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In a physical examination, medical examination, clinical examination, or medical checkup, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patient's medical history followed by an examination based on the reported symptoms. Together, the medical history and the physical examination help to determine a diagnosis and devise the treatment plan. These data then become part of the medical record.
A medical error is a preventable adverse effect of care ("iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, infection, or other ailment.
The Joint Commission is a United States-based nonprofit tax-exempt 501(c) organization that accredits more than 22,000 US health care organizations and programs. The international branch accredits medical services from around the world.
The Agency for Healthcare Research and Quality is one of twelve agencies within the United States Department of Health and Human Services (HHS). The agency is headquartered in North Bethesda, Maryland, a suburb of Washington, D.C.. It was established as the Agency for Health Care Policy and Research (AHCPR) in 1989 as a constituent unit of the Public Health Service (PHS) to enhance the quality, appropriateness, and effectiveness of health care services and access to care by conducting and supporting research, demonstration projects, and evaluations; developing guidelines; and disseminating information on health care services and delivery systems.
The Johns Hopkins University School of Medicine (JHUSOM) is the medical school of Johns Hopkins University, a private research university in Baltimore, Maryland. Founded in 1893, the School of Medicine shares a campus with Johns Hopkins Hospital and Johns Hopkins Children's Center, established in 1889.
A clinical decision support system (CDSS) is a health information technology that provides clinicians, staff, patients, and other individuals with knowledge and person-specific information to help health and health care. CDSS encompasses a variety of tools to enhance decision-making in the clinical workflow. These tools include computerized alerts and reminders to care providers and patients, clinical guidelines, condition-specific order sets, focused patient data reports and summaries, documentation templates, diagnostic support, and contextually relevant reference information, among other tools. CDSSs constitute a major topic in artificial intelligence in medicine.
Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.
A patient safety organization (PSO) is a group, institution, or association that improves medical care by reducing medical errors. Common functions of patient safety organizations are data collection, analysis, reporting, education, funding, and advocacy. A PSO differs from a Federally designed Patient Safety Organization (PSO), which provides health care providers in the U.S. privilege and confidentiality protections for efforts to improve patient safety and the quality of patient care delivery
Donald M. Berwick is a former Administrator of the Centers for Medicare and Medicaid Services (CMS). Prior to his work in the administration, he was President and Chief Executive Officer of the Institute for Healthcare Improvement a not-for-profit organization.
Lisa A. Cooper is an American internal medicine and public health physician who is the Bloomberg Distinguished Professor of Equity in Health and Healthcare at Johns Hopkins University, jointly appointed in the Johns Hopkins School of Medicine, Johns Hopkins School of Nursing and in the departments of Health, Behavior and Society, Health Policy and Management; Epidemiology; and International Health in the Johns Hopkins Bloomberg School of Public Health. She is the James F. Fries Professor of Medicine in the Division of General Internal Medicine, Director of the Johns Hopkins Center for Health Equity, and Director of the Johns Hopkins Urban Health Institute. Cooper is also a Gilman Scholar and a core faculty member in the Welch Center for Prevention, Epidemiology, and Clinical Research. She is internationally recognized for her research on the impact of race, ethnicity and gender on the patient-physician relationship and subsequent health disparities. She is a member of the President’s Council of Advisors on Science and Technology (PCAST). In 2007, she received a MacArthur Fellowship.
The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care. According to the model, information about quality of care can be drawn from three categories: “structure,” “process,” and “outcomes." Structure describes the context in which care is delivered, including hospital buildings, staff, financing, and equipment. Process denotes the transactions between patients and providers throughout the delivery of healthcare. Finally, outcomes refer to the effects of healthcare on the health status of patients and populations. Avedis Donabedian, a physician and health services researcher at the University of Michigan, developed the original model in 1966. While there are other quality of care frameworks, including the World Health Organization (WHO)-Recommended Quality of Care Framework and the Bamako Initiative, the Donabedian Model continues to be the dominant paradigm for assessing the quality of health care.
Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.
David Bates is an American-born physician, biomedical informatician, and professor, who is internationally renowned for his work regarding the use of health information technology (HIT) to improve the safety and quality of healthcare, in particular by using clinical decision support. Bates has done work in the area of medication safety. He began by describing the epidemiology of harm caused by medications, first in hospitalized patients and then in other settings such as the home and nursing homes. Subsequently, he demonstrated that by implementing computerized physician order entry (CPOE), medication safety could be dramatically improved in hospitals. This work led the Leapfrog Group to call CPOE one of the four changes that would most improve the safety of U.S. healthcare. It also helped hospitals to justify investing in electronic health records and in particular, CPOE. Throughout his career, Bates has published over 600 peer reviewed articles and is the most cited researcher in the fields of both patient safety and biomedical informatics, with an h-index of 115. In a 2013 analysis published by the European Journal of Clinical Investigation, he ranked among the top 400 living biomedical researchers of any type. He is currently editor of the Journal of Patient Safety.
The Comparative Effectiveness Research Translation Network (CERTAIN) is a learning healthcare system in Washington State focused on patient-centered outcomes research (PCOR) and comparative effectiveness research (CER), leveraging existing healthcare data for research and healthcare improvement, incorporating patient and other healthcare stakeholder voices into research, and facilitating dissemination and implementation of research evidence into clinical practice.
Kathleen Sutcliffe is a Bloomberg Distinguished Professor of Medicine and Business at the Johns Hopkins University Carey Business School and School of Medicine and the Gilbert and Ruth Whitaker Professor Emerita of Business Administration at the University of Michigan Ross School of Business. She studies high-reliability organizations and group decision making in order to understand how organizations and their members cope with uncertainty and unexpected events, with a focus on reliability, resilience, and safety in health care.
Learning health systems (LHS) are health and healthcare systems in which knowledge generation processes are embedded in daily practice to improve individual and population health. At its most fundamental level, a learning health system applies a conceptual approach wherein science, informatics, incentives, and culture are aligned to support continuous improvement, innovation, and equity, and seamlessly embed knowledge and best practices into care delivery
Value-based health care (VBHC) is a framework for restructuring health care systems with the overarching goal of value for patients, with value defined as health outcomes per unit of costs. The concept was introduced in 2006 by Michael Porter and Elizabeth Olmsted Teisberg, though implementation efforts on aspects of value-based care began long before then in the 1990s. With patient value as the overarching goal, VBHC emphasis systematic measurement of outcomes and costs, restructuring provider organizations, and transitioning toward bundled payments. Within this framework, cost reduction alone is not seen as proper strategy for healthcare systems: health outcomes have to improve to enhance value. Although value-based health care is seen as a priority in many health systems worldwide, a global assessment in 2016 found many countries are only beginning to align their health systems with VBHC-principles. Additionally, several studies report incoherent implementation efforts, and there seem to be various interpretations of VBHC, both within and across countries.
Vineet M. Arora is an American medical researcher who is the Herbert T. Abelson Professor of Medicine and Dean for Medical Education at the University of Chicago Pritzker School of Medicine. She is a Fellow of the National Academy of Medicine. Her research considers clinical medicine and medical education, with a focus on the improvement of the quality of care in teaching hospitals.
Emily S. Patterson is an American ergonomist and academic. She is a professor in the Ohio State University College of Medicine.
Kaveh G. Shojania is a Canadian doctor, academic and an author. He is the vice chair of quality & innovation in the department of medicine at the University of Toronto as well as staff physician at the Sunnybrook Health Sciences Centre.
References
- 1 2 "Kathryn Mack McDonald, Ph.D., Professor of Medicine". Johns Hopkins Medicine. Retrieved 2021-07-26.
- ↑ McDonald, Kathryn Mack (2017). Ambulatory Care Organizations: Improving Diagnosis (PhD dissertation). University of California, Berkeley. OCLC 994290014.
- 1 2 3 4 Duff-Brown, Beth (2019-11-06). "SHP's Kathy McDonald named Bloomberg Distinguished Professor at Johns Hopkins" (Press release). University of Stanford. Retrieved 2021-07-26.
- ↑ Duff-Brown, Beth (2015-09-22). "Landmark report on diagnostic errors unveiled by Institute of Medicine" (Press release). University of Stanford. Retrieved 2021-07-26.
- 1 2 "Kathryn McDonald: Health Systems, Quality and Safety" . Retrieved 2021-07-26.
- ↑ McDonald, Kathryn M.; Sundaram, Vandana; Bravata, Dena M.; Lewis, Robyn; Lin, Nancy; Kraft, Sally A.; McKinnon, Moira; Paguntalan, Helen; Owens, Douglas K. (2007). Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 7: Care Coordination). AHRQ Technical Reviews. Rockville (MD): Agency for Healthcare Research and Quality (US). PMID 20734531.
- ↑ "AHRQ - Quality Indicators". qualityindicators.ahrq.gov. Retrieved 2021-07-26.
- ↑ "Leadership Awards". Society for Medical Decision Making. Retrieved 2021-07-26.
- ↑ "Disparities". Society to Improve Diagnosis in Medicine. Retrieved 2021-07-26.
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