Since the 1999 report by the Institute of Medicine (IOM) 'To Err is Human.', medication safety has become a public health concern due to its impact on preventable harm and healthcare costs. While formal systems in hospitals exist to address medication errors, there is less evidence in community pharmacies. The objective of this systematic review is to synthesise and critically appraise the international evidence about the prevalence, nature, and severity of medication errors in community pharmacies. A systematic review was conducted for the literature published from January 1995 to December 2023. The choice of this date range was made to include a sufficient breadth of research conducted both preceding and subsequent to the publication of the IOM report. Various databases were used, supplemented by manual searches of bibliographies and grey literature. Studies were selected through a rigorous screening process. Data extraction and quality assessment were carried out using structured tools. Narrative and descriptive synthesis was conducted by geographical regions. 56898 potentially eligible studies were identified, yielding 73 included studies. Most studies were conducted in Europe and Central Asia and North America with few conducted in other regions. Most studies focused on prescribing and dispensing errors, with fewer studies addressing errors in other stages of the medication use process. Variations in error rates and types were observed across regions, which made calculating a global rate of errors challenging. Very few studies assessed the severity of medication errors with the majority of these being conducted in Europe and Central Asia and North America. Risk of bias varied, with selection and identification bias being common in all regions. This review underscores the need to assess medication safety in regions with limited pharmacy access and advocate for a standardised global reporting framework to streamline data analysis. Additionally, it implies that investigating the types and severity of medication errors is imperative. Addressing these gaps through rigorous quantitative and qualitative research could inform policy-making and implementation of strategies to enhance patient safety in community pharmacies.

The controversy surrounding measles, mumps, and rubella (MMR) vaccination and autism has been ongoing for over 30 years. It is rooted in the parent-led grassroots movements of the 1990s; and a case-series clinical study in 1998 by Wakefield et al. This controversy cascaded through numerous observational studies and US Institute of Medicine reports, culminating in 2019 with a population-based observational study by Hviid et al. This study was hailed at the time by the US media and medical establishment as conclusive proof that the MMR vaccine does not increase the risk of autism, even among “genetically susceptible children”. However, as detailed in this critical review, Hviid et al. did not faithfully intend or interpret the data to test this hypothesis and, therefore, cannot possibly have falsified it. We elucidate methodological flaws, discrepancies, irreproducibility, and conflicts of interest for Hviid et al. In addition, the conclusion from Hviid et al. cannot be generalized to the CDC childhood vaccination schedule. All these salient features have remained oblivious to so many regulators, mainstream media, and professional associations in the USA. This reveals the need for more communication about the limitations of available evidence to facilitate informed consent for the childhood vaccination schedule.

Racial disparities of medical care have been well documented for decades. That much is clear. Less clear are the cause or causes. By the time of the historic 2003 report by the Institute of Medicine (IOM), investigators had uncovered a pervasive pattern of disparities – often, however, without access to clinical or socioeconomic data which might help explain them. It was in these circumstances that the authors of the IOM report adopted the theory of unconscious bias as the ultimate explanation of observed disparities of care. The theory of a profound bias working outside the holder’s awareness and control seemed to many to account for patterns of disparate treatment as nothing else could. However, to this day there exists little good evidence that such bias warps clinical decisions – certainly not enough to bear out the sweeping theory of a psychological mechanism that operates automatically. Impressive in principle but doubtful in practice, the theory of unconscious bias does not account for the evidence but covers its absence, just as it did when it was enshrined in the IOM report in 2003.

Thirty-five years after the Institute of Medicine report, The Future of Public Health (1988), multiple authors have considered what needs to be achieved to build a robust public health system that improves health for all. A central theme is the renewed emphasis on the role of evidence-based policy. This study provides clear evidence using a ranking methodology of how important policy is to achieving better health outcomes across the United States. The purpose of this study is to assess the association of state health rankings with well-established state health outcomes. Specifically, we calculate the strength of relationship of the rankings used in a previous study to six widely referenced health outcomes. Utilizing 88 predominantly health policy-oriented data elements found online for each of the United States, a state ranking was calculated across all actual, or behavioral, causes of death using the percent weightings attributable to each actual cause. These state rankings were correlated to state health outcomes. Findings indicated that state rankings correlated highly with five of the six health outcomes, excluding disability. States having supportive health policies ranked better in terms of the actual causes of death and population health outcomes. This finding is important to the field because it quantifies the degree that robust health policies matter to population health status and how these policies may be predictive of positive health outcomes. For practitioners, this finding supports greater emphasis on policy advocacy skills and encourages increased advocacy training in schools and programs of public health.

Vitamin D is essential for bone health, immune function, and overall well-being. Numerous ecological, observational, and prospective studies, including randomized controlled clinical trials (RCTs), report an inverse association between higher serum 25-hydroxyvitamin D [25(OH)D; calcifediol] levels in various conditions, including cardiovascular disease, metabolic disorders such as diabetes and obesity, susceptibility to infection-related complications, autoimmune diseases, and all-cause mortality. Vitamin D operates through two distinct systems. The endocrine system comprises the renal tubular cell-derived circulatory calcitriol, which primarily regulates calcium homeostasis and muscular functions. In contrast, intracellularly generated calcitriol in peripheral target cells is responsible for intracrine/paracrine system signaling and calcitriol-vitamin D receptor-mediated genomic effects. Government-appointed committees and health organizations have developed various clinical practice guidelines for vitamin D supplementation and management. However, these guidelines heavily relied on the 2011 Institute of Medicine (IoM) report, which focused solely on the skeletal effects of vitamin D, ignoring other body systems. Thus, they do not represent maintaining good overall health and aspects of disease prevention. Additionally, the IoM report was intended as a public health recommendation for the government and is not a clinical guideline. New country- and regional-specific guidelines must focus on healthy nations through disease prevention and reducing healthcare costs. They should not be restricted to bone effect and must encompass all extra-skeletal benefits. Nevertheless, due to misunderstandings, medical societies and other governments have used faulty IoM report as a foundation for creating vitamin D guidelines. Consequently, they placed disproportionate emphasis on bone health while largely overlooking its benefits for other bodily systems, making current guidelines, including 2024, the Endocrine Society less applicable to the public. As a result, the utility of published guidelines has been significantly reduced for clinical practice and RCTs that designed on bone-centric are generate misleading information and remain suboptimal for public health and disease prevention. This review and its recommendations address the gaps in current vitamin D clinical practice guidelines and propose a framework for developing more effective, country and region-specific recommendations that capture the extra-skeletal benefits of vitamin D to prevent multiple diseases and enhance public health.

Since the authoring of the seminal report by the Institute of Medicine (IOM) “To Err is Human: Building a Safer Health System” in 2000, there has been an increased focus on patient safety and the responsibility born by the healthcare system to reduce what are known as adverse events (AE). One of the recommendations of the IOM report was the establishment and development of Incident Reporting System (IRS) that would track AE resulting in serious injury and death. The Joint Commission in the USA similarly requires all hospitals have and use an IRS. The objective of this review is to explore barriers and feature of IRS and patient safety.

Adverse Drug Reactions (ADR) add a significant clinical and economic burden to the healthcaresystem of a country. We present an overview of the different approaches of ADR reporting systems worldwide andtheir evolution over time. A systematic review of the literature was made based on PubMed and theCochrane database of systematic reviews. The articles searched for included original articles, WHO and FDAreports and institute of medicine reports. Reporting ADRs is the cornerstone ofdetecting uncommon ADRs once the drugs are on the market. In many countries, ADR reporting is regulated bynational regulatory bodies and various methods are employed to report ADRs. Direct reporting by healthcareprofessionals has been adopted by many developed and developing countries. With emerging new technologies inthe field of medicine, there is a great potential to develop better ADR reporting systems in the countries where theyhave poor reporting. Development and acquisition of newer technologies to promote ADR monitoringand reporting is a necessity for an effective pharmacovigilance system in a country.

Transformational Leadership Meets Innovative Strategy: How Nurse Leaders and Clinical Nurses Redesigned Bedside Handover to Improve Nursing Practice

The Centers for Disease Control and Prevention reports that one-third of all Americans have not done any advance care planning, which is essential for maintaining autonomy when people are no longer able to communicate wishes directly at the end of life. The Institute of Medicine reports that providers have limited training in communication techniques and low confidence in holding advance care planning conversations. Forty-four family nurse practitioner students received classroom communication training using evidence-based end-of-life nursing education consortium materials and role-play opportunities. One month later, students participated in a palliative care simulation experience in a high-fidelity simulated medical office environment with standardized patient. The family practice nurse practitioner students were required to communicate bad news of a poor diagnosis to a family member and begin the advance care planning conversation using the SPIKES protocol. Findings include a significant increase in postintervention advance care planning communication knowledge scores and self-confidence in holding these conversations (mean, 30.55 [SD, 2.992]; 95% confidence interval, 29.64-31.46; median, 31; range, 11-35) and satisfaction with the learning experience (mean, 18.14 [SD, 2.11]; 95% confidence interval, 17.50-18.78; median, 19; with range between 13 and 20).

Building the future geriatrics workforce through transformative interprofessional education and community-engaged experiential learning

The United States Institute of Medicine (IOM) published reports in 1999 and 2011 identifying drug use as a priority area for sexual minority health research, specifically focused on mechanisms contributing to drug use disparities and the development of tailored interventions. Limited research has prioritized sexual minority women (SMW) with the majority of substance use research among sexual minorities focused on adolescents and men who have sex with men. This scoping review will characterize the research literature related to illicit drug use and prescription drug misuse among SMW and sub-groups within the SMW population. Through this, we will identify: (1) specific substances used; (2) patterns of substance use; (3) risk and protective factors; (4) prevention interventions; and (5) drug treatment programs specific to SMW. This review will include studies with empirical data of illicit or prescription drug misuse among sexual minority women. Peer-reviewed quantitative research conducted in the United States and published in English from 2011-Present will be included. We will search Medline, PsycINFO, and Web of Science databases for relevant articles. Two independent reviewers will screen abstracts and relevant full-text studies for eligibility. Data will be extracted from eligible articles and results will be presented in narrative and tabular form as appropriate. This work will identify gaps of knowledge in the research pertaining to illicit or prescription drug misuse among sexual minority women since the 2011 US IOM report. As a result of this work, we will propose directions for future research to address identified gaps.

The US cancer cooperative groups (cooperative groups) were founded in the 1950s to establish a standing infrastructure to conduct multi-institutional cancer clinical trials. Initially funded almost entirely by the US National Cancer Institute (NCI), over the years, the research conducted by the Cooperative Groups has evolved to meet the demands of cancer clinical research, with a scope now encompassing trials to advance cancer treatment, cancer control, biomarker development and validation, and health services research, with a corresponding broadening of their funding sources. The cooperative groups are also a critical mechanism for educating the next generation of cancer clinical trialists from many different disciplines. This review outlines the overall mission, structure, and funding of the cooperative groups, beginning in 1955 when they were first established by the NCI, and describes the considerable progress against cancer achieved over the past decade.

Educating healthcare professionals in patient safety is essential to achieving sustainable improvements in care. This study aimed to identify the key constituents of patient safety education alongside its facilitators and barriers from a frontline perspective. An electronic survey was sent to 592 healthcare professionals and educators in patient safety education in the United Kingdom. Two independent reviewers conducted a thematic analysis of the free-text data. Themes focused on effective content, learning practices and facilitators and barriers to patient safety education. Of 592 individuals completing the survey, 545 (92%) submitted analyzable responses. Interrater reliability of coding was high with Cohen k value of 0.86. Participants endorsed experiential and interactive learning as ideal modalities for delivery and expressed a need for content to be based on real clinical cases and tailored to the needs of the learners. The most commonly mentioned facilitators were standardization of methods and assessment (49%), dedicated funding (21%), and culture of openness (20%). Staffing problems and high workload (41%) and lack of accessibility of training (23%) were identified as primary barriers of efficacy and uptake. This study identified key factors to the success of patient safety education in terms of content and delivery alongside facilitators and barriers. Future curricula developers and interventions should improve standardization, funding, culture, and access so as to optimize education programs to enhance patient safety.

To evaluate the effectiveness of an online learning, certificate programme for front-line nurse leaders' sense of empowerment. Front-line leaders play a crucial role in health care. Current training is often inadequate. The Institute of Medicine report on The Future of Nursing: Leading Change, Advancing Health (2010) recommends nurses at all levels receive training for their role. A pre- to post-study design was used; instruments included Conditions for Work Effectiveness Questionnaire, Psychological Empowerment Scale, intent to stay, and self-reported knowledge and effectiveness of intervention questions. This study evaluated the effects of online learning for 29 acute care front-line leaders in the USA and Australia. Structural empowerment significantly improved, pre-assessment (M=18.50, SD=1.6940) to post-assessment (M=19.47, SD=1.6940). There was no significant difference in intent to stay or overall psychological empowerment. Participants agreed (24/29, 83%) the intervention contributed to their 'sense of empowerment in their role' and 'ability to create an empowering work environment'. Online learning was effective and could be integrated into orientation and/or continuing education plans to develop empowering work environments. Online learning may be a means of educating and empowering front-line leaders for their role.

Of the 3 million nurses in the United States, only 5.4% of registered nurses are Latinos. This is a grave concern since the U.S. Census' projected increase of Latinos in the United States is expected to be 28% by 2060. In 2010, the Institute of Medicine report recommended a diverse workforce in health care to improve health outcomes. However, the increase in the Latino nursing workforce continues to be low compared to with the population of Latinos in the country. The National Association of Hispanic Nurses and the University of Alabama partnered to increase the number of baccalaureate-prepared registered nurses in the workforce. BAMA-Latino Project (BAMA-L) is a Health Resources and Services Administration-funded program to increase the diversity of registered nurses in the nursing workforce. The purpose of this article is to present the development and implementation of BAMA-L.

In today’s complex and evolving healthcare system, it is crucial for nurses to proficiently comprehend electronic health records (EHR) in the provision of quality, safe, patient care. Accordingly, the Institute of Medicine report in 2003 emphasized informatics as one of the core competencies for nursing education to improve upon. Upon completion of the their first academic clinical experience, the authors found a gap in the student’s ability to perform at the bedside and balance the documentation requirements of the electronic health record. In order to better equip Fort Hays State University Nursing students with the technological skill sets necessary to navigate modern health care informatics, we designed an academic electronic health record (AEHR) training module to incorporate into their regularly scheduled simulation.

Pathologists are being considered as “Doctor’s doctor”, the reason is not they are far more knowledgeable or experienced than the treating physicians. The only reason is for decades, the only bridges between the patient and Pathologists are the treating physician. Many times, the patient suffering from cancer, doesn’t know that the confirmed diagnosis was not given by the treating physician but by the Pathologist. The input of the pathologist (and radiologist) is often essential to a proper diagnosis, yet rarely is the patient given those reports and rare access to the reporting individuals. To date, Pathologists are advising clinical colleagues on appropriate tests, result-interpretation, follow-up testing and to reach the diagnosis. Various clinico-pathological meetings help in overcoming this hurdle.
 However, in this era of expanding, decentralized health systems and rapidly increasing the complexity of newer laboratory tests, diagnostic algorithms, and guidelines, it is being difficult for treating physicians to stay updated, even in the area of their expertise. One survey of laboratory utilization patterns revealed that primary care physicians were uncertain of up to 23% of tests utilized, with test ordering uncertainty in 14.7% and test interpretation uncertainty in 8.3%. The 2015 Institute of Medicine report, “Improving Diagnosis in Healthcare” recognizes diagnosis as a team effort that requires pathologist input and interaction with clinical colleagues. Educating and providing consultation is a role that pathologists must embrace. On top of this, social media is beginning to change the way that medicine is practiced. It has the power to engage people in public health and policy discussions, establish professional networks and facilitate patients’ access to information about health and services.
 We have integrated social media into our lives by choice and we in the medical practice, amidst our busy schedules, have been using it for easy connectivity with friends and families and also, if not important, for our continued education.3 Various information is available about any disease conditions and available diagnostic methods. Once a patient gets his/her report, they tend to surf on the internet and an overwhelming amount of information present on the internet may not only confuse the patient but also lead to anxiety by going through all the possible consequences which rarely occur. Furthermore, histopathological or cytological reports are better explained by the reporting pathologists. Sometimes, it becomes difficult for treating physicians to explain what exactly does “suggestive of” or “Suspicious” means and what to do next. Limitations and the superiority of any diagnostic tool are better understood by the pathologists. All the issues can be settled with patient-pathologist direct communications. This will help the patient to know the details regarding the test, it’s limitations and its superiority. Direct patient-pathologist communication greatly decreases the burden of treating physicians in counseling the patients., helps to further explain the relevance of the tests and results and have a positive impact on their health and healthcare choices.

T here are 16.9 million cancer survivors in the United States, and by 2030, that number is projected to increase to more than 22.1 million according to the American Cancer Society (ACS). 1 However, as this population continues to grow, many experts worry that the oncology community is not adequately meeting survivors' needs and that the shortcomings in follow-up care will worsen unless systemic changes are made.

Student-Centered Curricular Revisions to Facilitate Transition from Associate Degree in Nursing to Bachelor of Science in Nursing Education

The Institute of Medicine (IOM) has reported that approximately 100 million Americans experience chronic pain. The IOM report on pain and the subsequent National Pain Strategy (NPS) issued by the U.S. Department of Health and Human Services have both noted the educational gaps regarding pain management and highlighted the pivotal role that psychology plays in the field of pain management. Fishman and colleagues (2013) emphasized the need for all providers involved in the study and practice of pain management to acquire a common fund of knowledge and proposed a comprehensive set of core competencies that would apply across multiple professions and specialty areas (e.g., anesthesiology, nursing, and psychology). These core competencies are meant to be tailored to allow each pain-related subspecialty to incorporate the factors and competencies unique to their discipline. To date, the terms pain psychology and pain psychologist are routinely used in public discourse to refer to psychologists practicing integrated, multimodal, and multidisciplinary pain care, but the field of psychology has not yet defined this emerging specialty. It is important for the discipline itself to define these terms and for psychologists to specify the competencies that would be expected of a clinician working as a pain psychologist. The current article represents an initial effort to define the core competencies necessary to fulfill the role of a pain psychologist working in the field of pain management. (PsycINFO Database Record (c) 2019 APA, all rights reserved).