Medical Care

For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe

Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.

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.

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.

A comprehensive guide to the medical complications, diagnosis, and treatment of eating disorders. In this new edition of their best-selling work, Drs. Philip S. Mehler and Arnold E. Andersen provide a user-friendly and comprehensive guide to treating and managing eating disorders for primary care physicians, mental health professionals, worried family members and friends, and nonmedical professionals (such as teachers and coaches). Mehler and Andersen identify common medical complications that people who have eating disorders face and answer questions about how to treat both physical and behavioral aspects of eating disorders. Serious complications, including cardiac arrhythmia, electrolyte abnormalities, and gastrointestinal problems, are discussed in detail. Incorporating illustrative case studies, medical background on the complications, guidelines for diagnosis and treatment, and an up-to-date list of selected references, chapters provide comprehensive coverage of topics, including team treatment and nutritional rehabilitation. The authors also address special areas of concern, such as athletes who have eating disorders, males with eating disorders, and the pharmacological treatment of obesity. New topics include diabetes and eating disorders, osteoporosis, involuntary feeding, innovative psychological strategies, and ethical dilemmas.

New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.

Demonstrating the benefits of creative expression for patients living with acute or chronic illness, this volume provides a complete, practical introduction to medical art therapy. It presents evidence-based strategies for helping people of all ages--from young children to older adults--cope with physical and cognitive symptoms, reduce stress, and improve their quality of life. The book includes detailed case material and 110 illustrations. It describes ways to work with individuals and groups with specific health conditions and challenges, as well as their family members. Contributors are experienced art therapists who combine essential knowledge with in-depth clinical guidance. This e-book edition features 87 full-color illustrations. (Illustrations will appear in black and white on black-and-white e-readers).

Making healthcare decisions is hard, but making the right choices has never mattered more. Healthcare Choices: 5 Steps to Getting the Care You Want and Needgives you the tools you need to choose the best medical care—for you. Archelle Georgiou, MD, explainsher CARES model, the formula she developed to help family, friends, and thousands of television viewers make smart healthcare decisions that balance the best medical options with individual preferences. Using more than 30 real-life stories and insider tips, she demonstrates how to use this step-by-step guide to access the medical information you need to evaluate your options and make well-informed choices. Whether you are addressing a life-threatening illness, self-managing a minor ailment, selecting a doctor, or buying insurance, Georgiou’s roadmap shows you how to be an active participant in your care. Her “go to” approach describes how to: Identify all treatment options for an illness, including those not mentioned by your doctor. Make treatment decisions that reflect your priorities and preferences. Find the best doctor to treat your condition. Communicate with your doctor and make shared treatment decisions. Choose the health insurance plan that’s right for you. Maintain a voice in your lifestyle as you age. Healthcare Choiceswill give you the confidence to advocate for the healthcare you want, need, and deserve.

As the population of older adults in the U.S. continues to grow, medical house calls are increasingly part of a system of comprehensive home-based care for patients who have difficulty accessing office-.based care. Clinicians who have been trained mostly in office and hospital settings must adapt their usual approaches to accommodate a wide range of environmental, social, and physical circumstances that impact home-limited patients. Ideally, a comprehensive team of clinicians proficient in multiple domains of functional, social, and medical care can work together to address potential gaps in any one clinician’s expertise. Unfortunately, such teams are still rare. This book aims to equip individual clinicians with the interdisciplinary knowledge, skills, and perspective they need to provide the best care possible with limited formal interdisciplinary support. This book offers 20 patient cases drawn from the collective experience of experts in home-based medical care from highly respected academic and clinical programs across the United States. Each case demonstrates a scenario that is frequently encountered and/or very important in home-based medical care practice. Each scenario frequently proves to be challenging for many professionals because it requires an approach or leverages aspects of care delivery that most are not trained in. Additionally, each scenario reflects an approach to care that is enhanced by interdisciplinary input. Finally, each case lends itself to a practical problem-solving approach that could be accomplished by most home-based medical care providers, even in the absence of an interdisciplinary team. Written by interdisciplinary experts in geriatric home-based care, this book serves as both an educational tool for learners in all related disciplines as well as a quick reference for experienced clinicians looking to augment their existing house call “toolbox.”