Registries for Evaluating Patient Outcomes


Book Description

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.




The Patient


Book Description

The Silent Patient by way of Stephen King: Parker, a young, overconfident psychiatrist new to his job at a mental asylum, miscalculates catastrophically when he undertakes curing a mysterious and profoundly dangerous patient. In a series of online posts, Parker H., a young psychiatrist, chronicles the harrowing account of his time working at a dreary mental hospital in New England. Through this internet message board, Parker hopes to communicate with the world his effort to cure one bewildering patient. We learn, as Parker did on his first day at the hospital, of the facility's most difficult, profoundly dangerous case--a forty-year-old man who was originally admitted to the hospital at age six. This patient has no known diagnosis. His symptoms seem to evolve over time. Every person who has attempted to treat him has been driven to madness or suicide. Desperate and fearful, the hospital's directors keep him strictly confined and allow minimal contact with staff for their own safety, convinced that releasing him would unleash catastrophe on the outside world. Parker, brilliant and overconfident, takes it upon himself to discover what ails this mystery patient and finally cure him. But from his first encounter with the mystery patient, things spiral out of control, and, facing a possibility beyond his wildest imaginings, Parker is forced to question everything he thought he knew. Fans of Sarah Pinborough's Behind Her Eyes and Paul Tremblay's The Cabin at the End of the World will be riveted by Jasper DeWitt's astonishing debut.




Remaking the American Patient


Book Description

In a work that spans the twentieth century, Nancy Tomes questions the popular--and largely unexamined--idea that in order to get good health care, people must learn to shop for it. Remaking the American Patient explores the consequences of the consumer economy and American medicine having come of age at exactly the same time. Tracing the robust development of advertising, marketing, and public relations within the medical profession and the vast realm we now think of as "health care," Tomes considers what it means to be a "good" patient. As she shows, this history of the coevolution of medicine and consumer culture tells us much about our current predicament over health care in the United States. Understanding where the shopping model came from, why it was so long resisted in medicine, and why it finally triumphed in the late twentieth century helps explain why, despite striking changes that seem to empower patients, so many Americans remain unhappy and confused about their status as patients today.




The Silent Patient


Book Description

**THE INSTANT #1 NEW YORK TIMES BESTSELLER** "An unforgettable—and Hollywood-bound—new thriller... A mix of Hitchcockian suspense, Agatha Christie plotting, and Greek tragedy." —Entertainment Weekly The Silent Patient is a shocking psychological thriller of a woman’s act of violence against her husband—and of the therapist obsessed with uncovering her motive. Alicia Berenson’s life is seemingly perfect. A famous painter married to an in-demand fashion photographer, she lives in a grand house with big windows overlooking a park in one of London’s most desirable areas. One evening her husband Gabriel returns home late from a fashion shoot, and Alicia shoots him five times in the face, and then never speaks another word. Alicia’s refusal to talk, or give any kind of explanation, turns a domestic tragedy into something far grander, a mystery that captures the public imagination and casts Alicia into notoriety. The price of her art skyrockets, and she, the silent patient, is hidden away from the tabloids and spotlight at the Grove, a secure forensic unit in North London. Theo Faber is a criminal psychotherapist who has waited a long time for the opportunity to work with Alicia. His determination to get her to talk and unravel the mystery of why she shot her husband takes him down a twisting path into his own motivations—a search for the truth that threatens to consume him....




The Borderline Patient


Book Description

This volume focuses on treatment issues pertaining to patients with borderline psychopathology. A section on psychoanalysis and psychoanalytic psychotherapy (with contributors by V. Volkan, H. Searles, O. Kernberg, L. B. Boyer, and J. Oremland, among others) is followed by a section exploring a variety of alternative approaches. The latter include psychopharmacology, family therapy, milieu treatment, and hospitalization. The editors' concluding essay discusses the controversies and convergences among the different treatment approaches.




The Patient History: Evidence-Based Approach


Book Description

The definitive evidence-based introduction to patient history-taking NOW IN FULL COLOR For medical students and other health professions students, an accurate differential diagnosis starts with The Patient History. The ideal companion to major textbooks on the physical examination, this trusted guide is widely acclaimed for its skill-building, and evidence based approach to the medical history. Now in full color, The Patient History defines best practices for the patient interview, explaining how to effectively elicit information from the patient in order to generate an accurate differential diagnosis. The second edition features all-new chapters, case scenarios, and a wealth of diagnostic algorithms. Introductory chapters articulate the fundamental principles of medical interviewing. The book employs a rigorous evidenced-based approach, reviewing and highlighting relevant citations from the literature throughout each chapter. Features NEW! Case scenarios introduce each chapter and place history-taking principles in clinical context NEW! Self-assessment multiple choice Q&A conclude each chapter—an ideal review for students seeking to assess their retention of chapter material NEW! Full-color presentation Essential chapter on red eye, pruritus, and hair loss Symptom-based chapters covering 59 common symptoms and clinical presentations Diagnostic approach section after each chapter featuring color algorithms and several multiple-choice questions Hundreds of practical, high-yield questions to guide the history, ranging from basic queries to those appropriate for more experienced clinicians




The Book of Patience


Book Description

Discover why patience really is a virtue with these 250 quotes and exercises designed to help you lead a happier, more successful life. Patience is both a virtue and a skill that you can learn and apply in your daily life to be calmer and more stress-free. Wouldn’t it be nice to calmly zen out when stuck in traffic delays instead of losing your cool? In The Book of Patience, you will discover practical exercises, habits, thoughts, and moments of pause to allow you to cultivate and improve your patience. These 250 quotes and activities will help you deescalate feelings of irritability and become less reactive in moments of stress and duress. Being patient means facing challenges and adversity with calm and ease and The Book of Patience is here to make this skill easier than ever!




The Patient Will See You Now


Book Description

The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. 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.




Improving Patient Care


Book Description

As innovations are constantly being developed within health care, it can be difficult both to select appropriate new practices and technologies and to successfully adopt them within complex organizations. It is necessary to understand the consequences of introducing change, how to best implement new procedures and techniques, how to evaluate success and to improve the quality of patient care. This comprehensive guide allows you to do just that. Improving Patient Care, 2nd edition provides a structure for professionals and change agents to implement better practices in health care. It helps health professionals, managers, policy makers and researchers to assess new techniques and select and implement change in their organizations. This new edition includes recent evidence and further coverage on patient safety and patient centred strategies for change. Written by an international expert author team, Improving Patient Care is an established standard text for postgraduate students of health policy, health services and health management. The strong author team are global professors involved in managing research and development in the field of quality improvement, evidence-based practice and guidelines, quality assessment and indicators to improve patient outcomes through receiving appropriate healthcare.




When Doctors Become Patients


Book Description

For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill.The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be-- a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine in America today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.