Building a Better Delivery System A New Engineering/Health Care Partnership (2005) / Chapter Skim
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Equipping the Patient and the Care Team
Equipping the Patient and the Care Team
Pages 115-138
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Equipping the Patient and the Care Team
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How can we Best evidence must complement decision making, which address the gap between research and practice? First and must take into account a number of issues, including how foremost, the evidence must be clearly understood and asseverely a disease affects an individual, other diseases com- sessed so we can develop clinical policies based on the peting for the individual's body space, allergies, financial strengths and limitations of the evidence and the settings in constraints, and so on.
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The system will also need ongoing perfor- grate clinical data with current, evidence-based, bestmance reports as feedback so a practitioner's performance practice information and that provide information on can be compared with the performance of his or her col- when and why it may be appropriate to deviate from leagues or against quality standards. Many practitioners are best practices.
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Research agencies (Agency for Healthcare Research and The SAQ has been adapted for use in intensive care units Quality, National Patient Safety Foundation, and National (ICUs) , operating rooms (ORs)
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with a negative teamwork climate. These organizations are Poor teamwork climate in the ICU might suggest a need information poor; the quality of collaboration is abysmal; for multidisciplinary rounds (Uhlig et al., 2001)
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Current research at the these relationships suggest that the SAQ can shed light on University of Texas Center of Excellence for Patient Safety important clinical, economical, and administrative issues in Research and Practice is focused on the relationships medicine and beyond.
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1993. The Flight Management Attitudes Questionnaire Pronovost, P.J., B
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Organizational assessment in intensive care units (ICUs) : con- analysing risk and safety in clinical medicine.
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And it was spent to see her die in a the vast majority of health care is self-care, not care from the very unpleasant situation. As a matter of fact, my mom was traditional health care delivery system.
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The system I will describe is CHESS (the com- ference dif prehensive health enhancement support system) (Figure 2)
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Could outpatient care have been at least system as we know it, and then back into the current health partially effective while I was waiting for a bed? Would it be care system only when it's absolutely necessary.
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But too often, we focus on developing more sophis velopment in consumer health informatics for broad populations, inticated tools rather than on asking how we can spread the cluding the underserved. International Journal of Medical Informatics application of the tools we have.
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Now CareGroup master patient index, reflecting 6 hospitals (Beth one can have complete, ubiquitous, transparent, seamless Israel-Deaconess, Mt. Auburn, New England Baptist, and access to all aspects of the clinical care process.
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three Martha Fords are the same person (this patient has Here is an overview of how provider order entry works. given permission for access to her medical records)
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medical records their doctors see, with certain limitations; The system covers all aspects of ordering care plans and patients can access information about their medications, visprocesses and contains standard order-sets for diseases, such its, reports, x-rays, allergies, and problems, but cannot access as congestive heart failure and asthma. The system has also laboratory reports, microbiology, or DICOM imagery.
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picked up entirely because of the shared medical record, To ensure that the system is improving quality and using amendable by the patient and seen by the care staff. resources appropriately, the performance of the system is The patient portal also makes available standard services, evaluated with metrics.
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Learning is the mecha- As interactive innovations occasion rearrangements of organism by which we advance the practice of medicine and en- nizational roles and routines, care delivery teams have to sure that these advances are widely applied. Learning occurs learn to use new technologies, perform new tasks, and deat many levels in the health care industry.
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As the team learning. Harvard Business Review 79(9)
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quality year after year. Toyota's system is designed to bring The current design of most hospital work systems is disproblems to light, resolve them, and improve the system to respectful to both patients and frontline caregivers, as eviensure that the problems are not repeated and that the orga- denced by the high turnover of nurses and the complaints of nization learns.
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. The study was down, for example, the medication will not be administered focused on two intensive care units (ICUs)
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Eliminating Central Line Infections in summarize what we learned through direct observation of Two Intensive Care Units: Results of Real-time Investigation of Indi vidual Problems. Harvard Business School Working Paper.
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