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This volume examines the intersections of health care and environmental health, both in terms of traditional failures and the revolution underway to fix them. Authored by one of the pioneers in health care's green movement, it presents practical solutions for health care organizations and clinicians to improve their environments and the health of their communities.
Healthcare Organizations offer significant opportunities for change and improvement in their overall performance. Hospitals and clinics are generally large, complex, and inefficient, and need serious development in process workflow and management systems, which will ultimately lead to better patient and financial outcomes. The National Academy of Medicine has stated that hospital systems are broken, and that they must begin by "... improving hospital efficiency and patient flow, and using operational management methods and information technologies." In fact, costs and quality are two of the important aspects of the "triple aim" in healthcare. One area that offers significant potential for improvement is through the application of performance improvement methods to patient and process flows. Performance improvement has a significant impact on a hospital’s over financial and strategic performance. Performance improvement involves the deployment of quantitative and scientific methods to model and influence the functioning of organizations. Performance improvement professionals are tasked with managing a variety of activities, such as deploying new information technologies, serving as project managers for construction events, re-engineering departmental process workflow, eliminating bottlenecks, and improving the flow and movement of patients between resource-intensive clinical areas. All of these are high risk, and require use of advanced, sophisticated methods to improve efficiency and quality, while minimizing disruptions from change. This updated edition is a comprehensive and concise guide to performance improvement in healthcare. It describes the management engineering principles focused on designing optimal management and information systems and processes. Case studies and examples are integrated throughout all chapters.
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
More and more not-for-profit hospitals are becoming financially unstable and being acquired by large hospital systems. The effects range from not having necessary life-saving equipment to losing the most experienced nurses to better jobs at other hospitals. In Health Care in Crisis, Theresa Morris takes an in-depth look at how this unintended consequence of the Affordable Care Act plays out in a non-profit hospital's obstetrical ward. Based on ethnographic observations of and in-depth interviews with obstetrical nurses and hospital administrators at a community, not-for-profit hospital in New England, Health Care in Crisis examines how nurses' care of patients changed over the three-year period in which the Affordable Care Act was implemented, state Medicaid funds to hospitals were slashed, and hospitals were being acquired by a for-profit hospital system. Morris explains how the tumultuous political-economic changes have challenged obstetrical nurses, who are at the front lines of providing care for women during labor and birth. --
The inspiring story of how a leading innovator in patient safety found a simple way to save countless lives. First, do no harm-doctors, nurses and clinicians swear by this code of conduct. Yet in hospitals and doctors' offices across the country, errors are made every single day - avoidable, simple mistakes that often cost lives. Inspired by two medical mistakes that not only ended in unnecessary deaths but hit close to home, Dr. Peter Pronovost made it his personal mission to improve patient safety and make preventable deaths a thing of the past, one hospital at a time. Dr. Pronovost began with simple improvements to a common procedure in the ER and ICU units at Johns Hopkins Hospital. Creating an easy five-step checklist based on the most up-to-date research for his fellow doctors and nurses to follow, he hoped that streamlining the procedure itself could slow the rate of infections patients often died from. But what Dr. Pronovost discovered was that doctors and nurses needed more than a checklist: the day-to-day environment needed to be more patient-driven and staff needed to see scientific results in order to know their efforts were a success. After those changes took effect, the units Dr. Pronovost worked with decreased their rate of infection by 70%. Today, all fifty states are implementing Dr. Pronovost's programs, which have the potential to save more lives than any other medical innovation in the past twenty-five years. But his ideas are just the beginning of the changes being made by doctors and nurses across the country making huge leaps to improve patient care. In Safe Patients, Smart Hospitals, Dr. Pronovost shares his own experience, anecdotal stories from his colleagues at Johns Hopkins and other hospitals that have made his approach their own, alongside comprehensive research-showing readers how small changes make a huge difference in patient care. Inspiring and thought provoking, this compelling book shows how one person with a cause really can make a huge difference in our lives.
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.
Argues for more transparent, democratic and safer healthcare practices to keep patients better informed and hold poor-performing doctors and flawed systems accountable.
Developed throughout early modern Europe, lazaretti, or plague hospitals, took on a central role in early modern responses to epidemic disease, in particular the prevention and treatment of plague. The lazaretti served as isolation hospitals, quarantine centres, convalescent homes, cemeteries, and depots for the disinfection or destruction of infected goods. The first permanent example of this institution was established in Venice in 1423 and between the fifteenth and eighteenth centuries tens of thousands of patients passed through the doors. Founded on lagoon islands, the lazaretti tell us about the relationship between the city and its natural environment. The plague hospitals also illustrate the way in which medical structures in Venice intersected with those of piety and poor relief and provided a model for public health which was influential across Europe. This is the first detailed study of how these plague hospitals functioned, where they were situated, who worked there, what it was like to stay there, and how many people survived. Comparisons are made between the Venetian lazaretti and similar institutions in Padua, Verona and other Italian and European cities. Centred on the sixteenth and seventeenth centuries, during which time there were both serious plague outbreaks in Europe and periods of relative calm, the book explores what the lazaretti can tell us about early modern medicine and society and makes a significant contribution to both Venetian history and our understanding of public health in early modern Europe, engaging with ideas of infection and isolation, charity and cure, dirt, disease and death.