scispace - formally typeset
Search or ask a question
Book

Health Professions Education: A Bridge to Quality

TL;DR: Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education.
Abstract: The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Content maybe subject to copyright    Report

Citations
More filters
Journal ArticleDOI
06 Sep 2006-JAMA
TL;DR: While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess, and processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.
Abstract: ContextCore physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs.ObjectiveTo determine how accurately physicians self-assess compared with external observations of their competence.Data SourcesThe electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection.Study SelectionStudies were included if they compared physicians' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention.Data ExtractionStudy population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted.Data SynthesisThe search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions.ConclusionsWhile suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.

2,141 citations

Book
05 Jun 2013
TL;DR: The knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost, and a better use of data is a critical element of a continuously improving health system.
Abstract: America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009--roughly $750 billion--was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances.About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

1,324 citations

Journal ArticleDOI
TL;DR: The authors propose statements of the knowledge, skills, and attitudes (KSAs) for each competency that should be developed during pre-licensure nursing education and invite the profession to comment on the competencies and their definitions.

1,155 citations

References
More filters
BookDOI
01 Jan 2000
TL;DR: Boken presenterer en helhetlig strategi for hvordan myndigheter, helsepersonell, industri og forbrukere kan redusere medisinske feil.
Abstract: Boken presenterer en helhetlig strategi for hvordan myndigheter, helsepersonell, industri og forbrukere kan redusere medisinske feil.

16,469 citations

Journal ArticleDOI
17 Nov 2001-BMJ
TL;DR: Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Abstract: Crossing the Quality Chasm identifies and recommends improvements in six dimensions of health care in the U.S.: patient safety, care effectiveness, patient-centeredness, timeliness, care efficiency, and equity. Safety looks at reducing the likelihood that patients are harmed by medical errors. Effectiveness describes avoiding over and underuse of resources and services. Patient-centeredness relates both to customer service and to considering and accommodating individual patient needs when making care decisions. Timeliness emphasizes reducing wait times. Efficiency focuses on reducing waste and, as a result, total cost of care. Equity looks at closing racial and income gaps in health care.

15,046 citations

Journal ArticleDOI
04 Nov 1992-JAMA
TL;DR: An important goal of the medical residency program is to educate physicians in the practice of evidence-based medicine, and strategies include a weekly, formal academic half-day for residents devoted to learning the necessary skills.
Abstract: A NEW paradigm for medical practice is emerging. Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research. Evidence-based medicine requires new skills of the physician, including efficient literature searching and the application of formal rules of evidence evaluating the clinical literature. An important goal of our medical residency program is to educate physicians in the practice of evidence-based medicine. Strategies include a weekly, formal academic half-day for residents, devoted to learning the necessary skills; recruitment into teaching roles of physicians who practice evidence-based medicine; sharing among faculty of approaches to teaching evidence-based medicine; and providing faculty with feedback on their performance as role models and teachers of evidence-based medicine. The influence of evidencebased medicine on clinical practice and medical education is increasing. CLINICAL SCENARIO A junior medical resident working in a teaching hospital

3,906 citations

Journal ArticleDOI
TL;DR: The CCM is described, its use in intensive quality improvement activities with more than 100 health care organizations, and insights gained in the process are described, to guide quality improvement.
Abstract: The growing number of persons suffering from major chronic illnesses face many obstacles in coping with their condition, not least of which is medical care that often does not meet their needs for effective clinical management, psychological support, and information. The primary reason for this may be the mismatch between their needs and care delivery systems largely designed for acute illness. Evidence of effective system changes that improve chronic care is mounting. We have tried to summarize this evidence in the Chronic Care Model (CCM) to guide quality improvement. In this paper we describe the CCM, its use in intensive quality improvement activities with more than 100 health care organizations, and insights gained in the process.

3,215 citations


"Health Professions Education: A Bri..." refers background in this paper

  • ...Interdisciplinary teams have been shown to enhance quality and lower costs in some studies (Baldwin, 1996; Burl et al., 1998; Curley et al., 1998; McDonough and Doucette, 2001; Shortell, 1994; Wagner et al., 2001)....

    [...]

  • ...Evidence demonstrates that patients who are involved in their care decisions and management have better outcomes, lower costs, and higher functional status than those who are not so involved (Gifford et al., 1998; SuperioCabuslay et al., 1996; Von Korff et al., 1998; Wagner et al., 2001)....

    [...]

  • ...management have better outcomes, lower costs, and higher functional status than those who are not so involved (Gifford et al., 1998; SuperioCabuslay et al., 1996; Von Korff et al., 1998; Wagner et al., 2001)....

    [...]

  • ...Sources: Felt-Lisk and Kleinman (2000); McCulloch et al. (1998); Wagner et al. (2001)....

    [...]

Journal ArticleDOI
09 Oct 2002-JAMA
TL;DR: The chronic care model is a guide to higher-quality chronic illness management within primary care and predicts that improvement in its 6 interrelated components can produce system reform in which informed, activated patients interact with prepared, proactive practice teams.
Abstract: The chronic care model is a guide to higher-quality chronic illness management within primary care. The model predicts that improvement in its 6 interrelated components—self-management support, clinical information systems, delivery system redesign, decision support, health care organization, and community resources—can produce system reform in which informed, activated patients interact with prepared, proactive practice teams. Case studies are provided describing how components of the chronic care model have been implemented in the primary care practices of 4 health care organizations.

2,909 citations


"Health Professions Education: A Bri..." refers background in this paper

  • ...63 measures (Bodenheimer et al., 2002)....

    [...]

  • ...…patients, such as eye and foot exams, better glycemic control, lower HgA1C, and substantial increases in the percentage of diabetic patients with at least two hemoglobin tests within a year (Bodenheimer et al., 2002; Institute for Healthcare Improvement and National Coalition on Health Care, 2002)....

    [...]

  • ...patient’s life, which health professionals can access to manage the many forms of chronic illness that require frequent monitoring and ongoing patient support (Bodenheimer et al., 2002)....

    [...]

  • ...Outcomes for both settings, described above, have shown substantial increases in preventive measures for patients, such as eye and foot exams, better glycemic control, lower HgA1C, and substantial increases in the percentage of diabetic patients with at least two hemoglobin tests within a year (Bodenheimer et al., 2002; Institute for Healthcare Improvement and National Coalition on Health Care, 2002)....

    [...]

  • ...…databases or disease registries can enable the meticulous collection of personal health information throughout a patient s life, which health professionals can access to manage the many forms of chronic illness that require frequent monitoring and ongoing patient support (Bodenheimer et al., 2002)....

    [...]