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This volume provides the important concepts necessary for a physician to participate in a reengineering process, develop decision-making skills based on probability and logic rather than “rules,” and to measure and analyze meaningful outcomes of care delivery. This approach has been developed over ten years in a medical student-based program and has been enthusiastically embraced by medical students without backgrounds in engineering or statistics. More specifically, this text will introduce physicians to relevant and available computer software, combined with an in depth knowledge of measurement, variation, and uncertainty. It provides a basis for the transformation of data into information, information into knowledge, and knowledge into wisdom. The first quarter of the book will address understanding and visualizing data, using statistical and graphic analysis. The next quarter addresses the fundamentals of applied statistics, and the application of conditional probability to clinical decision making. The next quarter addresses the four “cornerstones” of modern analytics: regression, classification, association analysis, and clustering. The final section addresses the identification of outliers and their importance in understanding, the assessment of cause and effect and the limitations associated with retrospective data analysis. This toolbox will prepare the interested physician to actively engage in the identification of problem areas, the design of process-based solutions, and the continuous assessment of outcomes of clinical practice. Armed with this toolbox, the reader will be “prepared to make a difference” in the rapidly changing world of healthcare delivery. Measurement and Analysis in Transforming Healthcare Delivery is an excellent resource for general practitioners, health administrators, and all medical professionals interacting with healthcare delivery. /div
This volume is complementary to Volume 1: Quantitative Approaches in Health Systems Engineering which provides in-depth analysis of the statistical and quantitative aspects of Health Systems Engineering. Volume 2: Practical Applications to Engage and Align Providers and Consumers builds upon these concepts with the integration of additional economic, performance and quality measures. Stressing the importance of changes in the economics of health care financing, it will serve as a resource for not only leaders of organizations, but also providers who will be practicing a different type of medicine from that of which they were trained. After defining the challenges, the authors will quantify and define funds flows and various margins necessary for viability, how providers will be measured and rewarded for quality, and the importance of accurate dashboard of physician performance. Types of payment systems, including capitation, ACOs, risk contracts, and hybrid forms of fee for service will be defined and their relative advantages discussed. Lessons from other countries that provide high quality care at a lower cost will be examined for applicability to our challenges. Finally, experts in leadership will focus on influencing behavior to achieve results while remembering that healthcare is about the patient. This textbook will serve as a useful resource for clinicians, healthcare executives, governmental agencies, and emerging leaders in organizations.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.
Measuring Capacity to Care Using Nursing Data presents evidence-based solutions regarding the adoption of safe staffing principles and the optimum use of operational data to enable health service delivery strategies that result in improved patient and organizational outcomes. Readers will learn how to make better use of informatics to collect, share, link and process data collected operationally for the purpose of providing real-time information to decision- makers. The book discusses topics such as dynamic health care environments, health care operational inefficiencies and costly events, how to measure nursing care demand, nursing models of care, data quality and governance, and big data. The content of the book is a valuable source for graduate students in informatics, nurses, nursing managers and several members involved in health care who are interested in learning more about the beneficial use of informatics for improving their services. Presents and discusses evidences from real-world case studies from multiple countries Provides detailed insights of health system complexity in order to improve decision- making Demonstrates the link between nursing data and its use for efficient and effective healthcare service management Discusses several limitations currently experienced and their impact on health service delivery
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
This open access book comprehensively covers the fundamentals of clinical data science, focusing on data collection, modelling and clinical applications. Topics covered in the first section on data collection include: data sources, data at scale (big data), data stewardship (FAIR data) and related privacy concerns. Aspects of predictive modelling using techniques such as classification, regression or clustering, and prediction model validation will be covered in the second section. The third section covers aspects of (mobile) clinical decision support systems, operational excellence and value-based healthcare. Fundamentals of Clinical Data Science is an essential resource for healthcare professionals and IT consultants intending to develop and refine their skills in personalized medicine, using solutions based on large datasets from electronic health records or telemonitoring programmes. The book’s promise is “no math, no code”and will explain the topics in a style that is optimized for a healthcare audience.
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.
Using straightforward, accessible language, this groundbreaking resource is a comprehensive primer on the most progressive tools and techniques currently used for assessing healthcare systems and healthcare process effectiveness. Typically these tools are embedded in programs such as Total Quality Management, continuous process improvement, process reengineering, protocol redesign, or most recently, Six Sigma and organizational transformation. Transforming Health Care Management presents an integrated, multi-disciplinary approach while focusing on fundamental concepts. It will thoroughly prepare the reader to design, implement, manage, operate, monitor or improve technology, processes, and programs and is an ideal text for those studying healthcare information technology, operations research, systems analysis, process improvement, or informatics. Features: Chapters cover highly technical subjects using clear and accessible language. Vignettes from the author’s years of professional experience illustrate particularly complex concepts. Focuses on key concepts and applications rather than theory and jargon. Accompanied by a complete package of instructor resources (downloadable Instructor’s Manual, TestBank, PowerPoint slides) to facilitate teaching and learning.