Palomar Medical Center, like many California healthcare institutions in the 1990s, faced the challenge of needing to meet state building seismic requirements. As a result of the mandate and infrastructure demands that would need to be made to accommodate the new standards, the health system set out to assess the larger needs of the communities served, evaluate the medical and technological chan...

This book comprises an edited collection of research studies and conceptual essays on the topic of integrated care. There is no specific logic to the presentation of the material and the contents represent a highly varied and eclectic mix of subjects. Indeed, the contents have all the hallmarks of a set of conference papers that have been collated together without a huge amount of thought. As a...

The detonation of a nuclear device in a US city would be catastrophic. Enormous loss of life and injuries would characterize an incident with profound human, political, social, and economic implications. Nevertheless, most responders have not received sufficient training about ionizing radiation, principles of radiation safety, or managing, diagnosing, and treating radiation-related injuries an...

Patient safety is a prominent theme in health care delivery today. This should come as no surprise, given that “first, do no harm” has been the ethical watchword throughout the history of medicine, nursing, and pharmacy. In recent years, we have become increasingly aware of the magnitude of our failure to successfully live up to this ethical imperative. We have also become increasingly aware of...

English The aim of this article is to provide some insight into ways in which action research can contribute to the development of theory about the process of health care delivery. It focuses on a variety of action research that is a methodology for carrying out research into management and organisations, which can lead to deep conceptualisations about what can happen in practice and the reason...

BACKGROUND Reverse Innovation has been endorsed as a vehicle for promoting bidirectional learning and information flow between low- and middle-income countries and high-income countries, with the aim of tackling common unmet needs. One such need, which traverses international boundaries, is the development of strategies to initiate and sustain community engagement in health care delivery system...

All nurses should practice to the full extent of their education and training. This key message from the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, applies to all RNs. Barriers need to come down that prevent nurses from reaching their full potential at a time when the US health care system needs to be operating at full capacity. With the focus of US h...

20090501 Kaiser Permanente Leadership Program Copyright 2009 Michael E. Porter Medical Association, 2007; 297:1103:1111. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means — electronic, mechanical, photocopying, recording, or otherwise — without the permission of Michael E. Porter and Elizabeth Olmsted Teisberg. Further inform...

Outcomes research on treatments for schizophrenia has identified a number of efficacious interventions. The degree to which such scientific knowledge influences the care delivered in everyday practice depends on a large number of patient, practitioner, service system, and other social factors. The current atmosphere for change in the health care delivery system poses both risks and opportunitie...

Patients, payers, and the public have increased expectations concerning the quality, safety and costs of our health care delivery systems. Whether or not to redesign our complex delivery systems is no longer in question. In order to succeed in optimizing care and outcomes (clinical and financial) for our stakeholders, we must design and evaluate tests of change. This journey will require a fund...