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This visionary reframing of health and healthcare uses a complexity science approach to building healthcare systems that are accessible, effective, and prepared for change and challenges. Its holistic map for understanding the human organism emphasizes the interconnectedness of the individual’s physical, psychological, cognitive, and sociocultural functioning. Applications of this approach are described in primary, specialist, and emergency care and at the organizational and policy levels, from translating findings to practice, to problem solving and evaluation. In this model, the differences between disease and illness and treating illness and restoring health are not mere wordplay, but instead are robust concepts reflecting real-world issues and their solutions. Based on the Proceedings of the 1st International Conference of Systems and Complexity for Healthcare, topics covered include: • Coping with complexity and uncertainty: insights from studying epidemiology in family medicine • Anticipation in complex systems: potential implications for improving safety and quality in healthcare • Monitoring variability and complexity at the bedside • Viewing mental health through the lens of complexity science • Ethical complexities in systems healthcare: what care and for whom? • The value of systems and complexity thinking to enable change in adaptive healthcare organizations supported by informatics • If the facts don’t fit the theory, change the theory: implications for health system reform The Value of Systems and Complexity Sciences for Healthcare will interest and inspire health and disease researchers, health professionals, health care planners, health system financiers, health system administrators, health services administrators, health professional educators, and, last but not least, current and future patients.
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.
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.
Complex Systems and Computation in Public Health Sciences is the first comprehensive book in population health science that meaningfully integrates complex systems theory, methodology, modeling, computational simulation, and real-world applications while incorporating current population health perspectives.
This accessible textbook introduces a wide spectrum of ideas, approaches, and examples that make up the emerging field of implementation science, including implementation theory, processes and methods, data collection and analysis, brokering interest on the ground, and sustainable implementation. Containing over 60 concise essays, each addressing the thorny problem of how we can make care more evidence-informed, this book looks at how implementation science should be defined, how it can be conducted, and how it is assessed. It offers vital insight into how research findings that are derived from healthcare contexts can help make sense of service delivery and patient encounters. Each entry concentrates on an important concept and examines the idea’s evidence base, root causes and effects, ideas and applications, and methodologies and methods. Revealing a very human side to caregiving, but also tackling its more complex and technological aspects, the contributors draw on real-life healthcare examples to look both at why things go right in introducing a new intervention and at what can go wrong. Implementation Science: The Key Concepts provides a toolbox of rich, contemporary thought from leading international thinkers, clearly and succinctly delivered. This comprehensive and enlightening range of ideas and examples brought together in one place is essential reading for all students, researchers, and practitioners with an interest in translating knowledge into practice in healthcare.
"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.
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
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.
This forward-looking volume challenges professionals and interested lay readers to reconsider our ways of looking at health and wellness, illness and disease, and the goals of health/healthcare systems. Reframing health systems as complex adaptive systems, the book identifies health care as a central aspect of social care and security for all people, particularly the most vulnerable. From there, the author outlines necessary organizational, design, medical, and community steps toward building health systems that view and practice health care as a human right and can produce optimum care in the long term. And extensive illustrations display effective collaborative problem solving within these systems, in both intriguing theoretical models and the real world. Highlights of the coverage: · Systems and complexity thinking in health and health care · Redesign based on “first principles” · Redesign from an organizational perspective · Working together effectively and efficiently to achieve a common purpose · Analyzing “the workings” of health systems as complex adaptive systems · Person-centered, equitable, and sustainable health systems: achieving the goal Health System Redesign brings a voice and a vision to the most pressing problems in healthcare service delivery, and offers new goals and purpose to health policymakers, health financiers, organizational leaders, clinicians, and concerned members of the local community
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.