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From newborns switched in the nursery to medication mix-ups and hospital-acquired infections, we are all familiar with the horror stories about hospital safety, and unfortunately, the statistics say we aren’t exaggerating. The safety issue in U.S. hospitals has become so profound and embedded, that we cannot hope to fix it without a paradigm shift in our approach. After defining and demonstrating the true depth of this dangerous concern, Safer Hospital Care: Strategies for Continuous Innovation elaborates on the steps required to make that paradigm shift a reality. A respected and sought out expert on hospital safety, author Dev Raheja draws on his 25 years of experience as a risk management and quality assurance consultant to provide hospital stakeholders with a systematic way to learn the science of safe care. Supported by case studies as well as input from such paradigm pioneers as Johns Hopkins and Seattle Children’s, he explains how to: Adapt evidence-based safety theories and tools taken from the aerospace, nuclear, and chemical industries Identify the combination of root causes that result in an adverse event Apply analytical tools that can effectively measure hospital efficiency Establish evidence between Lean strategies and patient satisfaction Make use of various types of innovation including accidental, incremental, strategic, and radical, and establish a culture conducive to innovation This practical guide shows how to find solutions that are simple and comprehensive, and can produce a high ROI. To reform hospitals, we must recognize that they are highly dynamic systems that must be fixed systemically. Instead of thinking in terms of continuous improvement, we need to think in terms of continuous innovation. Safe hospital care is not just about doing things right; it is also about breaking old habits, finding new tools and doing the right things.
A critical and often overlooked aspect of preventing medical device recalls is the ability to implement systems thinking. Although systems thinking won’t prevent every mistake, it remains one of the most effective tools for evaluating hidden risks and discovering robust solutions for eliminating those risks. Based on the author’s extensive experience in the medical device, aerospace, and manufacturing engineering industries, Preventing Medical Device Recalls presents a detailed structure for systems thinking that can help to prevent costly device recalls. Based on Dr. W. Edwards Deming’s System of Profound Knowledge, this structure can help medical device designers and manufacturers exceed their customers’ expectations for quality and safety. This book is among the first to demonstrate how to control safety risks—from specifications all the way through to safely retiring products without harm to the environment. Supplying an accessible overview of medical device requirements and the science of safety, it explains why risk analysis must start with product specification and continue throughout the product life cycle. Covering paradigms for proactive thinking and doing, the text details methods that readers can implement during the specification writing, product design, and product development phases to prevent recalls. It also includes numerous examples from the author’s experience in the medical device, consumer, and aerospace industries. Even in healthcare, where compliance with standards is at its highest level, more patients die from medical mistakes each week than would be involved in a jumbo jet crash. With coverage that includes risk assessment and risk management, this book provides you with an understanding of how mishaps happen so you can account for unexpected events and design devices that are free of costly recalls.
As developed economies enter a period of slower growth, emerging economies such as India have become prime examples of how more can be achieved with less. Bringing together experience and expertise from across the healthcare industry, this book examines innovations that can bring about real advances in the healthcare industry. Innovations in Healthcare Management: Cost-Effective and Sustainable Solutions explores recent innovations in healthcare from a global and Indian perspective. Emphasizing the importance of Lean healthcare and innovation, it presents low-cost, high-volume solutions that improve access to care. Providing concrete examples of the five levels of innovation present in healthcare, the book presents new concepts, methods, and tools for advancing processes and operational flow. It includes case studies of actual results in healthcare innovation from three continents that highlight emerging global trends in healthcare system innovation. The book describes how to organize resources and flows so that given targets, such as cost, clinical quality, and patient experience, can be achieved with available resources. It also covers nontraditional ecosystems of innovation that move outside of expected technological innovations, such as innovations in social persuasion, rural health delivery, and the planning and design of hospitals. The book maintains a focus on key issues across the healthcare industry—such as access to care, demand creation, patient experiences, and data—to help readers implement new ideas and new models of delivery of affordable care in healthcare systems around the world.
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009--roughly $750 billion--was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
"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.
The Second Edition features new content, examples,methods, techniques, and best practices Assurance Technologies Principles and Practices is based on the assertion that safety is not a cost, but an excellent investment. According to the authors, more than sixty percent of problems in complex systems arise from incomplete, vague, and poorly written specifications. In keeping with the authors' passion for safety, the text is dedicated to uniting the gamut of disciplines that are essential for effective design applying assurance technology principles, including system safety, reliability, maintainability, human engineering, quality, logistics, software integrity, and system integration. Readers familiar with the first edition of this text will recognize all the hallmarks that have made it a classic in its field. The Second Edition features a host of new examples, methods, techniques, and best practices to bring the text fully up to date with the state of the art in assurance technology. Much new content has been added as well, including four new chapters: Managing Safety-Related Risks Statistical Concepts, Loss Analysis, and Safety-Related Applications Models, Concepts, and Examples: Applying Scenario-Driven Hazard Analysis Automation, Computer, and Software Complexities The text begins with an introduction and overview of assurance technology. Next, readers are provided with fundamental statistical concepts. The chapters that follow explore in depth the approaches and disciplines that make up assurance technology applications. Each chapter is organized into major phases-design, manufacturing, test, and use phase-that help readers understand both how and when to apply particular measures. Throughout the text, readers discover detailed examples that prepare them to manage real-world challenges. References and further reading are provided at the end of each chapter leading to more in-depth discussion on specialized topics. With its extensive use of examples and highly structured approach, this is an excellent course book for students in industrial engineering, systems engineering, risk engineering, and other assurance technology domains. Design and system engineers as well as safety professionals will find the material essential in troubleshooting complex projects and ensuring product, process, and system safety.
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.

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