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Author: Joseph Schulman
Publisher: Springer Nature
ISBN: 303094655X
Category : Medical
Languages : en
Pages : 282
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Book Description
Neonatal intensive care unit (NICU) teams in the US and around the world receive performance reports that locate their particular value for selected process and outcome measures within the range of values from all reporting NICUs. Understandably, many providers focus primarily, if not exclusively, on their particular value. When a value appears undesirable, providers often justify it in an apparent reflex response rather than critically analysing their data. Exceedingly few reflect on the width or implications of the range within which their performance lies. Standard medical education does not include these skills, yet unwarranted practice variation necessarily compromises a population’s overall quality of care. Researchers report wide variation in health care resource use with little connection to patient outcomes, challenging the belief that directing incrementally more resources at certain healthcare problems necessarily produces better results. This book provides requisite knowledge to enable readers without research expertise to understand the notion of unwarranted practice variation, how to recognize it, its ubiquity, and why it is generally undesirable – why narrowing is pervasiveness improves quality. The book begins by describing practice variation, its prevalence, and why it matters. Next, it examines alternative conceptualizations of NICU work. One view is task-oriented, while the other is aim-oriented. NICU teams rarely articulate their aims explicitly, so this book offers examples that guide thinking and action. Finally, this book asks, “Which rate is 'right'; what is the performance target?” The answer entails identifying the lowest resource use rate associated with desirable outcomes. This requires data describing efficient and predictably performing provision of current evidence-based care, along with relationships to a variety of outcomes. Provider conceptualization of healthcare quality also is often vague. The challenge lies in defining this notion operationally. This book does precisely that and gives readers tools to think critically about process, outcome, and quality measures, via some understanding of systems, risk-adjustment modelling, and discriminating signal from noise in process data.
Author: Joseph Schulman
Publisher: Springer Nature
ISBN: 303094655X
Category : Medical
Languages : en
Pages : 282
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Book Description
Neonatal intensive care unit (NICU) teams in the US and around the world receive performance reports that locate their particular value for selected process and outcome measures within the range of values from all reporting NICUs. Understandably, many providers focus primarily, if not exclusively, on their particular value. When a value appears undesirable, providers often justify it in an apparent reflex response rather than critically analysing their data. Exceedingly few reflect on the width or implications of the range within which their performance lies. Standard medical education does not include these skills, yet unwarranted practice variation necessarily compromises a population’s overall quality of care. Researchers report wide variation in health care resource use with little connection to patient outcomes, challenging the belief that directing incrementally more resources at certain healthcare problems necessarily produces better results. This book provides requisite knowledge to enable readers without research expertise to understand the notion of unwarranted practice variation, how to recognize it, its ubiquity, and why it is generally undesirable – why narrowing is pervasiveness improves quality. The book begins by describing practice variation, its prevalence, and why it matters. Next, it examines alternative conceptualizations of NICU work. One view is task-oriented, while the other is aim-oriented. NICU teams rarely articulate their aims explicitly, so this book offers examples that guide thinking and action. Finally, this book asks, “Which rate is 'right'; what is the performance target?” The answer entails identifying the lowest resource use rate associated with desirable outcomes. This requires data describing efficient and predictably performing provision of current evidence-based care, along with relationships to a variety of outcomes. Provider conceptualization of healthcare quality also is often vague. The challenge lies in defining this notion operationally. This book does precisely that and gives readers tools to think critically about process, outcome, and quality measures, via some understanding of systems, risk-adjustment modelling, and discriminating signal from noise in process data.
Author: Joseph Schulman
Publisher:
ISBN: 9783030946562
Category :
Languages : en
Pages : 0
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Book Description
Neonatal intensive care unit (NICU) teams in the US and around the world receive performance reports that locate their particular value for selected process and outcome measures within the range of values from all reporting NICUs. Understandably, many providers focus primarily, if not exclusively, on their particular value. When a value appears undesirable, providers often justify it in an apparent reflex response rather than critically analysing their data. Exceedingly few reflect on the width or implications of the range within which their performance lies. Standard medical education does not include these skills, yet unwarranted practice variation necessarily compromises a population's overall quality of care. Researchers report wide variation in health care resource use with little connection to patient outcomes, challenging the belief that directing incrementally more resources at certain healthcare problems necessarily produces better results. This book provides requisite knowledge to enable readers without research expertise to understand the notion of unwarranted practice variation, how to recognize it, its ubiquity, and why it is generally undesirable - why narrowing is pervasiveness improves quality. The book begins by describing practice variation, its prevalence, and why it matters. Next, it examines alternative conceptualizations of NICU work. One view is task-oriented, while the other is aim-oriented. NICU teams rarely articulate their aims explicitly, so this book offers examples that guide thinking and action. Finally, this book asks, "Which rate is 'right'; what is the performance target?" The answer entails identifying the lowest resource use rate associated with desirable outcomes. This requires data describing efficient and predictably performing provision of current evidence-based care, along with relationships to a variety of outcomes. Provider conceptualization of healthcare quality also is often vague. The challenge lies in defining this notion operationally. This book does precisely that and gives readers tools to think critically about process, outcome, and quality measures, via some understanding of systems, risk-adjustment modelling, and discriminating signal from noise in process data.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309669820
Category : Social Science
Languages : en
Pages : 369
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Book Description
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
Author: James Boardman
Publisher: Lippincott Williams & Wilkins
ISBN: 197512927X
Category : Medical
Languages : en
Pages : 3238
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Book Description
For more than 45 years, Avery & MacDonald’s Neonatology has been the premier text on the pathophysiology and management of both preterm and full-term neonates, trusted by neonatologists, neonatology fellows, pediatricians, neonatal nurse practitioners, and ob/gyn practitioners worldwide. Continuing the tradition of excellence established by Drs. Gordon B. Avery and Mhairi G. MacDonald, this fully revised eighth edition features three new lead editors, numerous new chapters, reorganized and updated content, and an increased focus on global neonatology.
Author: Elaine M. Boyle
Publisher: Springer Nature
ISBN: 3030288293
Category : Medical
Languages : en
Pages : 575
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Book Description
This textbook addresses the themes that are at the forefront of neonatal clinical care and research, based on natural divisions in care during pregnancy, and postnatally by gestational age at birth. The book offers a unique approach, in that it proposes discussion of important general principles underpinning neonatal care that are not addressed in most general neonatology textbooks, such as ethical issues, counselling, effective training methods, quality and safety, among other subjects. These are fundamental aspects and challenges that need to be appreciated by senior clinicians. A chapter authored by parents describing their perspectives of neonatal intensive care is unique and will be highly educational, with the potential to influence the way in which individuals view and deliver neonatal care. The authors discuss common and important conditions, to promote adoption of sound evidenced based practice where this is available. However, where evidence is limited, as is the case in many areas of neonatal practice, the authors aim to encourage critical thinking and evidence appraisal, which are necessary skills for busy clinicians wishing to filter evidence to guide delivery of care. This text is suitable for senior trainees wishing to pursue a career in neonatal medicine, early career neonatologists and paediatricians with an interest in neonatology. It is also of interest to established neonatologists wishing to update their neonatal knowledge. The content is based on the RCPCH Level 3 curriculum, and addresses important topical and/or controversial aspects of neonatal care.
Author: Alan R. Spitzer
Publisher: Elsevier Health Sciences
ISBN: 1455700533
Category : Medical
Languages : en
Pages : 321
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Book Description
This issue of Clinics in Perinatology, guest edited by Drs. Alan Spitzer and Dan Ellsbury, examines Quality Improvement in Neonatal and Perinatal Medicine. The first part of the issue addresses Tools of Quality Improvement and includes articles on The Quality Chasm in Neonatal and Perinatal Medicine; Evaluating the Medical Evidence; The Vermont Oxford Network Database; The Pediatrix Clinical Data Warehouse; Role of Regional Collaboratives: The California Perinatal Quality Care Collaborative Model; A Primer on Quality Improvement Methodology; Using Statistical Process Control Methodology; Human Factors in Quality Improvement, Random Safety Audits, Root Cause Analysis, and Failure Mode and Effects Analysis; Collaboration Between Obstetricians and Neonatologists: Perinatal Safety Programs and Improved Clinical Outcomes; and Pay for Performance: A Business Strategy for Quality Improvement in Neonatal-Perinatal Medicine. The second part of this issue addresses Specific Applications of Documented Quality Improvement Methodology in Neonatal and Perinatal Medicine and includes articles on Delivery Room Intervention-Improving the Outcome, Reducing Retinopathy of Prematurity, Improving Breast Milk Use During and After the NICU Stay, Decreasing Catheter Related Bloodstream Infection, and Decreasing Bronchopulmonary Dysplasia.
Author: Ellen P. Tappero, DNP, RN, NNP-BC
Publisher: Springer Publishing Company
ISBN: 0826121934
Category : Medical
Languages : en
Pages : 392
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Book Description
Physical Assessment of the Newborn, 5th Edition, is a comprehensive text with a wealth of detailed information on the assessment of the newborn. This valuable and essential resource illustrates the principles and skills needed to gather assessment data systematically and accurately, and also provides a knowledge base for interpretation of this data. Coverage addresses: gestational assessment, neurologic assessment, neonatal history, assessment of the dysmorphic infant, and systemic evaluation of individual body systems, as well as key information on behavioral and pain assessment, including the use of specific tools with various groups ranging from term to extremely preterm infants. Numerous tables, figures, illustrations, and photos, many of them in full color, are a major strength that enhances the book’s usefulness as a clinical resource. The text is an excellent teaching tool and resource for anyone who performs newborn examinations including nurses, neonatal and pediatric nurse practitioners, nurse-midwives, physicians and therapists. It can also serve as a core text for any program preparing individuals for advanced practice roles in neonatal care. KEY FEATURES: An authoritative and renowned text that comprehensively addresses all key aspects of newborn assessment Provides a well-ordered evaluation of individual body systems. Assists the practitioner in identifying infant state, behavioral clues, and signs of pain, facilitating individualized care. Comprehensively addresses the tremendous range of variation among newborns of different gestational ages. The content is amplified by numerous photos and illustrations, many in full color Includes Power Point slides and an Image Bank
Author: Douglas S. Diekema
Publisher: Cambridge University Press
ISBN: 1139501836
Category : Medical
Languages : en
Pages : 263
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Book Description
This volume provides a practical overview of the ethical issues arising in pediatric practice. The case-based approach grounds the bioethical concepts in real-life situations, covering a broad range of important and controversial topics, including informed consent, confidentiality, truthfulness and fidelity, ethical issues relating to perinatology and neonatology, end-of-life issues, new technologies, and problems of justice and public health in pediatrics. A dedicated section also addresses the topics of professionalism, including boundary issues, conflicts of interests and relationships with industry, ethical issues arising during training, and dealing with the impaired or unethical colleague. Each chapter contains a summary of the key issues covered and recommendations for approaching similar situations in other contexts. Clinical Ethics in Pediatrics: A Case-Based Textbook is an essential resource for all physicians who care for children, as well as medical educators, residents and scholars in clinical bioethics.
Author: Edward Swift Dunster
Publisher:
ISBN:
Category :
Languages : en
Pages : 872
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Book Description
Author: Keith Sykes
Publisher: CRC Press
ISBN: 1000515419
Category : Medical
Languages : en
Pages : 245
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Book Description
Written by two anaesthetists, one British and one American, this unique book focuses on the transatlantic story of anaesthesia. The authors have both worked at the two hospitals where the first general anaesthetics for surgery were given in 1846, Massachusetts General Hospital in Boston, Massachusetts and University College Hospital, London. Each with more than fifty years' experience of working in anaesthesia, they combine their knowledge and expertise to offer a fresh outlook on the development of anaesthesia through the ages. This highly informative and intriguing text details the origins of anaesthesia, outlines the different techniques of anaesthesia and traces its progress with illuminating and enlightening commentaries. This is a fascinating book which considers the role key figures have played in developing anaesthesia including, Queen Victoria, William Morris, La Condamine, Bjorn Ibsen and Henry Beecher. Broken down into four sections, which are divided into easy-to-read chapters and filled with top quality photographs, this book makes compelling reading. It is recommended to all those interested in the history and development of medicine through the ages, and is of particular interest to anaesthetists. More than just the science of anaesthesia, this is the story about the people and personalities who have made anaesthesia what it is today.
