Factors Conditioning the Autonomy of Patients in Decision-Making Processes in Clinical Settings

Factors Conditioning the Autonomy of Patients in Decision-Making Processes in Clinical Settings PDF Author: Jesús Molina-Mula
Publisher: Cambridge Scholars Publishing
ISBN: 1527522717
Category : Medical
Languages : en
Pages : 147

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Book Description
This book explores the factors that determine and influence the quality of care in clinical setting from the perspective of understanding the decision-making capacity of patients. It looks at the nurse’s relationship with the patient, including the implications of this relationship in nursing practice; the relationship of the nurse with the family; interprofessional relationships within the health team and their influence on the clinical practice of nurses; and the nurse's relationship with the health system and its influence on patient-family care. The volume will guide managers of health organizations to establish programs and policies that reduce the negative effects of current management on health teams. These changes will improve the quality of care, and increase the autonomy of patients in decision-making.

Informed Consent

Informed Consent PDF Author: S. Wear
Publisher: Springer Science & Business Media
ISBN: 9401581223
Category : Philosophy
Languages : en
Pages : 190

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Book Description
Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received in a lukewarm fashion by most clinicians, many simply rejecting what they commonly refer to as the `myth of informed consent'. The purpose of this book is to defuse this seemingly intractable controversy by offering an efficient and effective operational model of informed consent. This goal is pursued first by reviewing and evaluating, in detail, the agendas, arguments, and supporting materials of its proponents and detractors. A comprehensive review of empirical studies of informed consent is provided, as well as a detailed reflection on the common clinician experience with attempts at informed consent and the exercise of autonomy by patients. In the end, informed consent is recast as a management tool for pursuing clinically and ethically important goods and values that any clinician should see as meriting pursuit. Concurrently, the model incorporates a flexible, anticipatory approach that recognizes that no static, generic ritual can legitimately pursue the quite variable goods and values that may be at stake with different patients in different situations. Finally, efficiency of provision is addressed by not pursuing the unattainable and ancillary. Throughout, the traditional principle of beneficence is appealed to toward articulating an operational model of informed consent as an intervention that is likely to change outcomes at the bedside for the better.

Crossing the Quality Chasm

Crossing the Quality Chasm PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132967
Category : Medical
Languages : en
Pages : 359

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Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. 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.

Improving the Quality of Health Care for Mental and Substance-Use Conditions

Improving the Quality of Health Care for Mental and Substance-Use Conditions PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133661
Category : Medical
Languages : en
Pages : 528

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Book Description
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

Code of Ethics for Nurses with Interpretive Statements

Code of Ethics for Nurses with Interpretive Statements PDF Author: American Nurses Association
Publisher: Nursesbooks.org
ISBN: 1558101764
Category : Business & Economics
Languages : en
Pages : 42

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Book Description
Pamphlet is a succinct statement of the ethical obligations and duties of individuals who enter the nursing profession, the profession's nonnegotiable ethical standard, and an expression of nursing's own understanding of its commitment to society. Provides a framework for nurses to use in ethical analysis and decision-making.

Shared Decision-making in Health Care

Shared Decision-making in Health Care PDF Author: Glyn Elwyn
Publisher: Oxford University Press
ISBN: 019872344X
Category : Medical
Languages : en
Pages : 337

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Book Description
Over the past decade health care systems around the world have placed increasing importance on the relationship between patient choice and clinical decision-making. In the years since the publication of the second edition of Shared Decision Making in Health Care, there have been significant new developments in the field, most notably in the US where 'Obamacare' puts shared decision making (SDM) at the centre of the 2009 Affordable Care Act. This new edition explores shared decision making by examining, from practical and theoretical perspectives, what should comprise an effective decision-making process. It also looks at the benefits and potential difficulties that arise when patients and clinicians share health care decisions. Written by leading experts from around the world and utilizing high quality evidence, the book provides an up-to-date reference with real-word context to the topics discussed, and in-depth coverage of the practicalities of implementing and teaching SDM. The breadth of information in Shared Decision Making in Health Care makes it the definitive source of expert knowledge for healthcare policy makers. As health care systems adapt to increasingly collaborative patient-clinician care frameworks, this will also prove a useful guide to SDM for clinicians of all disciplines.

Dying in America

Dying in America PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309303133
Category : Medical
Languages : en
Pages : 470

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Book Description
For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Taking Action Against Clinician Burnout

Taking Action Against Clinician Burnout PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309495474
Category : Medical
Languages : en
Pages : 335

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Book Description
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.

Helping people share decision making

Helping people share decision making PDF Author: Debra de Silva
Publisher: The Health Foundation
ISBN: 1906461406
Category : Chronic diseases
Languages : en
Pages : 78

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Book Description


Responsibility in Health Care

Responsibility in Health Care PDF Author: G.J. Agich
Publisher: Springer Science & Business Media
ISBN: 9400978316
Category : Philosophy
Languages : en
Pages : 294

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Book Description
Medicine is a complex social institution which includes biomedical research, clinical practice, and the administration and organization of health care delivery. As such, it is amenable to analysis from a number of disciplines and directions. The present volume is composed of revised papers on the theme of "Responsibility in Health Care" presented at the Eleventh Trans Disciplinary Symposium on Philosophy and Medicine, which was held in Springfield, illinois on March 16-18, 1981. The collective focus of these essays is the clinical practice of medicine and the themes and issues related to questions of responsibility in that setting. Responsibility has three related dimensions which make it a suitable theme for an inquiry into clinical medicine: (a) an external dimension in legal and political analysis in which the State imposes penalties on individuals and groups and in which officials and governments are held accountable for policies; (b) an internal dimension in moral and ethical analysis in which individuals take into account the consequences of their actions and the criteria which bear upon their choices; and (c) a comprehensive dimension in social and cultural analysis in which values are ordered in the structure of a civilization ([8], p. 5). The title "Responsibility in Health Care" thus signifies a broad inquiry not only into the ethics of individual character and actions, but the moral foundations of the cultural, legal, political, and social context of health care generally.