Care In America Research Articles

Health-Assistive Smart Homes for Aging in Place: Leading the Way for Integration of the Asian Immigrant Minority Voice.

Caring for America’s aging population is a complex humanitarian issue. The number of older adults is expected to increase to 98.5 million by 2060 with a 295% growth in foreign-born older adults, including Asian immigrants. Most older adults will have one or more chronic conditions and 95% of healthcare costs will be attributed to caring for these conditions. Among Asian Americans, common chronic conditions include respiratory disease, cancer, cardiovascular disease, and pain. The National Institutes of Health, Institute on Aging, and National Science Foundation call for innovative technologies to be developed by multidisciplinary teams to address these concerns. Asian community leaders at Asian Health & Service Center and community members in Oregon identified the use of health-assistive technologies as a priority for potentially reducing stress and improving quality of life for both older adults and their caregivers. The purpose of this article is to introduce nurses and healthcare workers, advocating for the interests of Asian/Pacific Island community members, to the innovative health-assistive smart home. The health-assistive smart home uses artificial intelligence to identify and predict health events. Inclusion of minority persons’ data in the development of artificial intelligence has been generally overlooked. This may result in continued health inequities and is incompatible with the goals of global health. Integration of minority voices while exploring the efficacious use of the health-assistive smart home is of significant value to minority populations. Asian immigrant older adults engaging in smart home research and development will enhance the cultural and technical safety of future devices. Asian families may be particularly interested in smart homes for extending independence because they place an emphasis on collective culture and family-based care. Community engagement of stakeholders and steadfast leadership are needed so that future technologies used in healthcare delivery are both technically and culturally sound. A community-engaged research approach promotes community empowerment that is responsive to community identified priorities and is a good fit for studying adoption of smart home monitoring for health-assistance.

Reviewing the Clinical Landscape of Patient Safety in Psychiatry.

Back to table of contents Previous article Next article Reviewing the Clinical LandscapeFull AccessReviewing the Clinical Landscape of Patient Safety in PsychiatryYad M. Jabbarpour, M.D.Yad M. JabbarpourSearch for more papers by this author, M.D.Published Online:16 Oct 2017https://doi.org/10.1176/appi.focus.154S04AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Patient safety is one of the core responsibilities of a physician. The principles of not only Salus aegroti suprema lex esto, beneficence, but also primum non nocere, nonmaleficence, are two of the ethical pillars that support medical service and attention to safety. Psychiatrists have expertise in areas of patient safety, ranging from suicide risk assessment to violence risk assessment, reduction of seclusion and restraint, prevention of psychiatric misdiagnosis, and supporting a holistic biopsychosocial treatment plan, which drives appropriate, timely, evidence-based, patient-centered services. However, the systems of care in which psychiatrists serve are challenged by sentinel events: self-inflicted injuries, elopements, falls, restraint-related events, delays in treatment, medication errors, and even criminal events. In the United States, suicide is the second most frequent sentinel event reported to the Joint Commission. Psychiatric hospitals rank second in the nation as the most frequent location for reported sentinel events, followed by hospital psychiatric units. Behavioral health care settings rank sixth (1).Nearing two decades ago, the Institute of Medicine (IOM) report, To Err Is Human: Building a Safer Health System (2), reported that “at least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented.” In March of 2001, IOM’s Crossing the Quality Chasm (3) concluded that “merely making incremental improvements in current systems of care will not suffice.” In 2016, a study by Makary and Daniel (4) suggested that medical error is the third leading cause of death in the United States. These reports have inspired the nation’s growing campaign to improve quality and safety in health care (5). However, adverse events causing morbidity and mortality continue. Not only are the patients affected, but so are family members, the community, and the clinicians providing care.Many organizations support system transformation to improve patient safety, including the IOM, the Agency for Healthcare Research and Quality, the National Patient Safety Foundation, The Joint Commission, the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association. In recent years physicians have received more support for gaining competence in the field of patient safety. The American Board of Medical Specialties has highlighted safety standards by integrating patient safety principles into its program for maintenance of certification (MOC) requirements (5). The American Board of Psychiatry and Neurology is part of this leadership drive and announced that beginning in 2016, physicians who passed a certification or MOC examination would be required to complete an approved Patient Safety Course up to three years prior to board certification or recertification or in their first continuous MOC block.Focus, as part of its mission to provide MOC review and lifelong learning in the field, offers a Safety Commentary column to provide expert commentary in the area of safety standards with a focus on those most relevant to psychiatry.Dr. Jabbarpour is assistant professor with the Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, and chief of staff at Catawba Hospital, Catawba, Virginia.References1 Summary Data of Sentinel Events Reviewed by the Joint Commission. The Joint Commission, March 3. 2017. https://www.jointcommission.org/assets/1/18/Summary_4Q_2016.pdfGoogle Scholar2 Kohn LT, Corrigan JM, Donaldson MS (eds): To Err is Human: Building a Safer Health System. Washington, DC, Institute of Medicine Committee on Quality of Health Care in America, National Academies Press, 2000Google Scholar3 Institute of Medicine: Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC, National Academies Press, 2001Google Scholar4 Makary MA, Daniel M: Medical error—the third leading cause of death in the US. BMJ 2016; 353:i2139Crossref, Google Scholar5 Standards for the ABMS program for maintenance of certification (MOC) for implementation in January 2015. Chicago, American Board of Medical Specialties, 2014. http://www.abms.org/media/1109/standards-for-the-abms-program-for-moc-final.pdfGoogle Scholar FiguresReferencesCited byDetailsCited byCorrelation of safety behavior, handover quality, and risk perception: A cross-sectional study among Chinese psychiatric nurses19 December 2022 | Frontiers in Psychiatry, Vol. 13 Volume 15Issue 4 Fall 2017Pages 4s-5sTreating the Invisible Wounds of War: Focus on PTSD and TBI PDF download

The Role of Electronic Feedback Loops in the Continuous Quality Improvement of Thyroid Nodule and Thyroid Cancer Care

Physicians strive to achieve and society demands that the delivery of health care undergo continuous quality improvement. In 2001, the Institute of Medicine's report, Crossing the Quality Chasm: A New Health System for the 21st Century, underscored the importance of improving the standards of care of our health care system and emphasized the goal of delivering personalized care for each patient ( 1. Insitute of Medicine Committee on Quality of Health Care in America Crossing the quality chasm: a new health system for the 21st century. National Academies Press, Washington, DC2001 Google Scholar ). In response to this report, the National Learning Consortium (NLC) was established as a “virtual and evolving body of knowledge and resources designed to support health care providers and IT professionals collaborating to achieving this end” ( 2. Continuous quality improvement (CQI) strategies to optimize your practice. National Learning Consortium; 2013. Google Scholar ). The NLC's strategy focused on “continuous quality improvement” (CQI), which emphasized the need to improve patient-specific quality of care through enhanced efficiency of data sharing between involved physicians as well as via electronic feedback loops as a mechanism to encourage continual self-assessment ( 2. Continuous quality improvement (CQI) strategies to optimize your practice. National Learning Consortium; 2013. Google Scholar ). Vital to this initiative was the adoption and use of electronic health record (EHR) systems, designed to efficiently record health data and facilitate the sharing of this health-related information between individual clinicians and their patients ( 2. Continuous quality improvement (CQI) strategies to optimize your practice. National Learning Consortium; 2013. Google Scholar ). While the concept of CQI can be broadly applied to health care, this model can also be employed to improve the quality of care of specific disease processes. Not only does enhancing quality of care lead to an improvement in patient outcomes, it also enhances patient safety and facilitates cost-effective utilization of precious health care resources. By establishing a culture as well as a mechanism for self-assessment, the development of feedback loops of patient information is vital to improve physician performance through continuous self-monitored modification and fine-tuning of diagnostic and therapeutic interventions. Ultimately, the goal of this initiative is to eliminate the current clinical silos of specialties that serve as barriers to clinical information sharing.

The American Society of Clinical Oncology Reports on the State of Cancer Care in America: 2017

The American Society of Clinical Oncology Reports on the State of Cancer Care in America: 2017

Chronicle of family medicine: view from iowa city (USA)

The article presents a brief essay about the training of two representatives of the department of family medicine of North-Western State Medical University named after I.I. Mechnikov in April - May 2017 in the Iowa University (USA) dedicated to study of education system and organization of health care in America.

Making Sense of ACOs: A Guide for Nurse Leaders

The upward spiraling cost and declining quality of health care in America contributed to the political environment that supported the passage of the Patient Protection and Affordable Care Act (ACA) in 2010. 1 Anderson G Davis K Guterman S Medicare Payment Reform: Aligning Incentives for Better Care. The Commonwealth Fund, June 2015http://www.commonwealthfund.org/publications/issue-briefs/2015/jun/medicare-payment-reform-aligning-incentives Google Scholar Although imperfect, the ACA challenged our health care system to provide safe, high-quality, and person-centered care. Historically, the care delivery model in the United States has been fragmented, with limited coordination between providers of care, leading to concerns with cost, quality, and access. 2 Barnes A Unruh L Chukmaitov A van Ginneken E Accountable care organizations in the USA: types, developments, and challenges. Health Policy. 2014; 118: 1-7 Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar Consensus among many providers, payers, patients, purchasers, and other stakeholders in the health care system is that efforts to deliver person-centered care have been stymied, in large part, by a payment system that is oriented largely toward volume, as opposed to value for patients and caregivers. 3 Alternative Payment Model Framework & Progress Tracking Work Group Alternative Payment Model (APM) Framework: Final Whitepaper. Health Care Payment Learning & Action Network, Bethesda, MD2016 Google Scholar The upward spiraling cost and declining quality of health care in America contributed to the political environment that supported the passage of the Patient Protection and Affordable Care Act (ACA) in 2010. 1 Anderson G Davis K Guterman S Medicare Payment Reform: Aligning Incentives for Better Care. The Commonwealth Fund, June 2015http://www.commonwealthfund.org/publications/issue-briefs/2015/jun/medicare-payment-reform-aligning-incentives Google Scholar Although imperfect, the ACA challenged our health care system to provide safe, high-quality, and person-centered care. Historically, the care delivery model in the United States has been fragmented, with limited coordination between providers of care, leading to concerns with cost, quality, and access. 2 Barnes A Unruh L Chukmaitov A van Ginneken E Accountable care organizations in the USA: types, developments, and challenges. Health Policy. 2014; 118: 1-7 Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar Consensus among many providers, payers, patients, purchasers, and other stakeholders in the health care system is that efforts to deliver person-centered care have been stymied, in large part, by a payment system that is oriented largely toward volume, as opposed to value for patients and caregivers. 3 Alternative Payment Model Framework & Progress Tracking Work Group Alternative Payment Model (APM) Framework: Final Whitepaper. Health Care Payment Learning & Action Network, Bethesda, MD2016 Google Scholar

The State of Cancer Care in America, 2017: A Report by the American Society of Clinical Oncology.

The State of Cancer Care in America, 2017: A Report by the American Society of Clinical Oncology.

The Illusion of Choice: Gender Segregation and the Challenge of Recruiting Women to Radiology

In recent decades, the feminization of medicine has promised equal educational and professional opportunities for women pursuing medical careers [ 1 Ross S. The feminization of medicine. Virtual Mentor. 2003; 5 Google Scholar , 2 Boulis A.K. Jacobs J.A. The changing face of medicine: women doctors and the evolution of health care in America. ILR, Ithaca, New York2008 Google Scholar , 3 Alers M. van Leerdam L. Dielissen P. Lagro-Janssen A. Gendered specialties during medical education: a literature review. Perspect Med Educ. 2014; 3: 163-178 Crossref PubMed Scopus (35) Google Scholar ]. Yet despite encouraging statistics that now show near even numbers of women (48%) and men (52%) enrolled in US medical schools [ 4 Association of American Medical Colleges. Total enrollment by U.S. medical school and sex 2012-2013 through 2016-2017. Available at: https://www.aamc.org/download/321526/data/factstableb1-2.pdf. Accessed January 14, 2017. Google Scholar , 5 Zener R. Lee S.Y. Visscher K.L. Ricketts M. Speer S. Wiseman D. Women in radiology: exploring the gender disparity. J Am Coll Radiol. 2016; 13: 344-350 Abstract Full Text Full Text PDF PubMed Scopus (63) Google Scholar ], vast inequalities remain. Radiology is just one example of the persistent gender gap that plagues many medical specialties, with women representing fewer than 30% of total practicing radiologists and trainees in the United States [ 6 Chapman C.H. Hwang W.T. Both S. Thomas C.R. Deville C. Current status of diversity by race, Hispanic ethnicity, and sex in diagnostic radiology. Radiology. 2014; 270: 232-240 Crossref PubMed Scopus (118) Google Scholar , 7 Fielding J.R. Major N.M. Mullan B.F. et al. Choosing a specialty in medicine: female medical students and radiology. AJR Am J Roentgenol. 2007; 188: 897-900 Crossref PubMed Scopus (61) Google Scholar , 8 Deitch C.H. Sunshine J.H. Chan W.C. Shaffer K.A. Women in the radiology profession: data from a 1995 national survey. AJR Am J Roentgenol. 1998; 170: 263-270 Crossref PubMed Scopus (52) Google Scholar ]. Radiology educators have long debated the most effective means by which to improve the recruitment of women to our field, but they have managed to identify only potential contributing factors [ 9 Potterton V.K. Ruan S. Sunshine J.H. Applegate K. Cypel Y. Forman H.P. Why don’t female medical students choose diagnostic radiology? A review of the current literature. J Am Coll Radiol. 2004; 1: 583-590 Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar , 10 Lightfoote J.B. Deville C. Ma L.D. Winkfield K.M. Macura K.J. Diversity, inclusion, and representation: it is time to act. J Am Coll Radiol. 2016; 13: 1421-1425 Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar ].

A History of Haematology: From Herodotus to HIV by John C. Burnham

Reviewed by: A History of Haematology: From Herodotus to HIV by John C. Burnham Barron H. Lerner John C. Burnham. Health Care in America: A History. Baltimore: Johns Hopkins University Press, 2015. xiv + 596 pp. Ill. $34.95 ( 978-1-4214-1608-3). I often get asked to recommend survey books on the history of medicine, and there are many good ones, including Jacalyn Duffin's History of Medicine: A Scandalously Short Introduction and William Bynum's The History of Medicine: A Very Short [End Page 442] Introduction.1 To this list is now added Burnham's history, although it is of health care—not medicine—and is not short at 596 pages. Health Care in America is a labor of love, in the best sense. Who among we historians are both willing and able to painstakingly review sources back to the seventeenth century, and then cover fairly dry topics such as the licensing of physicians in the late 1800s, the rise of subspecialization in the early to mid-twentieth century and the Hill-Burton Act of 1946? Burnham covers these and myriad other topics with clear writing and impressive documentation. Organizing such a vast historical landscape is a challenge. Burnham chooses to divide his history into three epochs. The first, from the 1600s to the mid-1800s, highlights the original institutions, beliefs, and folk customs that characterized early American health care. The second epoch, from the 1880s to the 1980s, emphasizes modernization, including the growth of the technologically advanced hospital, the expansion of surgery, and the introduction of antibiotics and other curative interventions. The third epoch, from the 1980s to the present, chronicles the rise of genetic and personalized medicine, which calls into question concepts of disease that were developed in the second epoch. Within each epoch, Burnham has identified eras, further explicating change. Surveys such as this book run the risk of becoming "great man history," a story of progress in which the role of doctors and their triumphs take too much precedence. Burnham avoids this pitfall ably. Health Care in America is solid social history, demonstrating how changes in health care occurred due to specific historical circumstances over time—and the choices that historical figures made. "The events and struggles that I describe," Burnham writes, "were not the inevitable outcome of some forces or scheme" (p. xiv). Thus, one will find in this book, sometimes in understandably small dollops, all of the themes that professors of the history of health care and medicine want their students to know. Particularly good is Burnham's section on "Physicians, Public Health and Progressivism," which places health care firmly within a major era in American history. So, too, we read about the rise of epidemiology and how research into smoking and lung cancer helped to validate this field. There is a lot of coverage of favorite topics in the history of medicine, such as tuberculosis and typhoid fever. Another challenge of survey books is how to cover issues such as race, gender, and class. Critics at times believe that such topics are added as appendages to a larger story of white, university-based health care. Burnham, however, tries hard not to treat these issues as peripheral. For example, he addresses the state of African-American health at several points in the book and cites well-known historians in the field, such as Keith Wailoo. Women's growing role in health care is duly noted, both as physicians and nurses but also as patient-activists. I was pleased to see a picture of the Boston Women's Health Collective, whose path [End Page 443] breaking book Our Bodies, Ourselves symbolized the entrance of both feminism and consumerism into medicine. Speaking of images, Burnham managed to get his editor to include dozens, including not only photos but cartoons and graphs. We should all be so lucky. Perhaps the one thing missing from Health Care in America is much historiography. To some extent, Burnham's version of the history of health care reads as if it is the version. For example, in the brief section on Louis Pasteur, Gerald Geison's revisionist book on the French scientist's ethics is not mentioned.2 The...

A Model for Providing Free Patient Care and Integrating Student Learning and Professional Development in an Interprofessional Student-Led Clinic

BACKGROUND AND PURPOSEMany individuals face significant barriers to accessing adequate, affordable health care. The report, Health Wanted: The State of Unmet Need for Primary Health Care in America, calls upon community-based health clinics to provide comprehensive care eliminating health care barriers, which will in turn reduce costly trips to emergency departments and expensive hospital stays.1 The Indiana University Student Outreach Clinic (IU SOC) is such a clinic serving the near eastside community of Indianapolis, Indiana. The mission of IU SOC is to provide medically underserved and uninsured populations within Indiana communities with access to free health care while providing students from multiple disciplines opportunity for professional development. Its primary goal is to decrease health care inequality.The IU SOC is a student-led, interprofessional, pro bono health care clinic, formed as a partnership in 2009 between IU medical students and the Neighborhood Fellowship Church (NFC). The clinic is located within the heart of a neighborhood with many unmet health needs that began with economic hardships in the 1940s and have continued through the turn of the century, resulting in a substantial uninsured population. Historically, this community has had the highest emergency department visit rate within the county. While the main focus of the clinic is on decreasing the health disparities within the community, the clinic affords an equally important benefit to students by providing an avenue for experiential learning in the areas of patient care, interprofessional education and collaborative practice, and leadership.In October 2012, Doctor of Physical Therapy (DPT) students from IU and the University of Indianapolis (UIndy) established a novel collaboration to provide free evidencebased physical therapist (PT) services. This addition added to the comprehensive nature of the clinic, which includes pharmacy (Butler University), legal (IU), social work (IU), dental (IU), physical therapy (IU, UIndy), occupational therapy (IU), public health (IU), and nursing (IU). This collection of services in 1 location provides the IU SOC with the opportunity to make a significant impact on health disparities in this community. The collaborative nature also makes it an ideal setting for applied interprofessional education and collaborative practice (IPECP). The World Health Organization (WHO) defines interprofessional education (IPE) as occurring when two of more professions learn about, from and with each other.2 IPE is an essential step in preparing learners for collaborative practice which happens when multiple health workers from different professional backgrounds work together with patients... to deliver the highest quality care.2 This is important since WHO recognizes IPECP as an innovative strategy that will play an important role in mitigating the global health workforce crisis.2Student-led free clinics are becoming more prevalent as the need for affordable and accessible health care is ever-growing. Moreover, educators are realizing the benefits of collaborating with community partners to improve patient care while enhancing student learning. A literature review was performed in PubMed, CINAHL, ProQuest, and Academic Premiere databases using the key words student-led, student-run, pro bono, multi-disciplinary and interprofessional clinics, and interprofessional education and collaborative practice. Findings from this review indicate educators are recognizing and beginning to evaluate the impact these clinics have on improving collaborative care as well as student learning.3,4 Several universities have found students who participate in a pro bono health clinic reported increased confidence, self-reflection, and civic mindedness.5-7 Other studies have reported that students indicate improved clinical skills after participation in a student-led clinic.8,9The literature review also revealed that there are many different clinic models with multiple disciplines and community partners; however, only a few include PT students, and even fewer with students from more than 1 university (Table 1). …

Improving Quality of Care through Primary Care Research

Journal of General and Family MedicineVolume 17, Issue 4 p. 267-269 EditorialsOpen Access Improving Quality of Care through Primary Care Research Machiko Inoue MD, MPH, PhD, Machiko Inoue MD, MPH, PhD Associate Editor, JGFMSearch for more papers by this author Machiko Inoue MD, MPH, PhD, Machiko Inoue MD, MPH, PhD Associate Editor, JGFMSearch for more papers by this author First published: 27 December 2016 https://doi.org/10.14442/jgfm.17.4_267Citations: 1 Corresponding author: Machiko Inoue, MD, MPH, PhDBeth Israel Deaconess Medical Center, Harvard Medical School AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1Crossing the Quality Chasm: A New Health System for the 21st Century. In. Washington (DC): Institute of Medicine (US) Committee on Quality of Health Care in America. 2001. 2Quality Improvement in Primary Care - External supports for practices [http://www.ahrq.gov/research/findings/factsheets/quality/qipc/index.html]. 3Markovitz AR, Alexander JA, Lantz PM, Paustian ML: Patient-centered medical home implementation and use of preventive services: the role of practice socioeconomic context. JAMA Intern Med. 2015; 175: 598– 606. 4Shi L, Lock DC, Lee DC, et al: Patient-centered medical home capability and clinical performance in HRSA-supported health centers. Med Care. 2015; 53: 389– 395. 5Kern LM, Edwards A, Kaushal R: The patient-centered medical home and associations with health care quality and utilization: a 5-year cohort study. Ann Intern Med. 2016; 164: 395– 405. 6CAHPS Surveys and Tools to Advance Patient-Centered Care [http://www.ahrq.gov/cahps/index.html]. 7Aoki T, Inoue M, Nakayama T: Development and validation of the Japanese version of Primary Care Assessment Tool. Fam Pract. 2016; 33: 112– 117. Citing Literature Volume17, Issue4December 2016Pages 267-269 ReferencesRelatedInformation

Achieving moral, high quality, affordable medical care in America through a true free market.

The basis of a just and moral economic model for health care is examined in the context of Catholic social teaching. The performance of the current model of "central economic planning" in medicine is evaluated in terms of the core principles of the social doctrine of the Catholic Church and compared to freedom-based economic models. It is clear that the best way to respect and serve human dignity, the common good, subsidiarity, and solidarity in medicine is through the establishment of a true, free-market health economy. Lay Summary : This article reviews the impact of recent healthcare reforms as well as traditional "third party payment" models for healthcare financing in America (insurance). Impact on patients and doctors are evaluated in the context of Catholic social doctrine and the Catechism. The many shortcomings and negative consequences of an economy planned centrally by government are compared to the benefits of a true free-market medical economy with empowered individuals. The analysis shows that interference in the patient-physician relationship and the centrally planned medical economy itself violates Catholic teachings, harms patients and doctors, and create morally evil outcomes and economic structures.

Black Lives Matter: Claiming a Space for Evidence-Based Outrage in Obstetrics and Gynecology.

The authors reflect on the Black Lives Matter (BLM) social movement in relation to the pregnancy-related deaths of black women in the U.S., and it mentions evidence-based outrage, racial disparities in medical research, and a call for obstetricians and gynecologists to prioritize racial equity in women's health care in America. The use of the phrase BLM in medical literature is examined, along with issues such as family planning for black women, maternal fetal medicine, and infertility.

Building a culture of health: A new framework and measures for health and health care in America

For generations, Americans’ health has been unequally influenced by income, education, ethnicity, and geography. Health care systems have operated largely apart from each other and from community life. The definition of health has been the “absence of illness,” rather than the recognition that all aspects of our lives should support health.Today, a growing number of communities, regions, and states are working to redefine what it means to get and stay healthy by addressing the multiple determinants of health. The requirements of federal health care reform are changing who has access to care, how care is paid for and delivered, and how patients and providers interact. Coordinated efforts to promote wellness and prevent diseases are proliferating among a diverse set of stakeholders. These developments in health and in society present a window of opportunity for real societal transformation—a chance to catalyze a national movement that demands and supports a widely shared, multifaceted vision for a Culture of Health.To address this challenge, the Robert Wood Johnson Foundation has embarked on a strategic direction to use the tools of a large national philanthropy to catalyze a social movement which we are calling Building a Culture of Health. This article presents the Foundation’s new model for a Culture of Health, the trans-disciplinary research that developed a set of metrics that tie to the model, and the community engagement activities undertaken in the development of both the model and metrics. The model and associated metrics and extensive communication, in addition to partnership, and grant funding strategies, represent a culture change strategy being implemented over 20 years. Addressing underlying inequities in health affirming life conditions and improving social cohesion across diverse groups to take action to improve theses condition lay at the heart of this strategy.

Health Care in America: A History

In Health Care in America, historian John C. Burnham describes changes over four centuries of medicine and public health in America. Beginning with seventeenth-century concerns over personal and neighborhood illnesses, Burnham concludes with the arrival of a new epoch in American medicine and health care at the turn of the twenty-first century. From the 1600s through the 1990s, Americans turned to a variety of healers, practices, and institutions in their efforts to prevent and survive epidemics of smallpox, yellow fever, cholera, influenza, polio, and AIDS. Health care workers in all periods attended births and deaths and cared for people who had injuries, disabilities, and chronic diseases. Drawing on primary sources, classic scholarship, and a vast body of recent literature in the history of medicine and public health, Burnham finds that traditional healing, care, and medicine dominated the United States until the late nineteenth century, when antiseptic/aseptic surgery and germ theory initiated an intellectual, social, and technical transformation. He divides the age of modern medicine into several eras: physiological medicine (1910s-1930s), antibiotics (1930s-1950s), technology (1950s-1960s), environmental medicine (1970s-1980s), and, beginning around 1990, genetic medicine. The cumulating developments in each era led to today's radically altered doctor-patient relationship and the insistent questions that swirl around the financial cost of health care. Burnham's sweeping narrative makes sense of medical practice, medical research, and human frailties and foibles, opening the door to a new understanding of our current concerns.

The State of Cancer Care in America, 2016: A Report by the American Society of Clinical Oncology.

The State of Cancer Care in America, 2016: A Report by the American Society of Clinical Oncology.

What is the best nursing handover style to ensure continuity of information for hospital patients?

The systematic review informing this Cochrane Nursing e Corner investigated nursing handover for evidence ted to safety, quality and measures of satisfaction eulers et al., 2014). The Institute of Medicine (United tes) released a seminal report in 2001 that included criptions of clinical handover (Committee on Quality of lth Care in America, 2001). Clinical handover incorpos the communication between nursing staff during a ft change about patients and their continuing care. The titute of Medicine described handover as time where in absence of good practice, the risk of miscommunicais high, and that risks to patient safety as well as erse events can be directly attributed to ineffective munication during clinical handover (Committee on lity of Health Care in America, 2001). The Institute of dicine report details that information communicated ut patients and their care should have two features, being both accurate and timely (Committee on Quality of Health Care in America, 2001). Potential adverse events associated with inaccurate or untimely clinical handover have been established. As the authors of this systematic review identify, handover that is erroneous may include increased risk of delays in diagnosis or treatment, inappropriate treatment or omission of care (Smeulers et al., 2014). Further more, handover that is not timely may increase the risk of duplication, redundant communication, lower satisfaction ratings for staff and patients, and at the organisational level may also lead to prolonged hospitalisation, with associated increases in costs. These findings (from individual studies) indicate how significant a process clinical handover is, not only for patient care, but also for organisational outcomes. While the literature indicates handover is a critical aspect of patient care and quality, studies also indicate that handover is often characterised by a lack of consistency in method, are time consuming and variable in terms of what is communicated. Handover while a critical aspect of continuity of patient care is characterised by a general lack of formalised training, therefore nurses learn and adapt according to current practices and cultural expectations, rather than develop evidence-based skills and knowledge. This systematic review was conducted to address the knowledge gap on effective strategies for clinical handover to reduce risks and improve the effectiveness and quality of communication.

Introduction of the transitional care model in the United States and the enlightenment to China

In this paper, the concept, policy support and existing modes of transitional care in America were introduced in detail. It can provide reference for the development of transitional care mode in our country, provide continuous nursing services for the elderly, and improve the health status of the elderly. Key words: Aged; Transitional care; United States

PC-FACS

PC-FACS

Government Giveaways: Your Chevy or Your Mother?

Government Giveaways: Your Chevy or Your Mother?