Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.

In a joint effort between the National Academy of Engineering and the Institute of Medicine, this books attempts to bridge the knowledge/awareness divide separating health care professionals from their potential partners in systems engineering and related disciplines. The goal of this partnership is to transform the U.S. health care sector from an underperforming conglomerate of independent entities (individual practitioners, small group practices, clinics, hospitals, pharmacies, community health centers et. al.) into a high performance "system" in which every participating unit recognizes its dependence and influence on every other unit. By providing both a framework and action plan for a systems approach to health care delivery based on a partnership between engineers and health care professionals, Building a Better Delivery System describes opportunities and challenges to harness the power of systems-engineering tools, information technologies and complementary knowledge in social sciences, cognitive sciences and business/management to advance the U.S. health care system.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

"""Reengineering Health Care" gets to the core of transforming our current system by advocating the widespread use of IT, eliminating inefficient practices, and keeping the system focused on a healthy individual and not on a broken process.""--Newt Gingrich, Founder of the Center for Health Transformation, and former Speaker of the U.S. House of Representatives ""This book is a prescription for streamlining health care. Using the techniques that have successfully transformed business into customer-focused and efficient organizations, the authors provide a step-by-step approach to improving health care processes, guiding health care into the next generation of Lean delivery systems.""--Dr. John Halamka, Chief Information Officer, Beth Israel Deaconess Medical Center ""In health care, we tend to inundate our people with information, rather than enabling them to have insights. This concise guide will resonate with both senior and front-line managers who know they're engaged in unproductive work. They will see that reengineering is not overly difficult and can enable them to improve patient care and efficiency.""--Trevor Fetter, President and CEO, Tenet Health Corporation, and Trustee, Federation of American Hospitals ""It isn't reform that will fix our ailing health care system, its reengineering. Champy and Greenspun highlight organizations that have transformed, and reinvented, themselves by reengineering care delivery-they've lowered costs, improved care quality and patient safety, and increased the satisfaction of those giving and receiving care. Every clinician, hospital executive, and politician should read this book.""--Bill Crounse, M.D., Senior Director, Worldwide Health, Microsoft Corporation ""Implement health care technology, and you have better health care tools; reengineer with a focus on technology, process, and people, and you have a better health care system. This straightforward guide shows how to transform health care to maximize quality, safety, convenience, and impact the cost of delivery. No one can read this book and not feel a profound call to action.""--H. Stephen Lieber, CAE, President & CEO, HIMSS In their legendary book, "Reengineering the Corporation", Jim Champy and Michael Hammer introduced businesspeople to the enormous power of a revolutionary methodology called "reengineering". Using reengineering, businesses around the world have systematically retooled their processes--achieving dramatic cost savings, greater customer satisfaction, and more value. Now, Jim Champy and Dr. Harry Greenspun show how to apply the proven reengineering methodology in health care: throughout physician practices, hospitals, and even entire health systems. You'll meet innovative and visionary leaders who've been successfully reengineering organizations across the entire delivery spectrum and learn powerful lessons for improving quality, reducing costs, and expanding access. This book doesn't just demonstrate the immense potential of health care reengineering to revolutionize health care delivery: "it offers a clear roadmap for realizing that potential in your own organization""." Deliver Better Care to More People, at Lower Cost How reengineering can lead to more efficient, safer delivery--and sharply reduced costs How to focus on prevention and wellness, as well as chronic disease and hospital care How to earn the trust, contributions, and passion of skeptical physicians and health care professionals How to harness technology to create more seamless, accessible, valued, and sustainable health care systems--and avoid technology's pitfalls How Zeev Neuwirth transformed the Lenox Hill Hospital ER and the 700-doctor Harvard Vanguard Medical Associates practice How Tom Knight is revolutionizing patient safety at Methodist Hospital System, one of America's largest private, nonprofit medical complexes How to start today in your own organization!

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.