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Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Existing research methods textbooks emphasize the mechanics of HOW to conduct research studies. However, many students fail to see WHY it is important to learn about research because they will never conduct research studies. These students do not become engaged in learning and believe that research courses and textbooks are useless. They do not see the need of developing “research literacy” to understand the applications and limitations of research to their daily lives. This book engages students with a nonmathematical presentation that includes real examples of the consequences of research errors in daily life. The organization facilitates learning with objectives, concepts, description of errors, best practices, and examples. This is a research methods textbook for students who fear research textbooks. The diversity of topics in this book permits application to research methods courses in these academic fields: Economics, Education, Political Science, Psychology, and Sociology. This should be the first book for all students to introduce research and develop “research literacy”.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
In 1996 the Institute of Medicine launched the Quality Chasm Series, a series of reports focused on assessing and improving the nation's quality of health care. Preventing Medication Errors is the newest volume in the series. Responding to the key messages in earlier volumes of the seriesâ€"To Err Is Human (2000), Crossing the Quality Chasm (2001), and Patient Safety (2004)â€"this book sets forth an agenda for improving the safety of medication use. It begins by providing an overview of the system for drug development, regulation, distribution, and use. Preventing Medication Errors also examines the peer-reviewed literature on the incidence and the cost of medication errors and the effectiveness of error prevention strategies. Presenting data that will foster the reduction of medication errors, the book provides action agendas detailing the measures needed to improve the safety of medication use in both the short- and long-term. Patients, primary health care providers, health care organizations, purchasers of group health care, legislators, and those affiliated with providing medications and medication- related products and services will benefit from this guide to reducing medication errors.
From the Nobel Prize-winning author of Thinking, Fast and Slow and the coauthor of Nudge, a revolutionary exploration of why people make bad judgments and how to make better ones—"a tour de force” (New York Times). Imagine that two doctors in the same city give different diagnoses to identical patients—or that two judges in the same courthouse give markedly different sentences to people who have committed the same crime. Suppose that different interviewers at the same firm make different decisions about indistinguishable job applicants—or that when a company is handling customer complaints, the resolution depends on who happens to answer the phone. Now imagine that the same doctor, the same judge, the same interviewer, or the same customer service agent makes different decisions depending on whether it is morning or afternoon, or Monday rather than Wednesday. These are examples of noise: variability in judgments that should be identical. In Noise, Daniel Kahneman, Olivier Sibony, and Cass R. Sunstein show the detrimental effects of noise in many fields, including medicine, law, economic forecasting, forensic science, bail, child protection, strategy, performance reviews, and personnel selection. Wherever there is judgment, there is noise. Yet, most of the time, individuals and organizations alike are unaware of it. They neglect noise. With a few simple remedies, people can reduce both noise and bias, and so make far better decisions. Packed with original ideas, and offering the same kinds of research-based insights that made Thinking, Fast and Slow and Nudge groundbreaking New York Times bestsellers, Noise explains how and why humans are so susceptible to noise in judgment—and what we can do about it.
This volume presents novel concepts to help physicians and health care providers better understand the thought processes and approaches used in clinical decision-making and how we develop those skills as we transition from being a medical student to post-graduate trainee to independent practitioner. Approaches presented range from simple rules of thumb, pattern recognition, and heuristics, to more formulaic methods such as standard operating procedures, checklists, evidence-based medicine, mathematical modeling, and statistics. Ways to recognize and manage errors and how our decision-making can be improved, are also discussed. An Introduction to Medical Decision-Making presents several innovative techniques to allow the reader to use the principles presented and integrate the ethical, humanistic and social aspects of decision-making with the pragmatic and knowledge-based aspects of clinical medicine. It also highlights how our thinking processes, emotions, and biases affect decision-making. This invaluable resource will allow students and physicians to evaluate and critically discuss their decisions objectively to become more efficient and effective, and maximize the quality of care they provide.
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
This concise, hands-on text provides dental hygiene and dentistry students and practitioners with a method for making evidence-based decisions in practice. The book presents a step-by-step approach to mastering the five essential skills of evidence-based decision making%formulating patient-centered questions, searching for the appropriate evidence, critically appraising the evidence, applying the evidence to practice, and evaluating the process. Five Case Scenarios are used throughout the book in coordination with these skills and cover the broad areas of therapy/prevention, diagnosis, etiology/harm/causation, and prognosis. Each chapter has objectives, suggested activities, a quiz, critical thinking questions, and exercises. A companion Website includes online tutorials, additional cases, and links to additional resources. http://thepoint.lww.com/product/isbn/9780781765336
People often follow intuitive principles of decision making, ranging from group loyalty to the belief that nature is benign. But instead of using these principles as rules of thumb, we often treat them as absolutes and ignore the consequences of following them blindly. In Judgment Misguided, Jonathan Baron explores our well-meant and deeply felt personal intuitions about what is right and wrong, and how they affect the public domain. Baron argues that when these intuitions are valued in their own right, rather than as a means to another end, they often prevent us from achieving the results we want. Focusing on cases where our intuitive principles take over public decision making, the book examines some of our most common intuitions and the ways they can be misused. According to Baron, we can avoid these problems by paying more attention to the effects of our decisions. Written in a accessible style, the book is filled with compelling case studies, such as abortion, nuclear power, immigration, and the decline of the Atlantic fishery, among others, which illustrate a range of intuitions and how they impede the public's best interests. Judgment Misguided will be important reading for those involved in public decision making, and researchers and students in psychology and the social sciences, as well as everyone looking for insight into the decisions that affect us all.