Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out:> How lean techniques of value-stream-mapping and rapid improvement events cut the average “door-to-balloon” time for heart attack patients at two hospitals from 90 minutes to 37.> What ThedaCare leaders did to replace medicine’s “shame and blame” culture with a lean culture based on continuous improvement and respect for people.> How the lean principle of “building in quality at the source” broke down divisions among medical specialties allowing teams to develop patient care plans faster.> Why traditional modern management is the single biggest impediment to lean healthcare.> How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six.> How the lean concept of “one piece flow” saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%.> How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did — and what it would do differently.Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-designed around patients, waste and errors are eliminated, quality improves, costs come down, and healthcare professionals have more time to spend with patients, who get even better care.

    R. Reid shows how all the other industrialized democracies have achieved something the United States can’t seem to do: provide health care for everybody at a reasonable cost. In his global quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own—including France, Germany, Japan, the U.K., and Canada—where he finds inspiration in example. Reid sees problems too: He finds poorly paid doctors in Japan, endless lines in Canada, mistreated patients in Britain, spartan facilities in France. In addition to long-established systems, Reid also studies countries that have carried out major health care reform. The first question facing these countries—and the United States, for that matter—is an ethical issue: Is health care a human right?The Healing of America lays bare the moral question at the heart of our troubled system, dissecting the misleading rhetoric surrounding the health care debate: Is health care a human right?

    The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800. Why?Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics ("young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries"), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

    Touch it and you die. Every politician knows this truism, which is why no one wants to debate it. Privately, many of them understand that the health care system, which costs about $200 billion a year in public and private money, cannot continue as it is—increasingly ill-adapted to an aging population with public costs growing faster than government revenues. In Chronic Condition, Jeffrey Simpson meets health care head on and explores the only four options we have to end this growing crisis: cuts in spending, tax increases, privatization, and reaping savings through increased efficiency. He examines the tenets of the Medicare system that Canadians cling to so passionately. Here, he finds that many other countries have more extensive public health systems, and Canadian health care produces only average value for money. In fact, our rigid system for some health care needs and a costly system for other needs—drugs, dentistry, and home care—is really the worst of both worlds. Chronic Condition breaks the silence about the huge changes and real choices that Canadians face.

    Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects.The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings? A decade-long investigation with international sweep, high-stakes brinkmanship and big money at its core, Bottle of Lies reveals how the world’s greatest public-health innovation has become one of its most astonishing swindles.

    This encouraging change not only has benefited veterans but also provides a blueprint for salvaging America's own deeply troubled healthcare system. "Best Care Anywhere" shows how a government bureaucracy, working with little notice, is setting the standard for best practices and cost reduction while the private sector is lagging in both areas. Author Phillip Longman challenges conventional wisdom by explaining exactly how market forces work to lower quality and raise prices in the healthcare sector, and how U.S. medical practices have a weak basis in science. The book, expanded from a widely praised article in the "Washington Monthly," mixes hard facts with author Philip Longmans' compelling human story of the loss of his wife to cancer. Part manifesto, part moving memoir, "Best Care Anywhere" offers new hope for addressing a major problem of contemporary society that affects all of us.

    What is going on? Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals. Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?  This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?  By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?  In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

    But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

    But starting in the late 1990s, shocking reports emerged that showed this was far from the truth. Treatment-related deaths or “complications” were found to be the fifth leading cause of death for Americans, and hundreds of thousands of patients were being harmed by botched medical procedures.Spurred by the quality crisis, a group of visionary physicians led by Donald Berwick and Paul Batalden embarked on a study of industrial “quality improvement” techniques, daring to apply them to the practice of medicine despite resistance from the medical community. The Best Practice tells the story of this burgeoning movement, and of how the medical landscape is being radically transformed—for the better.

    Although necessary health care should be available to all who need it, he says, the current health-care debate assumes that everyone requires massive amounts of expensive care to stay healthy. Hadler urges that before we commit to paying for whatever pharmaceutical companies and the medical establishment tell us we need, American consumers need to adopt an attitude of skepticism and arm themselves with enough information to make some of their own decisions about what care is truly necessary. Each chapter of Worried Sick is an object lesson regarding the uses and abuses of a particular type of treatment, such as mammography, colorectal screening, statin drugs, or coronary stents. For consumers and medical professionals interested in understanding the scientific basis for Hadler's arguments, each topical chapter has an accompanying source chapter in which Hadler discusses the medical literature and studies that inform his critique. According to Hadler, a major stumbling block to rational health-care policy in the United States is contention over the very concept of what constitutes good health. By learning to distinguish good medical advice from persuasive medical marketing, consumers can make better decisions about their personal health and use that wisdom to inform their perspectives on health-policy issues.

    Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's bestselling The Checklist Manifesto. As a busy surgeon who has worked in many of the best hospitals in the nation, he can testify to the amazing power of modern medicine to cure. But he's also been a witness to a medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting. Over the last ten years, neither error rates nor costs have come down, despite scientific progress and efforts to curb expenses. Why?To patients, the healthcare system is a black box. Doctors and hospitals are unaccountable, and the lack of transparency leaves both bad doctors and systemic flaws unchecked. Patients need to know more of what healthcare workers know, so they can make informed choices. Accountability in healthcare would expose dangerous doctors, reward good performance, and force positive change nationally, using the power of the free market. Unaccountable is a powerful, no-nonsense, non-partisan diagnosis for healing our hospitals and reforming our broken healthcare system.

    This updated edition of the Health Care Handbook covers:• New sections on health IT, team-based care and health care quality• A clear summary of health policy and the Affordable Care Act• Inpatient & outpatient health care and delivery systems• Health insurance and the factors that make health care so expensive• Concise summaries of 32 different health professions• Medical devices, pharmaceuticals, and the research world• And much, much moreThe Handbook is the one-stop guide to the people, organizations and industries that make up the U.S. health care system and major issues the system faces today. It is rigorously researched and scrupulously unbiased yet written in a conversational and humorous tone that's a pleasure to read and illuminates the convoluted health care system and its many components. The Handbook is now used by hundreds of academic programs and health care companies.Each section of the book includes an introduction to the key facts and foundations that make the health care system work along with balanced analyses of the major challenges and controversies within health care, including medical errors, government regulation, medical malpractice, and much more. Suggested readings are included for readers who wish to learn more about specific topics.

    There was atime when this revered organization ranked among the lowest in the country in this area. Within ten years, however, it had climbed to among the highest and has emerged as the thought leader in the space.How did Cleveland Clinic turn itself around so effectively and so quickly?More important, how can you do the same with your organization?In gripping, visceral, on-the ground fashion, Service Fanatics reveals the strategies and tactics the Clinic applied to become one of today's leading patient-experience healthcare organizations--methods that seamlessly translate to any business seeking to improveits customer experience. This strategic guide covers:How the Clinic's leaders redefined the concept of patient experience and developed a strategy to improve itCritical lessons learned regarding organization, recruitment, training, and measuring service excellenceWays in which the Clinic aligned its entire workforce around its Patients First strategyHow leaders improved the critical element of physician communicationRather than view patients simply as sick people who need treatment, Cleveland Clinic sees them also as important stakeholders in the organization's success. Patients are customers--who desire, pay for, and deserve the best possible care and experience during what is often a challenging time in their lives.Featuring customer service case studies, as well as invaluable insight from C-level executives at top corporations in various industries, Service Fanatics provides actionable lessons for any manager and business leader beyond healthcare.Whether you run a healthcare institution, nonprofit, or for-profit business, Service Fanatics will help you create the kind of customer experience that promises to transform your organization into an industry powerhouse.

    In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong -- with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track.Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems.How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.

    But they don’t always know how to care for them.Hardly anyone is happy with American healthcare these days. Patients are getting sicker and going bankrupt from medical bills. Doctors are burning out and making dangerous mistakes. Both parties blame our nation’s outdated and dysfunctional healthcare system. But that’s only part of the problem.In this important and timely book, Dr. Robert Pearl shines a light on the unseen and often toxic culture of medicine. Today’s physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us.Uncaring draws an original and revealing portrait of what it’s actually like to be a doctor. It illuminates the complex and intimidating world of medicine for readers, and in the end offers a clear plan to save American healthcare.