The Best Practice: How the New Quality Movement Is Transforming Medicine


Charles C. Kenney - 2008
    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.

The Cleveland Clinic Way: Lessons in Excellence from One of the World's Leading Health Care Organizations


Toby Cosgrove - 2013
    Join the revolution. Transform your organization the Cleveland Clinic way. One of the best healthcare systems in the world.President Barack ObamaAmerican healthcare is in crisis. It doesn't have to be.The Cleveland Clinic Way is a blueprint for fixing what's wrong with healthcare--and is a must-read for every leader seeking to transform his or her organization.There's a revolution going on right now. On the frontiers of medicine, some doctors have developed an approach for treating people that is more effective, more humane, and more affordable. It's an approach to healthcare that has captured the attention of the media and business elite--and the President of the United States.It's all happening at Cleveland Clinic, one of the most innovative, forward-looking medical institutions in the nation.In this groundbreaking book, the man who leads this global organization, Toby Cosgrove, MD, reveals how the Clinic works so well and argues persuasively for why it should be the model for the nation. He details how Cleveland Clinic focuses on the eight key trends that are shaping the future of medicine. Readers will learn:Why group practices provide not only better--but cheaper--care Why collaborative medicine is more effective How big data can be harnessed to improve the quality of care and lower costs How cooperative practices can be the wellspring of innovation Why empathy is crucial to better patient outcomes Why wellness of both mind and body depends on healthcare, not sickcare How care is best provided in different settings for greater comfort and value How tailor-made care treats a person instead of a disease At its core is Cleveland Clinic's emphasis on patient care and patient experience.A refreshingly positive and practical vision of healthcare, The Cleveland Clinic Way is essential reading for healthcare and business executives, medical professionals, industry analysts, and policymakers. It gives leaders lessons they can apply to their own organizations to achieve results and empowers average Americans to make more informed healthcare decisions.PRAISE FOR THE CLEVELAND CLINIC WAYA brilliant doctor and leader lays out practical and thought-provoking prescriptions for America's healthcare future. A must-read. -- Jack Welch, former Chairman and CEO of General Electric CompanyThe Cleveland Clinic Way is what the healthcare system in this country needs: honesty about the challenges, optimism about our ability to address them, and a focus on solutions. A must-read for healthcare leaders, it's written in clear, inclusive language that makes it just as valuable for the rest of us. -- John Chambers, Chairman and CEO of CiscoA pioneer in American healthcare, Toby Cosgrove shows just how the diligence and innovative thinking behind Cleveland Clinic has helped solve fundamental problems most other places barely touch. There are lessons here for everyone--patient, physician, and policymaker alike. -- Atul Gawande, MD, professor at Harvard Medical School and bestselling author of The Checklist ManifestoToby Cosgrove frames the eight important trends that will transform the U.S. healthcare system. The Cleveland Clinic Way is a good road map for those who want to make the U.S. healthcare system better. -- Jeffrey Immelt, Chairman and CEO of General Electric Company

A World without Cancer: The Making of a New Cure and the Real Promise of Prevention


Margaret I. Cuomo - 2012
    Margaret I. Cuomo is inspired to seek out new strategies for waging a smarter war on cancer.This year, about 1.6 million new cases of cancer will be diagnosed and more than 1,500 people will die "per day." We've been asked to accept the disappointing strategy to "manage cancer as a chronic disease." We've allowed pharmaceutical companies to position cancer drugs that extend life by just weeks and may cost $100,000 for a single course of treatment as breakthroughs. Where is the bold leadership that will transform our system from treatment to prevention? Have we forgotten the mission of the National Cancer Act of 1971 to "conquer cancer"?Through an analysis of more than 40 years of medical evidence and interviews with the top cancer researchers, drug company executives, and health policy advisers, Dr. Cuomo reveals intriguing answers to these questions. She shows us how all cancer stakeholders--the pharmaceutical industry, the government, physicians, and concerned Americans--can change the way we view and fight cancer in this country.

The Checklist Manifesto: How to Get Things Right


Atul Gawande - 2009
    Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third.In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds.An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.

On the Mend


John Toussaint - 2010
    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.

The Patient Will See You Now: The Future of Medicine is in Your Hands


Eric J. Topol - 2015
    You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"—but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical.In The Patient Will See You Now, Eric Topol, one of the nation’s top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system.The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result—better, cheaper, and more human health care—will be worth it.Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.

Worried Sick: A Prescription for Health in an Overtreated America


Nortin M. Hadler - 2008
    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.

When Blood Breaks Down: Life Lessons from Leukemia


Mikkael A. Sekeres - 2020
    Your brain can't function. You are asked to make decisions about treatment almost immediately, when you are not in your right mind. And yet you pull yourself together and start asking questions. Beside you is your doctor, whose job it is to solve the awful puzzle of bone marrow gone wrong. The two of you are in it together. In When Blood Breaks Down, Mikkael Sekeres, a leading cancer specialist, takes readers on the journey that patient and doctor travel together.Sekeres, who writes regularly for the Well section of the New York Times, tells the compelling stories of three people who receive diagnoses of adult leukemia within hours of each other: Joan, a 48-year-old surgical nurse, a caregiver who becomes a patient; David, a 68-year-old former factory worker who bows to his family's wishes and pursues the most aggressive treatment; and Sarah, a 36-year-old pregnant woman who must decide whether to undergo chemotherapy and put her fetus at risk. We join the intimacy of the conversations Sekeres has with his patients, and watch as he teaches trainees. Along the way, Sekeres also explores leukemia in its different forms and the development of drugs to treat it--describing, among many other fascinating details, the invention of the bone marrow transplant (first performed experimentally on beagles) and a treatment that targets the genetics of leukemia.The lessons to be learned from leukemia, Sekeres shows, are not merely medical; they teach us about courage and grace and defying the odds.

Pandemics: Our Fears and the Facts (Kindle Single)


Sunetra Gupta - 2013
    As recently as 1918, a pandemic of influenza claimed over 50 million lives worldwide. The advent of drugs and vaccines led to an era of hope when we thought our battles with infectious disease were won, but our optimism has been eroded by the recognition that many pathogens have the capacity to transform themselves and escape our efforts to eradicate them. Are we now facing an inevitable repeat of a calamity such as the 1918 influenza pandemic or the Black Death? Can we anticipate and thwart such an event, or are we wilfully creating the conditions that would promote the emergence of new and highly virulent human infectious disease?Sunetra Gupta is Professor of Theoretical Epidemiology at the University of Oxford specialising in infectious diseases. She holds a bachelor's degree from Princeton University and a Ph.D. from the University of London. She has been awarded the Scientific Medal by the Zoological Society of London and the Royal Society Rosalind Franklin Award for her scientific research. She is also a novelist whose books have been awarded the Sahitya Akademi Award, the Southern Arts Literature Prize, shortlisted for the Crossword Award, and longlisted for the DSC and Orange Prizes.

Innovator's Prescription


Clayton M. Christensen - 2008
    . .Our health care system is in critical condition. Each year, fewer Americans can afford it, fewer businesses can provide it, and fewer government programs can promise it for future generations.We need a cure, and we need it now.Harvard Business School's Clayton M. Christensen--whose bestselling The Innovator's Dilemma revolutionized the business world--presents The Innovator's Prescription, a comprehensive analysis of the strategies that will improve health care and make it affordable.Christensen applies the principles of disruptive innovation to the broken health care system with two pioneers in the field--Dr. Jerome Grossman and Dr. Jason Hwang. Together, they examine a range of symptoms and offer proven solutions.YOU'LL DISCOVER HOW"Precision medicine" reduces costs and makes good on the promise of personalized careDisruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors workPatient networks enable better treatment of chronic diseasesEmployers can change the roles they play in health care to compete effectively in the era of globalizationInsurance and regulatory reforms stimulate disruption in health care

Patients Come Second: Leading Change by Changing the Way You Lead


Paul Spiegelman - 2013
    Far too frequently, patients leave the doctor’s office or hospital feeling confused, angry, or neglected. Healthcare leaders recognize this problem, but in their focus on patients (and sometimes financials), they often overlook the true key to lasting patient loyalty and satisfaction: their employees. Patients Come Second shakes up the traditional healthcare model, arguing that in order to care for and retain patients, leaders must first create exceptional teams and find ways to engage nurses, administrative staff, physicians, supervisors, and even housekeeping staff and switchboard operators. By connecting employees’ work with a higher purpose and equipping them with the tools to become leaders themselves, patient care can be dramatically transformed. And with continuing healthcare changes on the horizon and ever-rising pressure to acquire and keep patients, doing so now is more important than ever. Britt Berrett, president of an 898-bed hospital, and Paul Spiegelman, founder and CEO of a successful patient-experience company, are the perfect guides to the changes needed in healthcare leadership. With a rich combined experience in their field, they have filled each chapter with an abundance of engaging, insightful stories and write with a humor and friendliness that balances and enhances the urgency of their message.

Management Lessons from Mayo Clinic: Inside One of the World's Most Admired Service Organizations


Leonard L. Berry - 2000
    Service business authority Leonard Berry and Mayo Clinic marketing administrator Kent Seltman explain how the Clinic implements and maintains its strategy, adheres to its management system, executes its care model, and embraces new knowledge - invaluable lessons for managers and service providers of all industries.Drs. Berry and Seltman had the rare opportunity to study Mayo Clinic's service culture and systems from the inside by conducting personal interviews with leaders, clinicians, staff, and patients, as well as observing hundreds of clinician-patient interactions. The result is a book about how the Clinic's business concept produces stellar clinical results, organizational efficiency, and interpersonal service.By examining the operating principles that guide every management decision at this legendary healthcare institution, the authors Demonstrate how a great service brand evolves from the core values that nourish and protect it Extrapolate instructive business lessons that apply outside healthcare Illustrate the benefits of pooling talent and encouraging teamwork Relate historical events and perspectives to the present-day Mayo Clinic Share inspiring stories from staff and patientsAn innovative analysis of this exemplary institution, "Management Lessons from Mayo Clinic" presents a proven prescription for creating sustainable service excellence in any organization.

Priced Out: The Economic and Ethical Costs of American Health Care


Uwe Reinhardt - 2019
    Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.The problem, Reinhardt says, is not one of economics but of social ethics. There is no American political consensus on a fundamental question other countries settled long ago: to what extent should we be our brothers' and sisters' keepers when it comes to health care? Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America finances health care, and he offers a penetrating ethical analysis of recent reform proposals. At this point, he argues, the United States appears to have three stark choices: the government can make the rich help pay for the health care of the poor, ration care by income, or control costs. Reinhardt proposes an alternative path: that by age 26 all Americans must choose either to join an insurance arrangement with community-rated premiums, or take a chance on being uninsured or relying on a health insurance market that charges premiums based on health status.An incisive look at the American health care system, Priced Out dispels the confusion, ignorance, myths, and misinformation that hinder effective reform.

Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience


Charles Kenney - 2010
    In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compelling vision to become The Quality Leader and to fulfill that vision, adopted the Toyota Production System as its management method.Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience takes you on the journey of of Virginia Mason Medical Center's pursuit of the perfect patient experience through the application of lean principles, tools, and methodology. Over the last several years Virginia Mason has become internationally known for its journey towards perfection by applying the Toyota Production System to healthcare. The book takes readers step by step through Virginia Mason's journey as it seeks to provide perfection to its customer - the patient. This book shows you how you use this system to transform your own organization.

If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently


Fred Lee - 2004
    It takes profound knowledge, not usually taught in business schools, to create and maintain an environment where people feel they are working with friends who share a common dream of making patients and communitites their loyal fans - a place where: Employees say, "I love to work here." Managers say, "I love the people I work with." Caregivers say, "I love our patients." Patients and families say, "We love this hospital." Loyalty is an organization's best source of long-term strategic advantage. But unlike traditional service organizations, Disney does not provide a service. Neither does your hospital. They both provide an "experience". Disney is the premier example of this newly evolved economic category, and hospitals would do well to emulate the most vital things that earn Disney the love of their guests and employees. Like his popular seminars, in these pages Fred Lee addresses the vexing reality that most of our approaches to patient satisfaction will not lead to patient loyalty. He takes aim at service excellence initiatives, quality and performance improvement efforts, and patient satisfaction surveys, dispelling some of our most cherished beliefs about loyalty and leadership. This captivating book, filled with stories and examples, will leave its readers inspired with fresh insights and energized with hope. It needs to be in every hospital manager's library and required reading in every health care leadership curriculum. If you have wondered why so much of what is done in the name of service excellence in health care has not lived up to its promise, this book is for you.