There is constant pressure on hospitals to improve health care delivery and increase cost effectiveness. New initiatives are the order of the day in the dramatically different health care systems of the United States and Great Britain. Often, as we know all too well, these efforts are not successful. In The Challenge to Change, Rebecca Kolins Givan analyzes the successes and failures of efforts to improve hospitals and explains what factors make it likely that the implementation of reforms will rewarded by positive transformation in a particular institution’s day-to-day operation. Givan’s in-depth qualitative case studies of both top-down initiatives and changes first suggested by staff on the front lines of care point clearly to the importance of all hospital workers in effecting change and even influencing national policy. Givan illuminates the critical role of workers, managers, and unions in enabling or constraining changes in policies and procedures and ensuring their implementation. Givan spotlights an Anglo-American model of hospital care and work organization, even while these countries retain their differences in access and payment. Entrenched professional roles, hierarchical workplace organization, and the sometimes-detached view of policymakers all shape the prospects for change in hospitals. Givan provides important examples of how the dedication and imagination of the people who work in hospitals can make all the difference when it comes to providing quality health care even in a challenging economic environment.

What are the political forces which drive the process of change in the health service? How do these forces impact on existing structures of power, policy and organisation? In addressing these questions, Brian Salter applies an original theory of political change to key areas of NHS activity. He shows how the escalating demand for health care combined with recent radical policy initiatives has posed different problems for politicians, doctors, bureaucrats and managers. Out of the accommodations reached, a new shape has emerged for the NHS.

This book compares how governments in 192 countries perceive climate change related health risks and which measures they undertake to protect their populations. Building on case studies from the United Kingdom, Ireland, South Korea, Japan and Sri Lanka, The Politics of the Climate Change-Health Nexus demonstrates the strong influence of epistemic communities and international organisations on decision making in the field of climate change and health. Jungmann shows that due to the complexity and uncertainty of climate change related health risks, governments depend on the expertise of universities, think tanks, international organisations and researchers within the public sector to understand, strategize and implement effective health adaptation measures. Due to their general openness towards new ideas and academic freedom, the book shows that more democratic states tend to demonstrate a higher recognition of the need to protect their populations. However, the level of success largely depends on the strength of their epistemic communities and the involvement of international organisations. This volume will be of great interest to students and scholars of climate change and public health. It will also be a valuable resource for policymakers from around the world to learn from best practices and thus improve the health adaptation work in their own countries.

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

How do policy and politics influence the social conditions that generate health outcomes? Reduced life expectancy, worsening health outcomes, health inequity, and declining health care options—these are now realities for most Americans. However, in a country of more than 325 million people, addressing everyone's issues is challenging. How can we effect beneficial change for everyone so we all can thrive? What is the great equalizer? In this book, Daniel E. Dawes argues that political determinants of health create the social drivers—including poor environmental conditions, inadequate transportation, unsafe neighborhoods, and lack of healthy food options—that affect all other dynamics of health. By understanding these determinants, their origins, and their impact on the equitable distribution of opportunities and resources, we will be better equipped to develop and implement actionable solutions to close the health gap. Dawes draws on his firsthand experience helping to shape major federal policies, including the Affordable Care Act, to describe the history of efforts to address the political determinants that have resulted in health inequities. Taking us further upstream to the underlying source of the causes of inequities, Dawes examines the political decisions that lead to our social conditions, makes the social determinants of health more accessible, and provides a playbook for how we can address them effectively. A thought-provoking and evocative account that considers both the policies we think of as "health policy" and those that we don't, The Political Determinants of Health provides a novel, multidisciplinary framework for addressing the systemic barriers preventing the United States from becoming the healthiest nation in the world.

Approximately 100,000 deaths per year in the United States result from preventable medical errors. This figure is about twice the number of people who die in car accidents and five times the number of murder victims annually, and twenty times the number of servicemen and women killed in Iraq and Afghanistan since the start of hostilities in 2001. If you think Americans have the best health-care system in the world, think again. In this deeply researched and controversial book, Dr. Stephen Schimpff explains why our health-care delivery system serves us so poorly, why it costs so much, and why government policy over many decades has not only failed to improve care delivery but has actually made it worse. In the process, he dispels common misconceptions about medicine and health care. The Future of Health-Care Delivery provides timely information and a road map to achieve world-class care delivery, putting health care where it belongs--in the hands of the patient and medical professionals instead of the insurance companies and government.

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.