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The Department of Veterans Affairs--the VA--operates the nation's largest and most diverse health care system. How many physicians does it need to carry out its principal mission-related responsibilities of patient care, education, and research? This book presents and demonstrates by concrete example a methodology to answer this basic, but extraordinarily complex, question. The heart of the methodology is a decision-making process in which both statistical and expert judgment approaches can be used separately or in concert to calculate the number of physicians required, by specialty, for any facility in the VA system. Although the analyses here focus entirely on the VA, the methodology could be used to determine physician staffing for a wide range of public and private sector health care organizations.
The Department of Veterans Affairsâ€"the VAâ€"operates the nation's largest and most diverse health care system. How many physicians does it need to carry out its principal mission-related responsibilities of patient care, education, and research? This book presents and demonstrates by concrete example a methodology to answer this basic, but extraordinarily complex, question. The heart of the methodology is a decision-making process in which both statistical and expert judgment approaches can be used separately or in concert to calculate the number of physicians required, by specialty, for any facility in the VA system. Although the analyses here focus entirely on the VA, the methodology could be used to determine physician staffing for a wide range of public and private sector health care organizations.
Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
The National Academies of Sciences, Engineering, and Medicine was tasked by the Veterans Health Administration (VHA) to prepare a comprehensive resource planning and staffing methodology guidebook for VHA Facility Management (Engineering) Programs. The resource and staffing methodology must take into account all significant parameters and variables involved in the VHA Engineering Programs. The methodology should yield customized outputs based on site-specific input data, to enable specification of the optimal budget and staffing levels for each site. Currently, the VHA does not utilize a staffing model for defining its facilities workforce. Each medical center defines its required facilities staffing. This interim report focuses on the types, availability, usage, and limitations of models in the staffing processes.
Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
Patient-centered medicine is not an illness-centered, a physician-centered, or a hospital-centered medicine approach. In this book, it is aimed at presenting an approach to patient-centered medicine from the beginning of life to the end of life. As indicated by W. Osler, "It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has." In our day, if the physicians and healthcare professionals could consider more than the diseased organ and provide healthcare by comforting the patients by respecting their values, beliefs, needs, and preferences; informing them and their relatives at every stage; and comforting the patients physically by controlling the pain and relieving their worries and fears, patients obeying the rules of physicians would become patients with high adaptation and participation to the treatment.
Entering its 6th edition, Physician Assistant: A Guide to Clinical Practice is the only text that covers all aspects of the physician assistant profession, the PA curriculum, and the PA's role in clinical practice. It is designed as a highly visual and practical resource to be used across the spectrum of lifelong learning, enabling students and practicing PAs to thrive in a rapidly changing health care system. - Teaches how to prepare for each core clinical rotation and common electives, as well as how to work with atypical patient populations such as homeless patients and patients with disabilities. - A succinct, bulleted writing style; convenient tables; practical case studies; and clinical application questions throughout enable you to master key concepts and clinical applications. - Helps you master all the core competencies needed for certification or recertification. - Addresses all six Physician Assistant Competencies, as well as providing guidance for the newly graduated PA entering practice. - Includes quick-use resources, such as objectives and key points sections for each chapter, tip boxes with useful advice, abundant tables and images, and 134 updated case studies. - Features chapters for the 7 core clinical rotations and 5 common electives, with key guidance on how to prepare effectively and what to expect. - Provides updated health policy information, expanded information about international programs, cultural competencies, and pearls and pitfalls on working internationally as a PA. - Outlines the basic principles of Interprofessional Education – an important new trend in medical education nationally. - New chapters cover: Maximizing Your Education, Future of the Profession, Principles of PA Education, Managing Stress and Burnout, and many other topics. - Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, and references from the book on a variety of devices.
The health and economic costs of tobacco use in military and veteran populations are high. In 2007, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) requested that the Institute of Medicine (IOM) make recommendations on how to reduce tobacco initiation and encourage cessation in both military and veteran populations. In its 2009 report, Combating Tobacco in Military and Veteran Populations, the authoring committee concludes that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs.