Wrong Medicine

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

Too often, patients in American hospitals are subjected to painful, expensive, and futile treatments because of a physician’s notion of medical duty or a family’s demands. Lawrence J. Schneiderman and Nancy S. Jecker renew their call for common sense and realistic expectations in medicine in this revised and updated edition of Wrong Medicine. Written by a physician and a philosopher—both internationally recognized experts in medical ethics—Wrong Medicine addresses key topics that have occupied the media and the courts for the past several decades, including the wrenching Terry Schiavo case. The book combines clear descriptions of ethical principles with real clinical stories to discuss the medical, legal, and political issues that confront doctors today as they seek to provide the best medical care to critically ill patients. The authors have added two chapters that outline theoretical, legislative, judicial, and clinical developments since the first edition. Based on the latest empirical research, Wrong Medicine continues to guide a broad range of health care professionals through the challenges of providing humane end-of-life care.

The field of solid state ionics deals with ionically conducting materials in the solid state and numerous devices based on such materials. Solid state ionic materials cover a wide spectrum, ranging from inorganic crystalline and polycrystalline solids, ceramics, glasses, polymers, composites and nano-scale materials. A large number of Scientists in Asia are engaged in research in solid state ionic materials and devices and since 1988. The Asian Society for solid state ionics has played a key role in organizing a series of bi-ennial conferences on solid state ionics in different Asian countries. The contributions in this volume were presented at the 10th conference in the series organized by the Postgraduate Institute of Science (PGIS) and the Faculty of Science, University of Peradeniya, Sri Lanka, which coincided with the 10th Anniversary of the Postgraduate Institute of Science (PGIS). The topics cover solid state ionic materials as well as such devices as solid state batteries, fuel cells, sensors, and electrochromic devices. The aspects covered include theoretical studies and modeling, experimental techniques, materials synthesis and characterization, device fabrication and characterization.

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.

This groundbreaking book challenges the medicalized approach to women's experiences including menstruation, pregnancy, and menopause and suggests that there are better ways for women to cope with real issues they may face. Before any woman diets, douches, botoxes, reduces, reconstructs, or fills a prescription for antidepressants, statins, hormones, menstrual suppressants, or diet pills, she should read this book. Contesting common medical practice, the book addresses the many aspects of women's lives that have been targeted as "deficient" in order to support the billion-dollar profits of the medical-pharmacological industry and suggests alternatives to these "remedies." The contributors—psychologists, sociologists, and health experts—are also gender experts and feminist scholars who recognize the ways in which gender is an important aspect of the human experience. In this eye-opening work, they challenge the marketing and "science" that increasingly render women's bodies and experiences as a series of symptoms, diseases, and dysfunctions that require treatment by medical professionals who prescribe pharmaceutical and surgical interventions. Each article in the book addresses the marketing of a specific "condition" that has been constructed in a way that convinces a woman that her body is inadequate or her experience and behavior are not good enough. Among the topics addressed are menstruation, menopause, pregnancy, post-partum adjustment, sexual desire, weight, body dissatisfaction, moodiness, depression, grief, and anxiety.

"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.

In this expanded 600+ page edition, Dr. Cohen brings together some 30 experts from pharmacy, medicine, nursing, and risk management to provide the most current thinking about the causes of medication errors and strategies to prevent them.