Pursuing the Triple Aim

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Publisher : John Wiley & Sons
ISBN 13 : 1118205723
Total Pages : 353 pages
Book Rating : 4.1/5 (182 download)

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Book Synopsis Pursuing the Triple Aim by : Maureen Bisognano

Download or read book Pursuing the Triple Aim written by Maureen Bisognano and published by John Wiley & Sons. This book was released on 2012-05-01 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Better Now

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Publisher : Penguin
ISBN 13 : 0735232601
Total Pages : 304 pages
Book Rating : 4.7/5 (352 download)

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Book Synopsis Better Now by : Dr. Danielle Martin

Download or read book Better Now written by Dr. Danielle Martin and published by Penguin. This book was released on 2017-01-10 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: Longlisted for British Columbia's National Award for Canadian Non-Fiction 2018 Dr. Danielle Martin sees the challenges in our health care system every day. As a family doctor and a hospital vice president, she observes how those deficiencies adversely affect patients. And as a health policy expert, she knows how to close those gaps. A passionate believer in the value of fairness that underpins the Canadian health care system, Dr. Martin is on a mission to improve medicare. In Better Now, she shows how bold fixes are both achievable and affordable. Her patients’ stories and her own family’s experiences illustrate the evidence she presents about what works best to improve health care for all. Better Now outlines “Six Big Ideas” to bolster Canada’s health care system. Each one is centred on a typical Canadian patient, making it clear how close to home these issues strike. · Ensure every Canadian has regular access to a family doctor or other primary care provider · Bring prescription drugs under medicare · Reduce unnecessary tests and interventions · Reorganize health care delivery to reduce wait times and improve quality · Implement a basic income guarantee to alleviate poverty, which is a major threat to health · Scale up successful local innovations to a national level Passionate, accessible, and authoritative, Dr. Martin is a fervent supporter of the best of medicare and a persuasive critic of what needs fixing.

Communities in Action

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Publisher : National Academies Press
ISBN 13 : 0309452961
Total Pages : 583 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Communities in Action by : National Academies of Sciences, Engineering, and Medicine

Download or read book Communities in Action written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-04-27 with total page 583 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Systems Practices for the Care of Socially At-Risk Populations

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Author :
Publisher : National Academies Press
ISBN 13 : 0309391970
Total Pages : 95 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Systems Practices for the Care of Socially At-Risk Populations by : National Academies of Sciences, Engineering, and Medicine

Download or read book Systems Practices for the Care of Socially At-Risk Populations written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-05-07 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.

Handbook Integrated Care

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Author :
Publisher : Springer
ISBN 13 : 3319561030
Total Pages : 578 pages
Book Rating : 4.3/5 (195 download)

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Book Synopsis Handbook Integrated Care by : Volker Amelung

Download or read book Handbook Integrated Care written by Volker Amelung and published by Springer. This book was released on 2017-06-30 with total page 578 pages. Available in PDF, EPUB and Kindle. Book excerpt: This handbook gives profound insight into the main ideas and concepts of integrated care. It offers a managed care perspective with a focus on patient orientation, efficiency, and quality by applying widely recognized management approaches to the field of health care. The handbook also provides international best practices and shows how integrated care does work throughout various health systems. The delivery of health and social care is characterised by fragmentation and complexity in most health systems throughout the world. Therefore, much of the recent international discussion in the field of health policy and health management has focused on the topic of integrated care. “Integrated” acknowledges the complexity of patients ́ needs and aims to meet it by taking into account both health and social care aspects. Changing and improving processes in a coordinated way is at the heart of this approach.

The High Cost of Low Morale...and what to do about it

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Author :
Publisher : CRC Press
ISBN 13 : 1000154505
Total Pages : 284 pages
Book Rating : 4.0/5 (1 download)

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Book Synopsis The High Cost of Low Morale...and what to do about it by : Carol A. Hacker

Download or read book The High Cost of Low Morale...and what to do about it written by Carol A. Hacker and published by CRC Press. This book was released on 2021-10-19 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: While the morale of an organization is an intangible element composed of feelings and attitudes of individuals and groups, the effects of morale include tangible and extremely important factors such as profits, efficiency, quality, and productivity. Low morale and its costliest indicator, high turnover, can be a tremendous drain on a company's finances. Managers often view morale as mysterious and unpredictable, when in fact it is a measurable, controllable expense. The High Cost of Low Morale explores the underlying causes of low morale and offers you field-proven, practical methods for increasing morale and reducing turnover in your organization.

The Future of Nursing 2020-2030

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Publisher :
ISBN 13 : 9780309685061
Total Pages : pages
Book Rating : 4.6/5 (85 download)

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Book Synopsis The Future of Nursing 2020-2030 by : National Academies of Sciences Engineering and Medicine

Download or read book The Future of Nursing 2020-2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.

Promising Care

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Publisher : John Wiley & Sons
ISBN 13 : 1118795881
Total Pages : 323 pages
Book Rating : 4.1/5 (187 download)

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Book Synopsis Promising Care by : Donald M. Berwick

Download or read book Promising Care written by Donald M. Berwick and published by John Wiley & Sons. This book was released on 2013-11-25 with total page 323 pages. Available in PDF, EPUB and Kindle. Book excerpt: Promising Care: How We Can Rescue Health Care by Improving It collects 16 speeches given over a period of 10 years by Donald M. Berwick, an internationally acclaimed champion of health care improvement throughout the course of his long and storied career as a physician, health care educator and policy expert, leader of the Institute for Healthcare Improvement (IHI), and administrator of the Centers for Medicare & Medicaid Services. These landmark speeches (including all of Berwick’s speeches delivered at IHI’s annual National Forum on Quality Improvement in Health Care from 2003 to 2012) clearly show why our medical systems don’t reliably contribute to our overall health. As a remedy he offers a vision for making our systems better – safer, more effective, more efficient, and more humane. Each of Berwick’s compelling speeches is preceded by a brief commentary by a prominent figure in health care, policy, or politics who has a unique connection to that particular speech. Contributors include such notables as Tom Daschle, Paul Batalden, and Lord Nigel Crisp. Their commentaries reflect on how it felt to hear the speech in the context in which it was delivered, and assess its relevance in today’s health care environment. The introduction is by Maureen Bisognano, CEO of Institute for Healthcare Improvement, and author of Pursuing the Triple Aim. Praise for previous books by Don Berwick Curing Health Care: "The book is an easy and affirming read for anyone who is familiar with and has used the TQM teachings of Dr. Joseph M. Juran and Dr. W. Edwards Deming and would be a simple and informative introduction to the concepts for anyone who has been hearing about TQM but has no idea what it is all about and wants to know more." —Permanent Fixes (blog) "Donald Berwick is the most clearly heard evangelist of applying industrial methods of continuous quality improvement in health care." —Annals of Internal Medicine Escape Fire: "With an effective blend of common sense, real-life stories, persuasive metaphors, and out-of-the-box thinking, Dr. Berwick’s presentations make for fascinating reading for anyone interested in improving America’s $1.7 trillion health care system." —Piper Report "Anyone interested in change in the healthcare system would enjoy this book. In degree programs, the various speeches would be useful for discussion in a health policy readings course." —The Annals of Pharmacotherapy

Making Healthcare Safe

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Publisher : Springer Nature
ISBN 13 : 3030711234
Total Pages : 450 pages
Book Rating : 4.0/5 (37 download)

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Book Synopsis Making Healthcare Safe by : Lucian L. Leape

Download or read book Making Healthcare Safe written by Lucian L. Leape and published by Springer Nature. This book was released on 2021-05-28 with total page 450 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.

The American Health Care Paradox

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Publisher : PublicAffairs
ISBN 13 : 1610392108
Total Pages : 272 pages
Book Rating : 4.6/5 (13 download)

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Book Synopsis The American Health Care Paradox by : Elizabeth H. Bradley

Download or read book The American Health Care Paradox written by Elizabeth H. Bradley and published by PublicAffairs. This book was released on 2013-11-05 with total page 272 pages. Available in PDF, EPUB and Kindle. Book excerpt: Foreword by Harvey V. Fineberg, President of the Institute of Medicine For decades, experts have puzzled over why the US spends more on health care but suffers poorer outcomes than other industrialized nations. Now Elizabeth H. Bradley and Lauren A. Taylor marshal extensive research, including a comparative study of health care data from thirty countries, and get to the root of this paradox: We've left out of our tally the most impactful expenditures countries make to improve the health of their populations-investments in social services. In The American Health Care Paradox, Bradley and Taylor illuminate how narrow definitions of "health care," archaic divisions in the distribution of health and social services, and our allergy to government programs combine to create needless suffering in individual lives, even as health care spending continues to soar. They show us how and why the US health care "system" developed as it did; examine the constraints on, and possibilities for, reform; and profile inspiring new initiatives from around the world. Offering a unique and clarifying perspective on the problems the Affordable Care Act won't solve, this book also points a new way forward.

The Political Crisis and Christian Ethics

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Publisher : Wipf and Stock Publishers
ISBN 13 : 1666746223
Total Pages : 287 pages
Book Rating : 4.6/5 (667 download)

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Book Synopsis The Political Crisis and Christian Ethics by : Ronald H. Stone

Download or read book The Political Crisis and Christian Ethics written by Ronald H. Stone and published by Wipf and Stock Publishers. This book was released on 2023-09-26 with total page 287 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Political Crisis and Christian Ethics addresses themes in political philosophy in the context of a crisis in democracy after the denial of the 2020 election by the Republican candidate for president. The refusal to accept the results of the election divided the electorate and drove the president’s followers to fail in their attempted coup attempt in January of 2020. Democracy is defended in Reinhold Niebuhr’s writing on politics and in Barack Obama’s use of the theologian’s thought. It is developed further in the political theory of Paul Tillich. The themes of just peacemaking are reviewed in Paul Tillich’s critique of John Foster Dulles’ work and in the author’s critique of just peacemaking in the work of Glen Stassen. Domestically the issues of race, inequality, ecology, and healthcare are addressed from the perspective of prophetic realism. The book concludes in terms of Alfred North Whitehead’s philosophy of education and religion and a vision of the good president. In summary, The Political Crisis and Christian Ethics is a volume of American, Christian political theory in a period of overcoming the trauma of 2016 with Christian ethics and political philosophy.

The Future of Home Health Care

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Publisher : National Academies Press
ISBN 13 : 0309367565
Total Pages : 168 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis The Future of Home Health Care by : National Research Council

Download or read book The Future of Home Health Care written by National Research Council and published by National Academies Press. This book was released on 2015-08-04 with total page 168 pages. Available in PDF, EPUB and Kindle. Book excerpt: Individuals with disabilities, chronic conditions, and functional impairments need a range of services and supports to keep living independently. However, there often is not a strong link between medical care provided in the home and the necessary social services and supports for independent living. Home health agencies and others are rising to the challenges of meeting the needs and demands of these populations to stay at home by exploring alternative models of care and payment approaches, the best use of their workforces, and technologies that can enhance independent living. All of these challenges and opportunities lead to the consideration of how home health care fits into the future health care system overall. On September 30 and October 1, 2014, the Institute of Medicine and the National Research Council convened a public workshop on the future of home health care. The workshop brought together a spectrum of public and private stakeholders and thought leaders to improve understanding of the current role of Medicare home health care in supporting aging in place and in helping high-risk, chronically ill, and disabled Americans receive health care in their communities. Through presentations and discussion, participants explored the evolving role of Medicare home health care in caring for Americans in the future, including how to integrate Medicare home health care into new models for the delivery of care and the future health care marketplace. The workshop also considered the key policy reforms and investments in workforces, technologies, and research needed to leverage the value of home health care to support older Americans, and research priorities that can help clarify the value of home health care. This summary captures important points raised by the individual speakers and workshop participants.

Primary Care and Public Health

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Publisher : National Academies Press
ISBN 13 : 0309255201
Total Pages : 212 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Primary Care and Public Health by : Institute of Medicine

Download or read book Primary Care and Public Health written by Institute of Medicine and published by National Academies Press. This book was released on 2012-07-19 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.

The Future of Nursing

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Author :
Publisher : National Academies Press
ISBN 13 : 0309208955
Total Pages : 700 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis The Future of Nursing by : Institute of Medicine

Download or read book The Future of Nursing written by Institute of Medicine and published by National Academies Press. This book was released on 2011-02-08 with total page 700 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

Crossing the Quality Chasm

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Publisher : National Academies Press
ISBN 13 : 0309072808
Total Pages : 360 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Crossing the Quality Chasm by : Institute of Medicine

Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-08-19 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

One World Health

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Author :
Publisher : CRC Press
ISBN 13 : 1498739431
Total Pages : 316 pages
Book Rating : 4.4/5 (987 download)

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Book Synopsis One World Health by : Lord Nigel Crisp

Download or read book One World Health written by Lord Nigel Crisp and published by CRC Press. This book was released on 2016-06-30 with total page 316 pages. Available in PDF, EPUB and Kindle. Book excerpt: This brand new textbook presents a new approach to the teaching and understanding of global health. It describes the shared opportunities but also the problems that we all face, wherever we live, and the particular needs of the poorest people in every society. Covering subjects from epidemics and climate change, the need to staff and resource health services appropriately, the rich potential of science and technology, and the impacts of social and political change in the world around us, all is presented at a level appropriate for the student looking to gain an understanding of this broad and developing area.

Keeping Patients Safe

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Publisher : National Academies Press
ISBN 13 : 0309187362
Total Pages : 485 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Keeping Patients Safe by : Institute of Medicine

Download or read book Keeping Patients Safe written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-27 with total page 485 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.