Institute of Medicine (U.S.). Committee on Enhancing Federal Healthcare Quality Programs's Books

Leadership by Example

Coordinating Government Roles in Improving Healthcare Quality

By: Institute of Medicine (U.S.). Committee on Enhancing Federal Healthcare Quality Programs,Janet Corrigan,Jill Eden,Barbara M. Smith

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Leadership by Example

Coordinating Government Roles in Improving Healthcare Quality

By: Institute of Medicine (U.S.). Committee on Enhancing Federal Healthcare Quality Programs,Janet Corrigan,Jill Eden,Barbara M. Smith

In response to a request from Congress, the Institute of Medicine (IOM) convened a committee to conduct an analysis of the federal government's quality enhancement processes in six government programs-- Medicare, Medicaid, the State Children's Health Insurance Program, the Department of Defense TRICARE and TRICARE for Life programs, the Veterans Health Administration program, and the Indian Health Services program"--Page 1.

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214

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ISBN 10

0309086302

ISBN 13

9780309086301

Leadership by Example

Coordinating Government Roles in Improving Health Care Quality

By: Institute of Medicine,Committee on Enhancing Federal Healthcare Quality Programs

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Leadership by Example

Coordinating Government Roles in Improving Health Care Quality

By: Institute of Medicine,Committee on Enhancing Federal Healthcare Quality Programs

The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government's role in health care.

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207

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National Academies Press

Published Date

ISBN 10

0309086183

ISBN 13

9780309086189

Leadership by Example

Coordinating Government Roles in Improving Health Care Quality

By: Institute of Medicine,Committee on Enhancing Federal Healthcare Quality Programs

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Leadership by Example

Coordinating Government Roles in Improving Health Care Quality

By: Institute of Medicine,Committee on Enhancing Federal Healthcare Quality Programs

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206

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National Academies Press

Published Date

ISBN 10

0309168880

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9780309168885

Future Directions for the National Healthcare Quality and Disparities Reports

By: Institute of Medicine,Board on Health Care Services,Committee on Future Directions for the National Healthcare Quality and Disparities Reports

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Future Directions for the National Healthcare Quality and Disparities Reports

By: Institute of Medicine,Board on Health Care Services,Committee on Future Directions for the National Healthcare Quality and Disparities Reports

As the United States devotes extensive resources to health care, evaluating how successfully the U.S. system delivers high-quality, high-value care in an equitable manner is essential. At the request of Congress, the Agency for Healthcare Research and Quality (AHRQ) annually produces the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). The reports have revealed areas in which health care performance has improved over time, but they also have identified major shortcomings. After five years of producing the NHQR and NHDR, AHRQ asked the IOM for guidance on how to improve the next generation of reports. The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the health care system. In addition to being sources of data on past trends, the national healthcare reports can provide more detailed insights into current performance, establish the value of closing gaps in quality and equity, and project the time required to bridge those gaps at the current pace of improvement.

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246

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National Academies Press

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ISBN 10

0309149851

ISBN 13

9780309149853

Medicare's Quality Improvement Organization Program

Maximizing Potential

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

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Medicare's Quality Improvement Organization Program

Maximizing Potential

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

Medicare's Quality Improvement Organization Program is the second book in the new Pathways to Quality Health Care series. Focusing on performance improvement, it considers the history, role, and effectiveness of the Quality Improvement Organization (QIO) program and its potential to promote quality improvement within a changing health care delivery environment that includes standardized performance measures and new data collection and reporting requirements. This book carefully examines the QIOs that serve every state as well as the national program that guides and supports them. In addition, it highlights the important roles that a national program with private organizations in each state can play in promoting higher quality care. Medicare's Quality Improvement Organization Program looks closely at the technical assistance role of the QIO program and the need to encourage and support providers to improve their performance. By providing an in-depth assessment of the federal experience with quality improvement and recommendations for program improvement, this book helps point the way for those who strive to create higher quality and better value in health care. Intended for multiple audiences, Medicare's Quality Improvement Organization Program is essential reading for members of Congress, the federal executive branch, the QIOs, health care providers and clinicians, and stakeholder groups.

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542

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National Academies Press

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ISBN 10

0309133696

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9780309133692

Managing Managed Care

Quality Improvement in Behavioral Health

By: Institute of Medicine,Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care

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Managing Managed Care

Quality Improvement in Behavioral Health

By: Institute of Medicine,Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care

Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

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395

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National Academies Press

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ISBN 10

030905642X

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9780309056427

Race, Ethnicity, and Language Data

Standardization for Health Care Quality Improvement

By: Institute of Medicine,Board on Health Care Services,Subcommittee on Standardized Collection of Race/Ethnicity Data for Healthcare Quality Improvement

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Race, Ethnicity, and Language Data

Standardization for Health Care Quality Improvement

By: Institute of Medicine,Board on Health Care Services,Subcommittee on Standardized Collection of Race/Ethnicity Data for Healthcare Quality Improvement

The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.

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287

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National Academies Press

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ISBN 10

0309148669

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9780309148665

Improving the Quality of Long-Term Care

By: Institute of Medicine,Division of Health Care Services,Committee on Improving Quality in Long-Term Care

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Improving the Quality of Long-Term Care

By: Institute of Medicine,Division of Health Care Services,Committee on Improving Quality in Long-Term Care

Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

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344

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National Academies Press

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ISBN 10

0309132746

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9780309132749

Strategies to Improve Cardiac Arrest Survival

A Time to Act

By: Institute of Medicine,Board on Health Sciences Policy,Committee on the Treatment of Cardiac Arrest: Current Status and Future Directions

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Strategies to Improve Cardiac Arrest Survival

A Time to Act

By: Institute of Medicine,Board on Health Sciences Policy,Committee on the Treatment of Cardiac Arrest: Current Status and Future Directions

Cardiac arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed. Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States.

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291

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National Academies Press

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ISBN 10

030937202X

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9780309372022

Improving the Quality of Health Care for Mental and Substance-Use Conditions

By: Institute of Medicine,Board on Health Care Services,Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders

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Improving the Quality of Health Care for Mental and Substance-Use Conditions

By: Institute of Medicine,Board on Health Care Services,Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

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529

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National Academies Press

Published Date

ISBN 10

0309100445

ISBN 13

9780309100441

Child and Adolescent Health and Health Care Quality

Measuring What Matters

By: National Research Council,Institute of Medicine,Board on Health Care Services,Board on Children, Youth, and Families,Committee on Pediatric Health and Health Care Quality Measures

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Child and Adolescent Health and Health Care Quality

Measuring What Matters

By: National Research Council,Institute of Medicine,Board on Health Care Services,Board on Children, Youth, and Families,Committee on Pediatric Health and Health Care Quality Measures

Increasing public investments in health care services for low-income and special needs children and adolescents in the United States have raised questions about whether these efforts improve their health outcomes. Yet it is difficult to assess the general health status and health care quality for younger populations, especially those at risk of poor health outcomes, because the United States has no national information system that can provide timely, comprehensive, and reliable indicators in these areas for children and adolescents. Without such a system in place, it is difficult to know whether and how selected health care initiatives and programs contribute to children's health status. Child and Adolescent Health and Health Care Quality identifies key advances in the development of pediatric health and health care quality measures, examines the capacity of existing federal data sets to support these measures, and considers related research activities focused on the development of new measures to address current gaps. This book posits the need for a comprehensive strategy to make better use of existing data, to integrate different data sources, and to develop new data sources and collection methods for unique populations. Child and Adolescent Health and Health Care Quality looks closely at three areas: the nature, scope, and quality of existing data sources; gaps in measurement areas; and methodological areas that deserve attention. Child and Adolescent Health and Health Care Quality makes recommendations for improving and strengthening the timeliness, quality, public transparency, and accessibility of information on child health and health care quality. This book will be a vital resource for health officials at the local, state, and national levels, as well as private and public health care organizations and researchers.

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281

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National Academies Press

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ISBN 10

0309225116

ISBN 13

9780309225113

Dying in America

Improving Quality and Honoring Individual Preferences Near the End of Life

By: Institute of Medicine,Committee on Approaching Death: Addressing Key End-of-Life Issues

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Dying in America

Improving Quality and Honoring Individual Preferences Near the End of Life

By: Institute of Medicine,Committee on Approaching Death: Addressing Key End-of-Life Issues

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

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470

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National Academies Press

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ISBN 10

0309303133

ISBN 13

9780309303132

Improving Access to Oral Health Care for Vulnerable and Underserved Populations

By: National Research Council,Institute of Medicine,Board on Health Care Services,Board on Children, Youth, and Families,Committee on Oral Health Access to Services

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Improving Access to Oral Health Care for Vulnerable and Underserved Populations

By: National Research Council,Institute of Medicine,Board on Health Care Services,Board on Children, Youth, and Families,Committee on Oral Health Access to Services

Access to oral health care is essential to promoting and maintaining overall health and well-being, yet only half of the population visits a dentist each year. Poor and minority children are less likely to have access to oral health care than are their nonpoor and nonminority peers. Older adults, people who live in rural areas, and disabled individuals, uniformly confront access barriers, regardless of their financial resources. The consequences of these disparities in access to oral health care can lead to a number of conditions including malnutrition, childhood speech problems, infections, diabetes, heart disease, and premature births. Improving Access to Oral Health Care for Vulnerable and Underserved Populations examines the scope and consequences of inadequate access to oral health services in the United States and recommends ways to combat the economic, structural, geographic, and cultural factors that prevent access to regular, quality care. The report suggests changing funding and reimbursement for dental care; expanding the oral health work force by training doctors, nurses, and other nondental professionals to recognize risk for oral diseases; and revamping regulatory, educational, and administrative practices. It also recommends changes to incorporate oral health care into overall health care. These recommendations support the creation of a diverse workforce that is competent, compensated, and authorized to serve vulnerable and underserved populations across the life cycle. The recommendations provided in Improving Access to Oral Health Care for Vulnerable and Underserved Populations will help direct the efforts of federal, state, and local government agencies; policy makers; health professionals in all fields; private and public health organizations; licensing and accreditation bodies; educational institutions; health care researchers; and philanthropic and advocacy organizations.

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296

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National Academies Press

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ISBN 10

0309209463

ISBN 13

9780309209465

Health Professions Education

A Bridge to Quality

By: Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit

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Health Professions Education

A Bridge to Quality

By: Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

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192

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National Academies Press

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ISBN 10

0309087236

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9780309087230

Leadership Commitments to Improve Value in Health Care

Finding Common Ground: Workshop Summary

By: Institute of Medicine,Roundtable on Evidence-Based Medicine,J. Michael McGinnis,W. Alexander Goolsby,LeighAnne Olsen

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Leadership Commitments to Improve Value in Health Care

Finding Common Ground: Workshop Summary

By: Institute of Medicine,Roundtable on Evidence-Based Medicine,J. Michael McGinnis,W. Alexander Goolsby,LeighAnne Olsen

This volume reports on discussions among multiple stakeholders about ways they might help transform health care in the United States. The U.S. healthcare system consists of a complex network of decentralized and loosely associated organizations, services, relationships, and participants. Each of the healthcare system's component sectors-patients, healthcare professionals, healthcare delivery organizations, healthcare product developers, clinical investigators and evaluators, regulators, insurers, employers and employees, and individuals involved in information technology-conducts activities that support a common goal: to improve patient health and wellbeing. Implicit in this goal is the commitment of each stakeholder group to contribute to the evidence base for health care, that is, to assist with the development and application of information about the efficacy, safety, effectiveness, value, and appropriateness of the health care delivered.

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368

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National Academies Press

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ISBN 10

030911053X

ISBN 13

9780309110532

Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement

Workshop Proceedings

By: Institute of Medicine,Roundtable on Value and Science-Driven Health Care

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Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement

Workshop Proceedings

By: Institute of Medicine,Roundtable on Value and Science-Driven Health Care

The Institute of Medicine\'s Roundtable on Value & Science-Driven Health Care held a workshop, titled Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement, on February 25 and 26, 2013. The workshop, supported by the Gordon and Betty Moore Foundation and the Blue Shield of California Foundation, focused on identifying and exploring issues, attitudes, and approaches to increasing patient engagement in and demand for the following: shared decision making and better communication about the evidence in support of testing and treatment options; the best value from the health care they receive; and the use of data generated in the course of their care experience for care improvement. The workshop hoped to build awareness and demand from patients and families for better care at lower costs and to create a health care system that continuously learns and improves. Participants included members of the medical, clinical research, health care services research, regulatory, health care economics, behavioral economics, health care delivery, payer, and patient communities. Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement Workshop Proceedings offers a summary of the 2-day workshop including the workshop agenda and biographies of speakers.

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207

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National Academies Press

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ISBN 10

0309288967

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9780309288965

Quality Through Collaboration

The Future of Rural Health

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Rural Health Care

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Quality Through Collaboration

The Future of Rural Health

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Rural Health Care

Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.

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289

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National Academies Press

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ISBN 10

0309094399

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9780309094399

Building a Better Delivery System

A New Engineering/Health Care Partnership

By: Institute of Medicine,National Academy of Engineering

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Building a Better Delivery System

A New Engineering/Health Care Partnership

By: Institute of Medicine,National Academy of Engineering

In a joint effort between the National Academy of Engineering and the Institute of Medicine, this books attempts to bridge the knowledge/awareness divide separating health care professionals from their potential partners in systems engineering and related disciplines. The goal of this partnership is to transform the U.S. health care sector from an underperforming conglomerate of independent entities (individual practitioners, small group practices, clinics, hospitals, pharmacies, community health centers et. al.) into a high performance "system" in which every participating unit recognizes its dependence and influence on every other unit. By providing both a framework and action plan for a systems approach to health care delivery based on a partnership between engineers and health care professionals, Building a Better Delivery System describes opportunities and challenges to harness the power of systems-engineering tools, information technologies and complementary knowledge in social sciences, cognitive sciences and business/management to advance the U.S. health care system.

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276

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National Academies Press

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ISBN 10

0309133580

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9780309133586

Priority Areas for National Action

Transforming Health Care Quality

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying Priority Areas for Quality Improvement

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Priority Areas for National Action

Transforming Health Care Quality

By: Institute of Medicine,Board on Health Care Services,Committee on Identifying Priority Areas for Quality Improvement

A new release in the Quality Chasm Series, Priority Areas for National Action recommends a set of 20 priority areas that the U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans. The priority areas selected represent the entire spectrum of health care from preventive care to end of life care. They also touch on all age groups, health care settings and health care providers. Collective action in these areas could help transform the entire health care system. In addition, the report identifies criteria and delineates a process that DHHS may adopt to determine future priority areas.

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159

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National Academies Press

Published Date

ISBN 10

0309133173

ISBN 13

9780309133173

Vital Signs

Core Metrics for Health and Health Care Progress

By: Institute of Medicine,Committee on Core Metrics for Better Health at Lower Cost

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Vital Signs

Core Metrics for Health and Health Care Progress

By: Institute of Medicine,Committee on Core Metrics for Better Health at Lower Cost

Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans.

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245

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National Academies Press

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ISBN 10

0309324963

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9780309324960

Performance Measurement

Accelerating Improvement

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

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Performance Measurement

Accelerating Improvement

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

Performance Measurement is the first in a new series of an ongoing effort by the Institute of Medicine (IOM) to improve health care quality. Performance Measurement offers a comprehensive review of available measures and introduces a new framework to examine these measures against the six aims of the health care system: health care should be safe, effective, patient-centered, timely, efficient, and equitable. This new book also addresses the gaps in performance measurement and introduces the need for measures that are longitudinal, comprehensive, population-based, and patient-centered. This book is directed toward all concerned with improving the quality and performance of the nation's health care system in its multiple dimensions and in both the public and private sectors.

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383

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National Academies Press

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ISBN 10

0309100070

ISBN 13

9780309100076

Childhood Cancer Survivorship

Improving Care and Quality of Life

By: National Research Council,Institute of Medicine,National Cancer Policy Board

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Childhood Cancer Survivorship

Improving Care and Quality of Life

By: National Research Council,Institute of Medicine,National Cancer Policy Board

Only more recently has it been realized that the intense effort to care for and cure a child with cancer does not end with survival. Continued surveillance and a variety of interventions may, in many cases, be needed to identify and care for consequences of treatment that can appear early or only after several decades and impair survivors' health and quality of life. The more than two-thirds of childhood cancer survivors who experience late effects-that is, complications, disabilities, or adverse outcomes-as a result of their disease, its treatment, or both, are the focus of this report which outlines a comprehensive policy agenda that links improved health care delivery and follow-up, investments in education and training for health care providers, and expanded research to improve the long-term outlook for this growing population now exceeding 270,000 Americans.

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225

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National Academies Press

Published Date

ISBN 10

0309088984

ISBN 13

9780309088985

Emergency Care for Children

Growing Pains

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Emergency Care in the United States Health System

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Emergency Care for Children

Growing Pains

By: Institute of Medicine,Board on Health Care Services,Committee on the Future of Emergency Care in the United States Health System

Children represent a special challenge for emergency care providers, because they have unique medical needs in comparison to adults. For decades, policy makers and providers have recognized the special needs of children, but the system has been slow to develop an adequate response to their needs. This is in part due to inadequacies within the broader emergency care system. Emergency Care for Children examines the challenges associated with the provision of emergency services to children and families and evaluates progress since the publication of the Institute of Medicine report Emergency Medical Services for Children (1993), the first comprehensive look at pediatric emergency care in the United States. This new book offers an analysis of: • The role of pediatric emergency services as an integrated component of the overall health system. • System-wide pediatric emergency care planning, preparedness, coordination, and funding. • Pediatric training in professional education. • Research in pediatric emergency care. Emergency Care for Children is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency health care providers, professional organizations, and policy makers looking to address the pediatric deficiencies within their emergency care systems.

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360

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National Academies Press

Published Date

ISBN 10

0309133769

ISBN 13

9780309133760

Advancing Oral Health in America

By: Institute of Medicine,Board on Health Care Services,Committee on an Oral Health Initiative

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Advancing Oral Health in America

By: Institute of Medicine,Board on Health Care Services,Committee on an Oral Health Initiative

Though it is highly preventable, tooth decay is a common chronic disease both in the United States and worldwide. Evidence shows that decay and other oral diseases may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes. However, individuals and many health care professionals remain unaware of the risk factors and preventive approaches for many oral diseases. They do not fully appreciate how oral health affects overall health and well-being. In Advancing Oral Health in America, the Institute of Medicine (IOM) highlights the vital role that the Department of Health and Human Services (HHS) can play in improving oral health and oral health care in the United States. The IOM recommends that HHS design an oral health initiative which has clearly articulated goals, is coordinated effectively, adequately funded and has high-level accountability. In addition, the IOM stresses three key areas needed for successfully maintaining oral health as a priority issue: strong leadership, sustained interest, and the involvement of multiple stakeholders from both the public and private sectors. Advancing Oral Health in America provides practical recommendations that the Department of Health and Human Services can use to improve oral health care in America. The report will serve as a vital resource for federal health agencies, health care professionals, policy makers, researchers, and public and private health organizations.

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211

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National Academies Press

Published Date

ISBN 10

0309186307

ISBN 13

9780309186308

Unequal Treatment

Confronting Racial and Ethnic Disparities in Health Care (with CD)

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care

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Unequal Treatment

Confronting Racial and Ethnic Disparities in Health Care (with CD)

By: Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

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781

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National Academies Press

Published Date

ISBN 10

030908265X

ISBN 13

9780309082655

Improving the Presumptive Disability Decision-Making Process for Veterans

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Evaluation of the Presumptive Disability Decision-Making Process for Veterans

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Improving the Presumptive Disability Decision-Making Process for Veterans

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Evaluation of the Presumptive Disability Decision-Making Process for Veterans

The United States has long recognized and honored the service and sacrifices of its military and veterans. Veterans who have been injured by their service (whether their injury appears during service or afterwards) are owed appropriate health care and disability compensation. For some medical conditions that develop after military service, the scientific information needed to connect the health conditions to the circumstances of service may be incomplete. When information is incomplete, Congress or the Department of Veterans Affairs (VA) may need to make a "presumption" of service connection so that a group of veterans can be appropriately compensated. The missing information may be about the specific exposures of the veterans, or there may be incomplete scientific evidence as to whether an exposure during service causes the health condition of concern. For example, when the exposures of military personnel in Vietnam to Agent Orange could not be clearly documented, a presumption was established that all those who set foot on Vietnam soil were exposed to Agent Orange. The Institute of Medicine (IOM) Committee was charged with reviewing and describing how presumptions have been made in the past and, if needed, to make recommendations for an improved scientific framework that could be used in the future for determining if a presumption should be made. The Committee was asked to consider and describe the processes of all participants in the current presumptive disability decision-making process for veterans. The Committee was not asked to offer an opinion about past presumptive decisions or to suggest specific future presumptions. The Committee heard from a range of groups that figure into this decision-making process, including past and present staffers from Congress, the VA, the IOM, veterans service organizations, and individual veterans. The Department of Defense (DoD) briefed the Committee about its current activities and plans to better track the exposures and health conditions of military personnel. The Committee further documented the current process by developing case studies around exposures and health conditions for which presumptions had been made. Improving the Presumptive Disability Decision-Making Process for Veterans explains recommendations made by the committee general methods by which scientists, as well as government and other organizations, evaluate scientific evidence in order to determine if a specific exposure causes a health condition.

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813

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National Academies Press

Published Date

ISBN 10

0309164397

ISBN 13

9780309164399

Public Financing and Delivery of HIV/AIDS Care

Securing the Legacy of Ryan White

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee on the Public Financing and Delivery of HIV Care

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Public Financing and Delivery of HIV/AIDS Care

Securing the Legacy of Ryan White

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee on the Public Financing and Delivery of HIV Care

Each year it is estimated that approximately 40,000 people in the U.S. are newly infected with HIV. In the late 1990s, the number of deaths from AIDS dropped 43% as a result of highly active antiretroviral therapy. Unfortunately, the complex system currently in place for financing and delivering publicly financed HIV care undermines the significant advances that have been made in the development of new technologies to treat it. Many HIV patients experience delays in access to other services that would support adhering to treatment. As a result, each year opportunities are missed that could reduce the mortality, morbidity, and disability suffered by individuals with HIV infections. Public Financing and Delivery of HIV/AIDS Care examines the current standard of care for HIV patients and assesses the extent the system currently used for financing and delivering care allows individuals with HIV to actually receive it. The book recommends an expanded federal program for the treatment of individuals with HIV, administered at the state level. This program would provide timely access and consistent benefits with a strong focus on comprehensive and continuous care and access to antiretroviral therapy. It could help improve the quality of life of HIV/AIDS patients, as well as reduce the number of deaths among those infected.

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375

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National Academies Press

Published Date

ISBN 10

0309092280

ISBN 13

9780309092289

Measuring What Matters

Allocation, Planning, and Quality Assessment for the Ryan White CARE Act

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee on the Ryan White CARE Act: Data for Resource Allocation, Planning, and Evaluation

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Measuring What Matters

Allocation, Planning, and Quality Assessment for the Ryan White CARE Act

By: Institute of Medicine,Board on Health Promotion and Disease Prevention,Committee on the Ryan White CARE Act: Data for Resource Allocation, Planning, and Evaluation

The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act gives funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance. The CARE Act is a discretionary program that relies on annual appropriations from Congress to provide care for low-income, uninsured, or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to address all of the inequalities and gaps in coverage for people with HIV. In response to a congressional mandate, an Institute of Medicine committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded. Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons.

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319

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National Academies Press

Published Date

ISBN 10

0309091152

ISBN 13

9780309091152

Systems for Research and Evaluation for Translating Genome-Based Discoveries for Health

Workshop Summary

By: Institute of Medicine,Board on Health Sciences Policy,Roundtable on Translating Genomic-Based Research for Health

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Systems for Research and Evaluation for Translating Genome-Based Discoveries for Health

Workshop Summary

By: Institute of Medicine,Board on Health Sciences Policy,Roundtable on Translating Genomic-Based Research for Health

With the advent of genome-wide association studies, numerous associations between specific gene loci and complex diseases have been identified-for breast cancer, coronary artery disease, and asthma, for example. This rapidly advancing field of genomics has stirred great interest in "personalized" health care from both the public and private sectors. The hope is that using genomic information in clinical care will lead to reduced health care costs and improved health outcomes as therapies are tailored to the genetic susceptibilities of patients. A variety of genetically based health care innovations have already reached the marketplace, but information about the clinical use of these treatments and diagnostics is limited. Currently data do not provide information about how a genomic test impacts clinical care and patient health outcomes-other approaches are needed to garner such information. This volume summarizes a workshop to address central questions related to the development of systems to evaluate clinical use of health care innovations that stem from genome-based research: What are the practical realities of creating such systems? What different models could be used? What are the strengths and weaknesses of each model? How effectively can such systems address questions about health outcomes?

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Page Count

102

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National Academies Press

Published Date

ISBN 10

030913983X

ISBN 13

9780309139830

Book's by Institute of Medicine (U.S.). Committee on Enhancing Federal Healthcare Quality Programs

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