Americas Healthcare Transformation

A revolution in American medicine is in full swing, with the race from fee-for-service to fee-for-value at the front line in an epic battle that will transform healthcare delivery for decades to come. In America’s Healthcare Transformation, eminent physician leader Robert A. Phillips brings together key thought leaders and trail-blazing practitioners, who provide a wide-ranging exploration of the strategies, innovations, and paradigm shifts that are driving this healthcare transformation. The contributors offer a panoramic look at the dramatic changes happening in the field of medicine, changes that put the patient at the heart of the process. Among other subjects, the essays evaluate innovative high quality and low cost care delivery solutions from around the United States and abroad, describe fundamental approaches to measuring the safety of care and the impact that guidelines have on improving quality of care and outcomes, and make a strong case that insurance reform will fundamentally and irreversibly drive delivery reform. In addition, America’s Healthcare Transformation reviews the role of health information technology in creating safer healthcare, provides a primer on the development of a culture of safety, and highlights ground-breaking new ways to train providers in patient safety and quality. Finally, the book looks at reports from Stanford Health Care and Houston Methodist which outline how successful behaviorally based strategies, anchored in values, can energize and empower employees to deliver a superior patient experience. Drawing on the wisdom and vision of today’s leading healthcare innovators, America’s Healthcare Transformation provides a roadmap to the future of American healthcare. This book is essential reading for all health care providers, health care administrators, and health policy professionals, and it will be an invaluable resource in the effort to improve the practice of medicine and the delivery of healthcare in our communities and nation.

Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review

A revolution in American medicine is in full swing, with the race from fee-for-service to fee-for-value at the front line in an epic battle that will transform healthcare delivery for decades to come. In America’s Healthcare Transformation, eminent physician leader Robert A. Phillips brings together key thought leaders and trail-blazing practitioners, who provide a wide-ranging exploration of the strategies, innovations, and paradigm shifts that are driving this healthcare transformation. The contributors offer a panoramic look at the dramatic changes happening in the field of medicine, changes that put the patient at the heart of the process. Among other subjects, the essays evaluate innovative high quality and low cost care delivery solutions from around the United States and abroad, describe fundamental approaches to measuring the safety of care and the impact that guidelines have on improving quality of care and outcomes, and make a strong case that insurance reform will fundamentally and irreversibly drive delivery reform. In addition, America’s Healthcare Transformation reviews the role of health information technology in creating safer healthcare, provides a primer on the development of a culture of safety, and highlights ground-breaking new ways to train providers in patient safety and quality. Finally, the book looks at reports from Stanford Health Care and Houston Methodist which outline how successful behaviorally based strategies, anchored in values, can energize and empower employees to deliver a superior patient experience. Drawing on the wisdom and vision of today’s leading healthcare innovators, America’s Healthcare Transformation provides a roadmap to the future of American healthcare. This book is essential reading for all health care providers, health care administrators, and health policy professionals, and it will be an invaluable resource in the effort to improve the practice of medicine and the delivery of healthcare in our communities and nation.

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.

“Everyone in a hospital leadership role should read this book as it offers a wealth of practical advice for organizations intent on improving their clinical care delivery.” —Amy C. Edmondson, professor, Harvard Business School, and author of The Fearless Organization All Americans deserve and should have access to high quality, affordable healthcare services delivered by professionals who have sufficient time and resources to care for them. This book offers proven and practical approaches for redesigning healthcare organizations to be less fragmented—and more patient-centered—by tapping into the experiences of staff on the front lines of patient care. Peter Lazes and Marie Rudden show how collaboration and active communication among administrators, medical staff, and patients are a core element of a successful organizational change effort. Through case studies and the direct voices and experiences of frontline workers, they explore exactly what it takes to effectively engage staff and providers in improving the patient care shortcomings within their institutions. This book not only is a manual detailing what can be achieved when frontline staff have a direct voice in controlling their practice environments but was written to show how to accomplish transformative changes in how our hospitals and outpatient clinics work. At a time when the massive gaps in our healthcare systems have been laid bare by the fragmented responses to the COVID-19 pandemic, this book offers hope and a plan for change.

This book, n=1 is a collaboration of physician health system CEO, venture capital entrepreneur and leading global business advisor and best-selling business author. These differing perspectives provide insights into the forces transforming the global society, business and professions with a focus on US healthcare and its transformation. Healthcare leaders must develop the incisive questions that challenge the orthodoxies hindering organizational transformation. Our experience indicates leaders of successful non-healthcare organizations develop cultures of inquiry that guide their organizations through dramatic market change. Unique individuals are the driving force in the transformation of healthcare. Digitization has democratized information, which feeds the desire of people to act, behave and be treated as unique individuals. Scientific innovation is revealing the importance of our biologic individuality. The financial risk of healthcare is increasingly passed to individuals and providers, fueling changes in financial incentives. An individual with information knows their options, and wants to choose the option most suited to his or her unique healthcare needs and financial means. This profound and fundamental change in the individual’s expectations and behavior is accelerating healthcare transformation. The title of this book, n = 1, is a symbol of the uniqueness of individuals. The n=1 will transform healthcare.

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

NOW FEATURING A NEW AFTERWORD, "PANDEMIC ETHICS" From two eminent scholars comes a provocative examination of bioethics and our culture’s obsession with having it all without paying the price. Shockingly, the United States has among the lowest life expectancies and highest infant mortality rates of any high-income nation, yet, as Amy Gutmann and Jonathan D. Moreno show, we spend twice as much per capita on medical care without insuring everyone. A “remarkable, highly readable journey” (Judy Woodruff ) sure to become a classic on bioethics, Everybody Wants to Go to Heaven but Nobody Wants to Die explores the troubling contradictions between expanding medical research and neglecting human rights, from testing anthrax vaccines on children to using brain science for marketing campaigns. Providing “a clear and compassionate presentation” (Library Journal) of such complex topics as radical changes in doctor-patient relations, legal controversies over in vitro babies, experiments on humans, unaffordable new drugs, and limited access to hospice care, this urgent and incisive history is “required reading for anyone with a heartbeat” (Andrea Mitchell).