Academic medical centers provide cutting edge acute care, train tomorrow's physicians, and carry out research that will expand the range of treatable and curable illnesses. But these centers themselves may need urgent care—experts generally agree that many are suffering acute—even life-threatening—financial distress. Many academic medical centers are suffering for several reasons: in-patient admissions are down, as many procedures that once required a hospital stay are now performed on an out-patient basis or in a physician's office ; managed care plans have negotiated discounted fees that cut hospital operating margins; the Balanced Budget Act of 1997 curtailed Medicare reimbursements, lowered margins and pushed some into the red; the revolution in information technology is imposing large new capital costs; and the character of medical education is receiving its most thorough review in decades. While there is a general consensus that medical centers are under pressure, experts disagree about the depth and pervasiveness of the current financial distress. Are they whining about financial pressures other, less-favored sectors find routine; or is the high quality American teaching hospital becoming an endangered species—that could face extinction if nothing is done. Because academic medical centers perform such important jobs, it is critical to determine the true nature and depth of their current financial problems—and then fashion analytically sound and politically sustainable solutions. This book brings together chief executive officers of major medical centers, university presidents, senior members of Congressional and executive office staffs, and leading analysts. These experts address the key issues and prescribe remedies both regulatory and legislative to ensure that the teaching hospital remains a picture of financial health. Contributors include Nancy Kane (Harvard School of Public Health), Jamie Reuter (Institute for Health Care Research P

The Transformation of Academic Health Centers: The Institutional Challenge to Improve Health and Well-Being in Healthcare's Changing Landscape presents the direct knowledge and vision of accomplished academic leaders whose unique positions as managers of some of the most complex academic and business enterprises make them expert contributors. Users will find invaluable insights and leadership perspectives on healthcare, health professions education, and bio-medical and clinical research that systematically explores the evolving role of global academic health centers with an eye focused on the transformation necessary to be successful in challenging environments. The book is divided into five sections moving from the broad perspective of the role of academic health centers to the role of education, training, and disruptive technologies. It then addresses the discovery processes, improving funding models, and research efficiency. Subsequent sections address the coming changes in healthcare delivery and future perspectives, providing a complete picture of the needs of the growing and influential healthcare sector. - Outlines strategies for academic health centers to successfully adapt to the global changes in healthcare and delivery - Offers forward-thinking and compelling professional and personal assessments of the evolving role of academic health centers by recognized outstanding academic healthcare leaders - Includes case studies and personal reflections, providing lessons learned and new recommendations to challenge leaders - Provides discussions on the discovery process, improving funding models, and research efficiency

Much as it is with the nation‘s overall healthcare system, the survival of academic medical centers (AMC‘s) is threatened by a combination of economic, cultural, and demographic factors. If AMC‘s are to survive to fill their societal responsibilities, they must adopt a new philosophy. Challenging assumptions and providing the shift in perspective t

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.

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.

This handbook examines health and medical care in the Arab world from a systems biology approach. It features comprehensive coverage that includes details of key social, environmental, and cultural determinants. In addition, the contributors also investigate the developed infrastructure that manages and delivers health care and medical solutions throughout the region.More than 25 sections consider all aspects of health, from cancer to hormone replacement therapy, from the use of medications to vitamin deficiency in emergency medical care. Chapters highlight essential areas in the wellbeing and care of this population. These topics include women’s health care, displaced and refugee women’s health needs, childhood health, social and environmental causes of disease, health systems and health management, and a wide range of diseases of various body systems. This resource also explores issues related to access and barriers to health delivery throughout the region.Health in the Arab world is complex and rapidly changing. The health burden in the region is distributed unevenly based on gender, location, as well as other factors. In addition, crises such as armed conflicts and an expanding migrant population place additional stress on systems and providers at all levels. This timely resource will help readers better understand all these major issues and more. It will serve as an ideal guide for researchers in various biological disciplines, public health, and regulatory agencies.