Changing Healthcare

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.

Healthcare is changing. It is moving to a paperless environment, a team-based, interdisciplinary and patient-centred profession. Value-driven strategies, evidence-based medicine, data-driven technology, decision support and automated decision-making are adopted in modern healthcare models. Health-related data are subject to eagerness characterising our data-driven economy.00Amidst these changes, is the patient and his or her right to data protection, privacy and autonomy.00The question arises how to match phenomena that characterise the predominant ethos in modern healthcare systems, such as e-health and personalised medicine, with patient autonomy and data protection laws. That matching exercise is essential. The successful adoption of ICT in healthcare depends, at least partly, on how the public?s concerns about data protection and confidentiality are addressed.00Three backbone principles of European data protection law, in particular, are considered bottlenecks for the implementation of modern healthcare systems: informed consent, anonymisation and purpose limitation. The book assesses the adequacy of these principles and considers them in the context of technological and societal evolutions. A must-read for every professional active in the field of data protection law, health law, policy development or IT-driven innovation.

The challenge of transforming organizational culture is at the heart of many key movements in contemporary healthcare, and understanding culture change has become a core leadership competency. However, much current practice is based on antiquated and psychologically unsophisticated theories, leaving leaders inadequately prepared for the complex task of implementing change. Leading Change in Healthcare presents relationship-centered administration, an effective new evidence-based alternative to traditional culture change methodologies. It integrates fresh insights and methods from complexity science, positive psychology and relationship-centered care, enabling a more spontaneous and reflective approach to change management. This fosters greater organizational awareness and real participation, as well as improved productivity and creativity, as well as staff recruitment and retention. Case studies drawn from primary care, hospitals, long-term care, professional education, international NGOs and other settings, rather than emphasizing the end results, are demonstrations of how to apply relationship-centered administration in everyday practice. Leading Change in Healthcare is a key resource for all practitioners, students and teachers of healthcare management, medical educators, and leaders in all areas of healthcare provision. 'We need a new way of seeing, a new way of leading - and the authors provide a clear guide and resources for the path ahead. Leading Change in Healthcare offers hope - and a method. A daily dose is just what the change doctor ordered.' from the Foreword by Carol Aschenbrener

This volume provides theory and research on organizational change and predominantly features the application of these ideas to the health care domain, broadly defined. It addresses enduring issues in advancing to an effective health care system. The aim of this book is to offer an accessible and readable text aimed at provoking thought and questioning, and aiding creativity. It proffers arguments and ideas which are firmly based in empirical data and evidence, so that the reader may make informed personal evaluations. This book is designed to furnish a comprehensive theoretical basis for understanding organizational change in health care, as well as selected core issues of contemporary and future importance to the provision of effective care within sustainable systems. A series of coherent themes are addressed throughout the book from differing perspectives. However, every chapter has been written to standalone and be read independently. Each offers resources relevant to its’ focal topic, in the form of references, case studies and critique. Setting out a future research agenda, the book will be vital reading for organizational change researchers and practitioners in the healthcare industry.

As innovations are constantly being developed within health care, it can be difficult both to select appropriate new practices and technologies and to successfully adopt them within complex organizations. It is necessary to understand the consequences of introducing change, how to best implement new procedures and techniques, how to evaluate success and to improve the quality of patient care. This comprehensive guide allows you to do just that. Improving Patient Care, 2nd edition provides a structure for professionals and change agents to implement better practices in health care. It helps health professionals, managers, policy makers and researchers to assess new techniques and select and implement change in their organizations. This new edition includes recent evidence and further coverage on patient safety and patient centred strategies for change. Written by an international expert author team, Improving Patient Care is an established standard text for postgraduate students of health policy, health services and health management. The strong author team are global professors involved in managing research and development in the field of quality improvement, evidence-based practice and guidelines, quality assessment and indicators to improve patient outcomes through receiving appropriate healthcare.

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.

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

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.