states and cardiogenic shock, and pacemaker and ICDs: troubleshooting and chapters have been extensively revised. Purchasers of the print edition will also receive an access code to access the online version of the textbook which includes additional figures, tables, and videos to better to better illustrate diagnostic and therapeutic techniques and procedures in IACC. The third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care will establish a common basis of knowledge and a uniform and improved quality of care across the field.