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Summarizes the science of climate change and impacts on the United States, for the public and policymakers.
This public inquiry report into serious failings in healthcare that took place at the Mid Staffordshire NHS Foundation Trust builds on the first independent report published in February 2010 (ISBN 9780102964394). It further examines the suffering of patients caused by failures by the Trust: there was a failure to listen to its patients and staff or ensure correction of deficiencies. There was also a failure to tackle the insidious negative culture involving poor standards and a disengagement from managerial and leadership responsibilities. These failures are in part a consequence of allowing a focus on reaching national access targets, achieving financial balance and seeking foundation trust status at the cost of delivering acceptable care standards. Further, the checks and balances that operate within the NHS system should have prevented the serious systemic failure that developed at Mid Staffs. The system failed in its primary duty to protect patients and maintain confidence in the healthcare system. This report identifies numerous warning signs that could and should have alerted the system to problems developing at the Trust. It also sets out 290 recommendations grouped around: (i) putting the patient first; (ii) developing a set of fundamental standards, easily understood and accepted by patients; (iii) providing professionally endorsed and evidence-based means of compliance of standards that are understood and adopted by staff; (iv) ensuring openness, transparency and candour throughout system; (v) policing of these standards by the healthcare regulator; (vi) making all those who provide care for patients , properly accountable; (vii) enhancing recruitment, education, training and support of all key contributors to the provision of healthcare; (viii) developing and sharing ever improving means of measuring and understanding the performance of individual professionals, teams, units and provider organisations for the patients, the public, and other stakeholders.
Every day thousands of people are killed and injured on our roads. Millions of people each year will spend long weeks in the hospital after severe crashes and many will never be able to live, work or play as they used to do. Current efforts to address road safety are minimal in comparison to this growing human suffering. This report presents a comprehensive overview of what is known about the magnitude, risk factors and impact of road traffic injuries, and about ways to prevent and lessen the impact of road crashes. Over 100 experts, from all continents and different sectors -- including transport, engineering, health, police, education and civil society -- have worked to produce the report. Charts and tables.
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Extreme weather and climate events, interacting with exposed and vulnerable human and natural systems, can lead to disasters. This Special Report explores the social as well as physical dimensions of weather- and climate-related disasters, considering opportunities for managing risks at local to international scales. SREX was approved and accepted by the Intergovernmental Panel on Climate Change (IPCC) on 18 November 2011 in Kampala, Uganda.
The study edition of book the Los Angeles Times called, "The most extensive review of U.S. intelligence-gathering tactics in generations." This is the complete Executive Summary of the Senate Intelligence Committee's investigation into the CIA's interrogation and detention programs -- a.k.a., The Torture Report. Based on over six million pages of secret CIA documents, the report details a covert program of secret prisons, prisoner deaths, interrogation practices, and cooperation with other foreign and domestic agencies, as well as the CIA's efforts to hide the details of the program from the White House, the Department of Justice, the Congress, and the American people. Over five years in the making, it is presented here exactly as redacted and released by the United States government on December 9, 2014, with an introduction by Daniel J. Jones, who led the Senate investigation. This special edition includes: • Large, easy-to-read format. • Almost 3,000 notes formatted as footnotes, exactly as they appeared in the original report. This allows readers to see obscured or clarifying details as they read the main text. • An introduction by Senate staffer Daniel J. Jones who led the investigation and wrote the report for the Senate Intelligence Committee, and a forward by the head of that committee, Senator Dianne Feinstein.