All manner of medical practitioners have had their scruples dissected ad infinitum. In spite of the attention paid to medical ethics and bioethics, little has been paid to the ethical roles and responsibilities of those who are ultimately in charge of hospital governance: hospital trustees. Deriving from a Hastings Center research project involving meetings with a national task force of experts and extensive interviews with 98 nonprofit hospital trustees and CEOs over a two-year period, The Ethics of Hospital Trustees shows that the decisions made by these often overlooked members of the health community do raise important ethical issues, and that ethical dimensions of trustee service should be more explicitly recognized and discussed. Practical as well as theoretical, The Ethics of Hospital Trustees uncovers four basic principles: 1. Fidelity to mission; 2. Service to patients; 3. Service to the community; and 4. Institutional stewardship. In delineating the extremely important functions of hospital trustees, from patient safety to financial responsibility, the contributors outline not only how hospital trustees do perform—they give a fresh understanding to how they should perform as well.

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

While the healthcare system continues to shift towards more emphasis on quality metrics, there remains a substantial gap between the expectations of healthcare policies and standards of hospital administrations vs. the realistic care provided by the average healthcare provider. This book offers the perspective of the healthcare provider and aims to fulfill the unmet need to educate other healthcare providers on recognizing quality measures and understanding how to achieve them to meet standards of quality care. This book covers the historical perspective of quality measures, the context of their existence, their utility, and the contemporary issues related to their use. Simultaneously, it critically addresses the quality of these quality metrics and presents the evidence available to date on the efficacy and the limitations of these quality measures. This text is all-inclusive and is organized into chapters that include the evolution of quality metrics in healthcare, the practical role of hospitals, as well as the practical role of individual healthcare providers in addressing quality metrics. The chapters also include assessment of quality metrics that uniquely pertain to medical and surgical practices, as well as non-clinical quality metrics that specifically target undergraduate and graduate medical training. Finally, the book reflects on the use of contemporary quality metrics and their impact on outcomes, patient care, and public health and policy making. In these chapters, tables and illustrations, including algorithms, will be used to provide systematic approaches to common issues related to quality metrics. In addition, historical anecdotes and case presentations will be used to address pearls in contemporary practice of quality metrics. Quality Measures is the definitive reference on quality metrics in healthcare and is a valuable resource for healthcare providers, trainees, administrators and public health agencies.

Vol. for -1913/14 include Report of Worcester State Asylum.