Communities in Action

Communities in Action
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 583
Release: 2017-04-27
Genre: Medical
ISBN: 0309452961

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Crossing the Quality Chasm

Crossing the Quality Chasm
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 359
Release: 2001-07-19
Genre: Medical
ISBN: 0309132967

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Finding What Works in Health Care

Finding What Works in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 267
Release: 2011-07-20
Genre: Medical
ISBN: 0309164257

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Urban Stormwater Management in the United States

Urban Stormwater Management in the United States
Author: National Research Council
Publisher: National Academies Press
Total Pages: 611
Release: 2009-03-17
Genre: Nature
ISBN: 0309125391

The rapid conversion of land to urban and suburban areas has profoundly altered how water flows during and following storm events, putting higher volumes of water and more pollutants into the nation's rivers, lakes, and estuaries. These changes have degraded water quality and habitat in virtually every urban stream system. The Clean Water Act regulatory framework for addressing sewage and industrial wastes is not well suited to the more difficult problem of stormwater discharges. This book calls for an entirely new permitting structure that would put authority and accountability for stormwater discharges at the municipal level. A number of additional actions, such as conserving natural areas, reducing hard surface cover (e.g., roads and parking lots), and retrofitting urban areas with features that hold and treat stormwater, are recommended.

Global Climate Change Impacts in the United States

Global Climate Change Impacts in the United States
Author: U.S. Global Change Research Program
Publisher: Cambridge University Press
Total Pages: 193
Release: 2009-08-24
Genre: Business & Economics
ISBN: 0521144078

Summarizes the science of climate change and impacts on the United States, for the public and policymakers.