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In the late 1990s, treatment-related deaths or ?complicationsOCO were the fifth leading cause of death for Americans. Spurred by the crisis, a group of dedicated physicians like Paul Batalden and Don Berwick made it their goal to study the concepts of ?quality improvementOCO used at Toyota and NASA, and to apply them to the practice of medicine. This book tells their story, and how these ?hereticalOCO ideas have blossomed into a movement, bringing the focus back to where it should have always been: the patient.
Calming fears, alleviating suffering, enhancing and saving lives?this is what motivates doctors virtually every single day. When the structure and culture in which physicians work are well aligned, being a doctor is a most rewarding job. But something has gone wrong in the physician world, and it is urgent that we fix it. Fundamental flaws in the US health care system make it more difficult and less rewarding than ever to be a doctor. The convergence of a complex amalgam of forces prevents primary care and specialty physicians from doing what they most want to do: Put their patients first at every step in the care process every time. Barriers include regulation, bureaucracy, the liability burden, reduced reimbursements, and much more. Physicians must accept the responsibility for guiding our nation toward a better health care delivery system, but the pathway forward?amidst jarring changes in our health care system?is not always clear. In "The Doctor Crisis," Dr. Jack Cochran, executive director of The Permanente Federation, and author Charles Kenney show how we can improve health care on a grassroots level, regardless of political policy disputes, by improving conditions for physicians and asking them to take on broader accountability; by calling on physicians to be effective leaders as well as excellent clinicians. The authors clarify the necessary steps required to enable physicians to focus on patient care and offer concrete ideas for establishing systems that place patientsOCO needs above all else. Cochran and Kenney make a compelling case that fixing the doctor crisis is a prerequisite to achieving access to quality and affordable health care throughout the United States. "
For decades Gerta Wahljak has been haunted by a photograph of ten Nazi officers taken in the concentration camp where she was imprisoned during the Holocaust. Since emigrating to the United States, she has carefully traced and recorded the fates of nine of these men. But there is one whom she has been unable to track--until now. While Gerta waits in her Boston cardiologist's office, she sees another patient who she is almost sure is the last man. She will not be at peace until she knows. After interviewing Gerta, assistant U. S. Attorney David Keegan is shocked to learn that he is closely linked to the man he's investigating. For the man accused of being a former Nazi is none other than Frederick Schiller, married to a renowned Jewish activist and the father of the woman Keegan loves. Poised to become U. S. attorney, Keegan suddenly finds his life maliciously uprooted. Someone envious of his rise to power will stop at nothing to ruin him . . . leaking the volatile story to the press and hoping Keegan's reputation is blackened in the firestorm. David Keegan is a man also haunted by the past, obsessed by his quest to uncover the facts behind his mother's death when he was a child. But as he pursues the truth about his mother, he must deal with the explosive case of Frederick Schiller. As newspaper headlines hurl accusations about Schiller and his wife, the two are forced to relive a dark history that was meant to be buried forever. Now Keegan must decide whether to risk his career to help the parents of the woman he loves. A gripping, relentlessly plotted story about the ambiguity of morality, the power of an unresolved past, and the necessity of forgiveness, The Last Man twists like a thriller, but has the truth-seeking depth of great fiction. Profound in theme and peopled with characters that possess a refreshing vitality, it is a novel that will breathlessly race you to its stunning, climactic finish.
A biography of Elizabeth McCormack, regarded by many as the very soul of philanthropy whoseaunstinting practical advice and compassion have helped to inform the distribution of hundreds of millions of dollars to worthy causes around the world. a
Written by the President and CEO of the Institute for Healthcare Improvement (IHI) and a leading health care journalist, this groundbreaking book examines how leading organizations in the United States are pursuing the Triple Aim--improving the individual experience of care, improving the health of populations, and reducing the per capita cost of care.Even with major steps forward - including the Affordable Care Act and the creation of the Center for Medicare and Medicaid Innovation -- the national health care debate is too often poisoned by negativity. A quieter, more thoughtful, and vastly more constructive conversation continues among health care leaders and professionals throughout the country. Innovative solutions are being designed and implemented at the local level, and countless health care organizations are demonstrating breakthrough remedies to some of the toughest and most expensive challenges in health care.Pursuing the Triple Aim shares compelling stories that are emerging in locations ranging from Pittsburgh to Seattle, from Boston to Oakland, focused on topics including improving quality and lowering costs in primary care; setting challenging goals to control chronic disease with notable outcomes; leveraging employer buying power to improve quality, reduce waste, and drive down cost; paying for care under an innovative contract that compensates for quality rather than quantity; and much more. The authors describe these innovations in detail, and show the way toward a health care system for the nation that improves the experience and quality of care while at the same time controlling costs.As the Triple Aim moves from being largely an aspirational framework to something that communities all across the US can implement and learn from, its potential to become a touchstone for the work ahead has never been greater. Pursuing the Triple Aim lays out the vision, the interventions, and promising examples of success.
Charles Kenney has written an authentic, compelling, morally complex novel of the men and women of law enforcement, penetrating the very heart of police culture--and bringing the powerful, tumultuous brotherhood of cops brilliantly to life. In The Son of John Devlin, a determined detective fights to clear his father's tarnished name.The U.S. Justice Department has declared war on the widespread corruption in Boston's police force, turning up the heat big time for detective Jack Devlin, assigned to snare cops on the take and root out vice in the rank and file. "The dirty cop will inevitably reveal himself. He'll always give off a sign, an indication."Tough words to hear for Jack Devlin, whose father was tied to the biggest scandal in Boston's history. Stripped of his honor, Jock Devlin died disgraced, a suicide, before his case went to trial--an act of cowardice that forced young Devlin to grow up in the shadow of his father's shame, creating personal demons that would drive him from a promising career as a Harvard-educated lawyer into the unlikely field of law enforcement.Now, more than twenty years later, a letter from his father surfaces, pushing Devlin to reopen old wounds. Through conflicting emotions of anger and devotion, he searches for truth, hoping to uncover the secrets behind his father's infamous fall from grace and tragic death. But what he finds could bring the Boston police force to its knees--and there are some who would kill to keep history silent.Flesh and blood characters in a page-turning plot. The gritty language of cops under fire. The explosive tension of the precinct. Charles Kenney weaves these elements into a tight, intelligent novel of people and principle that is also an absorbing, unforgettable thriller.From the Hardcover edition.
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