...Commission on a High Performance Health System, Aug. 2008). 2 Information about Kaiser Permanente was synthesized in part from a presentation by CEO George Halvorson to a Commonwealth Fund Commission on a High Performance Health Care System meeting in San Francisco, and from the Commission’s site visit to the Kaiser Permanente San Francisco Medical Center in March 2007. Additional information was obtained from presentations, telephone interviews, or e-mail communications with the individuals named in the acknowledgments; from information and documents available on the organization’s Web site (www.kp.org) and from regulatory filings; and from other presentations and publications cited below. 3 A summary of findings from all case studies in the series can be found in D. McCarthy and K. Mueller, Organizing for Higher Performance: Case Studies of Organized Delivery Systems. Series Overview, Findings, and Methods (New York: The Commonwealth Fund, 2009). 4 For examples, see A. C. Enthoven and L. A. Tollen, “Epilogue,” in Toward a 21st Century Health System, edited by A. C. Enthoven and L. A. Tollen (San Francisco: Jossey-Bass, 2004). 5 The Colorado region developed an EHR in collaboration with IBM Corporation that was fully functional by 1997. Physicians in the Northwest region had access to an EHR (from Epic Systems Corp.) starting in 1994; exam room computers were installed in 2001. Kaiser began rolling out the Colorado EHR to other regions early in the decade ...
Words: 913 - Pages: 4
...CASE: SM-136 DATE: 10/24/04 BETTER MEDICINE THROUGH INFORMATION TECHNOLOGY INTRODUCTION The health care industry in the United States was troubled. Most of the world’s state-of-the-art health care research occurred in U.S. university and corporate laboratories. Similarly, most of the best centers in the world for delivery of health care were located in the U.S. However, the costs of health care in the United States were exploding and overall quality, along many dimensions, was not increasing. For U.S. consumers it was the best of times and the worst of times—health care services were often terrific if judged by the ability of individual physicians to do more for patients and yet, as judged on almost any broad parameter such as life expectancy or infant mortality, the United States was at best average compared to other developed countries. In most developed countries, spending on health care grew dramatically over the past several years. This increase in spending, combined with lower overall economic growth, pushed up the share of health care expenditure as a percentage of gross domestic product (GDP) of OECD countries from an average 7.8 percent in 1997 to 8.5 percent in 2002. By comparison, the share of GDP spent on health care remained almost unchanged from 1992 to 1997 (Exhibit 1). In the United States, health care expenditure grew 2.3 times faster than GDP, rising from 13 percent in 1997 to 14.6 percent in 2002. Spending was $5,267 per capita in 2002, almost 140 percent...
Words: 10256 - Pages: 42
...University FIELD REPORT October 2002 Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and should not be attributed to The Commonwealth Fund or its directors, officers, or staff. Copies of this report are available from The Commonwealth Fund by calling our toll-free publications line at 1-888-777-2744 and ordering publication number 576. The report can also be found on the Fund’s website at www.cmwf.org. CONTENTS About the Authors.......................................................................................................... iv Acknowledgments .......................................................................................................... iv Executive Summary......................................................................................................... v Introduction .................................................................................................................... 1 Findings........................................................................................................................... 3 Defining Cultural Competence .................................................................................. 3 Barriers to Culturally Competent Care....................................................................... 3 Benefits of Cultural Competence ............................................................................... 6 Models of Culturally Competent Care...
Words: 12550 - Pages: 51
...STATE UNIVERSITY OF NEW YORK AT ALBANY Emanuel Medical Center Situational & Decision Analysis James T. Onisk 4/29/2012 Table of Contents Situational Analysis Appendices External Analysis Appendix A: S.W.O.T. Analysis Appendix B: External Trend/Issue Analysis Appendix C: Environmental Trends/Issues Plot Appendix D: Stakeholder Map Appendix E: Service Area Profile Appendix F: Service Area Structural Analysis Appendix G: Service Area Competitor Analysis Appendix H: Critical Success Factor Analysis Appendix I: Mapping Competitors Appendix J: Synthesizing the Analysis Internal Analysis Appendix K: Financial Analysis Appendix L: Value Chain Strengths and Weaknesses Appendix M: Value Chain Competitive Advantages Relative to Strengths Appendix N: Value Chain Competitive Disadvantages Relative to Weaknesses Appendix O: Strategic Implications of Strengths and Weaknesses References Decision Analysis Decision Analysis Appendices Appendix P: Directional Strategies Appendix Q: Adaptive Strategies Appendix R: Market Entry Strategies Appendix S: Strategic Positioning Appendix T: Value-Chain Funcations References 1 2-11 12-13 14-17 18-29 30-36 37-50 51-60 61-66 67 I-VII 68-74 75-81 82-86 87-91 92-95 96-105 VIII-XV 106-109 110-122 123-125 126-128 129-135 136 Issue Statement Emanuel Medical Center (EMC) is encountering tremendous financial troubles as it struggles to remain open as an independent general acute care hospital. Changes in federal regulations such as the implementation...
Words: 47712 - Pages: 191
...Spring 2003 TV Violence Since the advent of television, the effect of TV violence on society has been widely studied and vigorously debated. Based on the cumulative evidence of studies conducted over several decades, the scientific and public health communities overwhelmingly conclude that viewing violence poses a harmful risk to children. Critics of the research challenge this conclusion and dispute claims that exposure to TV violence leads to real-life aggression. As we move into the digital era with enhanced images and sound, media violence will undoubtedly continue to be a focus of public concern and scientific research. Prevalence of Violence on TV The National Television Violence Study is the largest content analysis undertaken to date. It analyzed programming over three consecutive TV seasons from 1994 to 1997.1 Among the findings: • Nearly 2 out of 3 TV programs contained some violence,2 averaging about 6 violent acts per hour.3 • Fewer than 5% of these programs featured an anti-violence theme or prosocial message emphasizing alternatives to or consequences of violence.4 • Violence was found to be more prevalent in children’s programming (69%) than in other types of programming (57%). In a typical hour of programming, children’s shows featured more than twice as many violent incidents (14) than other types of programming (6).5 • The average child who watches 2 hours of cartoons a day may see nearly 10,000 violent incidents each year, of which the researchers estimate...
Words: 3396 - Pages: 14
...Institute for Health Technology Transformation Population Health Management A Roadmap for Provider-Based Automation in a New Era of Healthcare Acknowledgements Alide Chase, MS Senior Vice President for Quality and Service Kaiser Foundation Health Plan, Inc. & Kaiser Foundation Hospitals Connie White Delaney, PhD, RN, FAAN, FACMI School of Nursing Professor & Dean Academic Health Center Director, Biomedical Health Informatics (BMHI) Acting Director of the Institute for Health Informatics (IHI) University of Minnesota Don Fetterolf, MD, MBA Principal Fetterolf Healthcare Consulting Robert Fortini VP & Chief Clinical Officer Bon Secours Health System Paul Grundy, MD, MPH Global Director of Healthcare Transformation IBM President Patient-Centered Primary Care Collaborative Richard Hodach, MD, PHD, MPH Chief Medical Officer Phytel Michael B. Matthews Chief Executive Officer Central Virginia Health Network Margaret O’Kane President National Committee for Quality Assurance Andy Steele, MD, MPH, MSC Director, Medical Informatics Denver Health 2 Dear Colleagues, Population health management has been around for a while, but only recently has it gained serious attention from mainstream healthcare organizations. The reason is simple: healthcare reimbursement is changing, and hospitals, healthcare systems, and physician groups must adapt to a new world in which providers are rewarded for meeting quality objectives for their entire patient panel, and not just those actively...
Words: 8702 - Pages: 35
...Chapter 33. Professional Communication and Team Collaboration Michelle O’Daniel, Alan H. Rosenstein Background In today’s health care system, delivery processes involve numerous interfaces and patient handoffs among multiple health care practitioners with varying levels of educational and occupational training. During the course of a 4-day hospital stay, a patient may interact with 50 different employees, including physicians, nurses, technicians, and others. Effective clinical practice thus involves many instances where critical information must be accurately communicated. Team collaboration is essential. When health care professionals are not communicating effectively, patient safety is at risk for several reasons: lack of critical information, misinterpretation of information, unclear orders over the telephone, and overlooked changes in status.1 Lack of communication creates situations where medical errors can occur. These errors have the potential to cause severe injury or unexpected patient death. Medical errors, especially those caused by a failure to communicate, are a pervasive problem in today’s health care organizations. According to the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations, JCHAO), if medical errors appeared on the National Center for Health Statistic’s list of the top 10 causes of death in the United States, they would rank number 5—ahead of accidents, diabetes, and Alzheimer’s disease, as well as AIDS, breast...
Words: 7203 - Pages: 29
...EMR Research & Opinion Paper Produced by: Jeremy Averella EMR Course Fall 2013 EMR Research & Opinion Paper Produced by: Jeremy Averella EMR Course Fall 2013 TABLE OF CONTENTS I. Advantages of EHRs 2 a. Cost Containment 2 b. Empowerment 3 c. Improved Communication 4 d. Less Waste 4 e. Compliance 5 II. Disadvantages of EHRs 6 a. Lack of Standardization 6 b. Security & Privacy Concerns 7 c. System Infrastructure Issues 8 d. Risk of Liability and Patient Uncertainty 8 III. EHR Technology 9 a. EHR Benefits 10 b. EHR Types 11 c. EHRs Future Evolution 13 d. EHR Technology versus Handheld SMART devices 14 IV. Trends and Consequences 15 a. Aggressive Implementation 16 b. High Costs 16 c. Labor Investment 17 d. Opportunity Cost 17 e. Impact on Researchers, Policymaker and Educators 18 V. Final Opinion 19 VI. Bibliography 22 VII. Appendix I 28 VIII. Appendix II 31 I. Advantages of EHRs In an effort to reign in rising health care costs and increased health care disparity and inequality in the U.S., former president George W. Bush doubled the funding for Health Care Information Technology to 100 million in 2005 (The White House). It was part of a larger plan to utilize latest information technology to standardize patient and health records, which despite spending 1.6 trillion dollars, attributed to 98,000 medically related errors in 2004. The plan was part of his campaign promise and was reiterated in his January 20...
Words: 7955 - Pages: 32
...The Families and Children Who Live in the Buena Vista Mobile Home Park Report of a study conducted by Donald Barr, MD, PhD, Professor (Teaching) of Pediatrics, and of Education (by courtesy) Amado Padilla, PhD, Professor of Education Stanford University Graduate School of Education , March 17 , 2014 As faculty members of the Graduate School of Education at Stanford University, we would like to share with the broader civic and academic community the results of our recent research on the educational and hea lth status of children who live in the Buena Vista Mobile Home Park in Palo Alto. We developed this study as we became increasingly aware of unanswered questions that are central both to the specific issue of the future of Buena Vista in Palo Alto, and to the broader issue of the impact on children from traditionally disadvantaged economic and ethnic backgrounds of living in socioeconomically advantaged communities such as Palo Alto. History of the Buena Vista Mobile Home Park As described in a 2008 artic le published in Palo Alto Online , “ Buena Vista began as a tourist camp for travelers, part of a 5,392 - acre property purchased by R.E. Ashley in 1926 ... During World War II, primitive hookups for trailers went in, housing war workers and people associated wi th the army camp on Page Mill Road or Moffett Field ... The park settled down into a permanent trailer camp in the 1950s. ” 1 Buena Vista has been part of Palo Alto for nearly...
Words: 4178 - Pages: 17
...Abide by Your Code of Ethics | Skill Set: Economics | TOPIC OR UNIT OF STUDY | Business Ethics and Social Responsibility | CONTENT STANDARD(S) AND OBJECTIVE(S) | Students will * point out the areas in which businesses demonstrate social responsibility and ethics. * recognize consumerism. * determine current trends to improve the workplace for employees. * research how regulatory agencies protect consumers, workers, and the environment. | INTRODUCTION | Review with students how to prepare unbound reports. Have a class discussion of the 4 components of social responsibility and ethics. Discuss how business people use values to make decisions that are acquired through family, educational, social and religious institutions. Discuss business code of ethics and how it serves as a guideline to help managers and other employees in any organization make better decisionsStudents will conduct on-line research of 5 major corporate websites in order to write a code of ethics for a fictitious company they will create. The students will then describe how these ethical guidelines relate to any or all of the four (4) components of social responsibility. Students will look at 2-3 companies that have practiced unethical behavior. The students will make a multi-media presentation to the class describing any relationship between their company’s code of ethics and the four components of social responsibility. | ESSENTIAL QUESTION | What is ethical behavior and social responsibility...
Words: 2051 - Pages: 9
...qwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwer...
Words: 2143 - Pages: 9
...Clostridium the most common food-borne diseases worldwide resulting from the contamination food. It is one of the most common causes of reported food-borne diseases in the United States. Although several Staphylococcal enterotoxins (SEs) have been identified, SEA, a highly heat-stable SE, is the most common cause of SFD worldwide. Outbreak investigations have found that improper food handling practices in the retail industry account for the majority of SFD outbreaks. However, several studies have documented prevalence of S. aureus in many food products including raw retail meat indicating that consumers are at potential risk of S. aureus colonization and subsequent infection. Presence of pathogens in food products imposes potential hazard for consumers and causes grave economic loss and loss in human productivity via food-borne disease. Symptoms of SFD include nausea, vomiting, and abdominal cramps with or without diarrhea. Preventive measures include safe food handling and processing practice, maintaining cold chain, adequate cleaning and disinfection of equipment, prevention of cross-contamination in home and kitchen, and prevention of contamination from farm to fork. This paper provides a brief overview of SFD, contributing factors, risk that it imposes to the consumers, current research gaps, and preventive measures. Clostridium difficile was first described as part of the normal microbiota in stool samples from healthy infants in 1935 (59)...
Words: 3044 - Pages: 13
...Designing effective collaboration A report from the Economist Intelligence Unit Sponsored by Cisco Systems Designing effective collaboration Preface n early 2008 the Economist Intelligence Unit published a paper titled “The role of trust in business collaboration”, one of a several papers produced since 2006 as a part of ongoing research sponsored by Cisco Systems. The paper focused on the need for different levels of trust in different business environments. Although each of those environments was commonly deemed “collaborative”, there was in fact a distinct difference between the level of trust required and the degree of collaboration. More importantly, trust was shown to be a key success factor in collaboration. These findings may seem unsurprising on the surface, but they became far more notable when combined with other results from that research. Particularly, few “collaborations” were seen as completely successful, few people actually trust very highly many of the people with whom they work and the term “collaboration” is most often used today to describe activities that are, in fact, quite mundane. What happens, then, when companies are pursuing complex and ambitious collaborations with lofty aspirations like innovation, margins and returns to shareholders? Furthermore, how do companies collaborate successfully on such ventures in an increasingly global economy and when knowledge is at a premium? The Economist Intelligence Unit and Cisco decided to join forces...
Words: 8996 - Pages: 36
...improving Quality and Value in the U.S. Health Care System August 2009 Preamble The Bipartisan Policy Center (BPC) is a public policy advocacy organization founded by former U.S. Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. Its mission is to develop and promote solutions that can attract the public support and political momentum to achieve real progress. The BPC acts as an incubator for policy efforts that engage top political figures, advocates, academics, and business leaders in the art of principled compromise. This report is part of a series commissioned by the BPC to advance the substantive work of the Leaders’ Project on the State of American Health Care. It is intended to explore policy trade-offs and analyze the major decisions involved in improving health care delivery, and discuss them in the broader context of health reform. It does not necessarily reflect the views or opinions of Senators Baker, Daschle, and Dole or the BPC’s Board of Directors. The Leaders’ Project was launched in March 2008. Co-Directed by Mark B. McClellan and Chris Jennings, its mission is (1) to create a bipartisan plan for health reform that can be used to transform the U.S. health care system, and (2) to demonstrate that health reform is an achievable political reality. Over the course of the project, Senators Baker, Daschle, and Dole hosted public policy forums across the country, and orchestrated a targeted outreach campaign to...
Words: 35073 - Pages: 141
...be a very successful venture. But, at this point continued intervention is needed. It is recognized that there are still technical issues related to functionality and interoperability. The problems appear to be due to sociological, cultural, and financial problems. But, in the end most would agree that the issues are related to managerial more than technological problems. Experience and research implemented by those with failures have identified the most important concerns being,” what constitutes success and what is failure?” Their question is what contributes to making successful or unsuccessful systems? How do these companies use their system failures to enhance learning opportunities for continued company improvement? How should they study this success or failure? The determination was related at workshops directed by the AMIA to enhance opportunities for future successes, with a research agenda and recommendations. The AMIA was convicted to take a leadership role and come up with practical projects that would likely succeed in a health care setting. Introduction In February 2009 Congress appropriated $20 billion for health information technology as a part of the President’s stimulus package. Then the United State joined with other countries to benefit from healthcare technology. Because of the changes made to Medicare and private insurance plans, new paradigm for payments have been made to reflect Value-Based Purchasing (VBP),...
Words: 5544 - Pages: 23
