02-Manual - The Culture of Healthcare

Component 2:
The Culture of
Healthcare
Instructor Manual
Version 3.0/Spring 2012
otes to Instructors
This Instructor Manual is a resource for instructors using this component. Each
component is broken down into units, which include the following elements:
Learning objectives
uggested student readings, te!ts, reference links to supplement the
narrated "ower"oint slides
Lectures #voiceover "ower"oint in $lash format%& "ower"oint slides
#Microsoft "ower"oint format%, lecture transcripts #Microsoft 'ord format%&
and audio files #M"( format% for each lecture
elf)assessment *uestions reflecting +nit ,bjectives with answer ke-s
and.or e!pected outcomes
/pplication /ctivities #e.g., discussion *uestions, assignments, projects%
with instructor guidelines, answer ke-s and.or e!pected outcomes
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare 2
3ersion (.4.pring 2452
This material was developed by Oregon Health & Science University, funded by the Department of Health and Human Services,
Office of the National oordinator for Health !nformation Technology under "ward Number !U#$O%%%%&'(
Contents
6otes to Instructors............................................................................................................2
7isclaimer........................................................................................................................(8
1omponent 2.+nit 5.........................................................................................................(9
5.( Table: :orman, ". #n.d.% $ield tudies to upport 0IT 7esign and Evaluation ;
E!amples. <etrieved from author, +sed with "ermission. ............................................(=
1omponent 2.+nit 2.........................................................................................................(>
1omponent 2.+nit (.........................................................................................................8(
+nit <eferences...............................................................................................................8(
5./merican 0ospital /ssociate. #2455.% $ast facts on + hospitals. <etrieved from
http:..www.aha.org.research.rc.stat)studies.fast)facts.shtml ..........................................88
2.1enters for Medicare and Medicaid ervices. #2455%. 'hat are long)term care
hospitals? <etrieved from http:..www.medicare.gov.publications.pubs.pdf.55(8=.pdf 88
(.7epartment of 0ealth and 0uman ervices, 6ational 1learing 0ouse for Long Term
1are Information. #2455%. ervices and providers. <etrieved from
http:..www.longtermcare.gov.LT1.Main@ite.+nderstanding.ervices.Inde!.asp! .......88
8.7epartment of 3eterans /ffairs. #2455% /bout the 30/ #3eterans 0ealth
/dministration%. <etrieved from http:..www.va.gov.health.about30/.asp....................88
9.7onaldson M, Aord- B7, Lohr B6, 3anselow, Eds& 1ommittee on the $uture of
"rimar- 1are, Institute of Medicine. #5CCD%. "rimar- care: /mericas health in a new
era. 'ashington, 71: 6ational /cadem- "ress. p. (5)(2. <etrieved from:
http:..www.nap.edu.catalog.php?record@idE9592...........................................................88
D.0ealthcare trateg- :roup. Emplo-er health clinics)threat and opportunit-. <etrieved
from http:..www.healthcarestrateg-group.com.newsletters.article.php?
showEemplo-er@health@clinics@@@threat@and@opportunit- ...........................................88
=.0ealth <esources and 0ealth /dministration, Fureau of 0ealth "rofessions. #2455%.
'hat is a health center? <etrieved from http:..bphc.hrsa.gov.about.inde!.html ...........88
>.Indian 0ealth ervices, 7epartment of 0ealth and 0uman ervices. #2445%. Indian
0ealth ervice: / *uick look retrieved from
http:..www.ihs.gov."ublic/ffairs.I0Frochure.GuickLook2455.asp................................88
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare (
C.Hournal of the /merican Medical /ssociation.#2455%. :lossar- of methodologic terms.
<etrieved from http:..jama.ama)assn.org.site.misc.auinst@term.!htmlItertiar- .............88
54.Bane <L. #2455%. $inding the right level of posthospital care: J'e didnKtK realiLe there
was an- other optionM. The Hournal of the /merican Medical /ssociation, (49#(%, 2>8)
2C(...................................................................................................................................88
55.Militar- 0ealth -stem, + 7epartment of 7efense. /bout M0. <etrieved from
http:..www.health.mil./bout@M0.,rganiLations.Inde!.asp!.........................................88
52.6ational /ssembl- on chool)Fased 0ealth 1are. #2455% /bout school)based
health. <etrieved from
http:..www.nasbhc.org.site.c.ckLGBb,3LkBDE.b.=92>C(9.k.>8E/./bout@F01s.htm
.........................................................................................................................................88
5(."alliative 1are /ustralia. 244>. "alliative and End of Life 1are: :lossar- of terms.
<etrieved from http:..www.palliativecare.org.au."ortals.8D.docs.publications."1/
N24:lossar-.pdf .............................................................................................................88
(.5 $igure: 0ickman #2452%. <epresents the range of care deliver- and the referral
patterns between the t-pes of care of deliver- organiLations. #11 FA)61)/ (.4%.......89
5.Longnecker 7E, "atton M, 7ickler <M. #244=%. <oles and responsibilities of 1hief
Medical ,fficers in member organiLations of the /ssociation of the /merican Medical
1olleges. /cademic Medicine, >2#(%, 29>)2D(. <etrieved Han 2452 from
http:..journals.lww.com.academicmedicine.$ullte!t.244=.4(444.<oles@and@<esponsibili
ties@of@1hief@Medical.C.asp!. ........................................................................................89
2.Medicare "a-ment /dvisor- 1ommittee. #2448%. 1hapter =: Information technolog- in
health care. In <eport to the 1ongress: new approaches in Medicare. <etrieved Han
2452 from: http:..www.medpac.gov.publicationsN91congressional@reports
N91Hune48@ch=.pdf. .....................................................................................................89
(.cribd. #2455%. ,rganiLational structure of a hospital. <etrieved Han 2452 from
http:..www.scribd.com.doc.24>>854>.,rganiLational)tructure)of)a)0ospital...............89
8.hortliffe E0, Farnett :,. #244D% Fiomedical data: their ac*uisition and use In:
hortliffe E0, 1imino HH, eds. Fiomedical 1omputer /pplications in 0ealth 1are and
Fiomedicine. (rd ed. 6ew Aork, 6A: pringer& 244D: p84()88(. ...................................89
9.+nited 0ospital $und. #244>%. $amil- care giver guide. 0ospital admission: how to
plan and what to e!pect during the sta-. <etrieved Han 2452 from
http:..www.ne!tstepincare.org.uploads.$ile.0ospital@/dmissions.pdf............................89
D.+niversit- of <ochester Medical 1enter. #2455%. trong Memorial 0ospital
organiLational chart. <etrieved Han 2452 from http:..www.urmc.rochester.edu.strong)
nursing.about.documents.6ursing,rg1hart.pdf..............................................................89
(.2 1hart: E!ample of a healthcare organiLational structure #0ickman 2452, 11 FA)
61)/ (.4%.......................................................................................................................89
1omponent 2.+nit 8.........................................................................................................8D
5.Evans, 7/ and "atel, 3. #5C>C% 1ognitive cience in Medicine: Fiomedical modeling.
MIT "ress, 1ambridge, M/ <etrieved from http:..portal.acm.org.citation.cfm?idE9=9=22
.........................................................................................................................................8D
2.$riedman, 1". #244C%. / J$undamental theoremM of biomedical informatics. Hournal
of the /merican Medical Informatics . <etrieved from
http:..jamia.bmj.com.content.5D.2.5DC.short ...................................................................8D
(.:orman, "6. #5CC9% Information needs of ph-sicians. Hournal of the /merican
ociet- for Information cience and Technolog-............................................................8=
8.0unter, BM. 7octorsO #5CC5% stories: The narrative structure of medical knowledge.
"rinceton +niversit- "ress #5CC5%...................................................................................8=
9.Bassirer, " and Bopelman, I. Learning clinical reasoning. pp. ((2..............................8=
D.Tumult-, "hilip /., #nd.% Guotation. J7isease hides its secrets in a casual
parenthesisM ....................................................................................................................8=
8.5 Table: T-pes of information that clinicians utiliLe when making decisions.............8=
8.2 Table: 1omparison of the classic paradigm with the operating room.....................8=
8.( Table: 1omparison of the classic paradigm with the operating room and acute
comple! illness.................................................................................................................8=
8.8 Table: 1omparison of the classic paradigm with the operating room, acute comple!
illness and emergenc- dept...........................................................................................8=
5.Elstein et al. #5C>5%& Medical problem)solving. /cademic Medicine............................8=
2.Elstein /, chwartL /. #2442 Mar 2(%& (28 1linical problem solving and diagnostic
decision making: selective review of the cognitive literature. FMH. #=((C%:=2C)(2.........8=
(.Evans 7/, :add 1. #5C>C%& Managing coherence and conte!t in medical problem)
solving discourse. In: Evans 7/, "atel 3L, eds. 1ognitive science in medicine:
Fiomedical modeling. 1ambridge, M/: MIT "ress& 255)299..........................................8=
8.:orman, "6. #5CC>%& Information seeking of primar- care ph-sicians: <etrieved from
conceptual models and empirical studies at
http:..informationr.net.isic.II15CC>.C>@:orman.pdf......................................................8=
8.D Table: 0ierarch- for clinical data . Evans, 7./., and :add, 1..,#5C>C%& Managing
coherence and conte!t in medical problem)solving discourse. In: Evans 7/, "atel 3L,
eds. 1ognitive science in medicine: Fiomedical modeling. 1ambridge, M/: MIT "ress&
255)299............................................................................................................................8=
8.= Table: 7epiction of how the 0ierarch- for 1linical 7ata might work for man with
Edema, or swelling of the ankles ...................................................................................8=
5.Folstad 'M. #244=% Introduction to Fa-esian tatistics. 'ile-)Interscience& 2 edition .
.........................................................................................................................................8=
2.Elstein /, chwartL /. 1 #2442% linical problem solving and diagnostic decision
making: selective review of the cognitive literature. FMH. (28#=((C%:=2C)(2.................8=
(.Bassirer, " and Bopelman, #5CC5% I. Learning clinical reasoning. pp. ((2..................8=
5.:awande., /, #2442%. 1omplications: / -oung surgeonOs notes on an imperfect
science. 0enr- 0olt and 1ompan-, LL1. .......................................................................8>
2.'eed, LL. #5CD>%. Medical records that guide and teach. 6ew England Hournal of
Medicine...........................................................................................................................8>
(.'ikipedia #2455% 7ecision anal-sis, retrieved from
http:..en.wikipedia.org.wiki.7ecision@anal-sis. ...............................................................8>
8.> $igure: The comple! and d-namic processes that are in pla- when a patient care
problem has to be translated into problem management b- the clinician. Mohan, 3.
#2454%...............................................................................................................................8>
8.C 1hart: 7ecision /nal-sis 1hart. Mills #5CC5%
http:..www.nlm.nih.gov.nichsr.hta545.tree59.jpg. <etrieved 6ov. 2454 from the 6ational
Librar- of Medicine website http:..www.nlm.nih.gov. ......................................................8>
8.54 Table: Evolving Management "lan. Mohan, 3. #2454%...........................................8>
5.1onan 7o-le /. ilver FlaLe. The Memoirs of herlock 0olmes #5>C(%.....................8>
2.Evans, 7. /., P :add, 1. . #5C>C%. Managing coherence and conte!t in medical
problem solving discourse. In 7. /. Evans P 3. L. "atel #Eds.%, 1ognitive science in
medicine: Fiomedical modeling #p. 258%. 1ambridge, M/: MIT "ress............................8>
(.$eldman M, 1hristensen H. Fehavioral Medicine: / :uide for 1linical "ractice, Third
Edition. Mc:raw)0ill Medical& ( edition #244=%................................................................8>
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare D
8.Le- ". 1ommunicating with patients: Improving communication, satisfaction and
compliance. "s-cholog- and medicine series. 6ew Aork, 6A, +: 1room 0elm. #5C>>%
.........................................................................................................................................8>
lide (: 1orner, T. 1. #5C49%.
http:..commons.wikimedia.org.wiki.$ile:ir@'illiam@,sler.jpg. <etrieved 6ovember
2455, from 'ikimedia 1ommons website: http:..commons.wikimedia.org. "ublic domain
image #"7)+%.................................................................................................................8>
1omponent 2.+nit 9.........................................................................................................8C
1omponent 2.+nit D.........................................................................................................9=
+nit <eferences...............................................................................................................9=
Lecture Da........................................................................................................................9=
5./merican /cadem- of 6urse "ractitioners QInternetR. 244= Qcited 2455 7ec 5R.
$re*uentl- /sked Guestions: 'h- 1hoose a 6urse "ractitioner as -our 0ealthcare
"rovider? Q( pagesR. /vailable from: http:..www.npfinder.com.fa*.pdf............................9=
2./merican Medical Informatics /ssociation QInternetR. +ndated Qcited 2455 7ec 9R:
6ursing Informatics Q5 pageR. /vailable from: http:..www.amia.org.programs.working)
groups.nursing)informatics..............................................................................................9=
(./merican 6urses /ssociation QInternetR. 2455 Qcited 2455 7ec 9R. 0ow to Fecome a
6urse Q5 pageR. /vailable from: http:..nursingworld.org.Especiall-$orAou.'hat)is)
6ursing.Tools)Aou)6eed.<egistered6urseLicensing.html..............................................9=
8./merican 6urses /ssociation QInternetR. 2455 Qcited 2455 7ec 5R. 'hat 6urses 7o Q5
pageR. /vailable from: http:..www.nursingworld.org.Especiall-$orAou.'hat)is)
6ursing.Tools)Aou)6eed.<6s/"6s.html........................................................................9=
9./merican 6urses /ssociation, 1enter for 1ontinuing Education and "rofessional
7evelopment QInternetR. 2455 Qcited 2455 7ec DR: Frowse 1E: ubject Q2 pagesR.
/vailable from: http:..ananursece.healthstream.com."ages.1ategor-.asp!?
categor-EubjectPcatE/6/Porderb-E7ispla-6amePdirE/1......................................9=
D./merican 6urses 1redentialing 1enter QInternetR. 2455 Qcited 2455 7ec DR: /611
1ertification 1enter Q2 pagesR. /vailable from:
http:..www.nursecredentialing.org.1ertification.asp!Ispecialt-......................................9>
=.Fureau of Labor tatistics, +.. 7epartment of Labor QInternetR. +pdated 244C 7ec 5=
Qcited 2455 7ec 5R. ,ccupational ,utlook 0andbook, 2454)55 Edition: Licensed
"ractical and Licensed 3ocational 6urses Q( pagesR. /vailable from:
http:..www.bls.gov.oco.ocos542.htm...............................................................................9>
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare =
>.Fureau of Labor tatistics, +.. 7epartment of Labor QInternetR. +pdated 244C 7ec 5=
Qcited 2455 7ec 5R. ,ccupational ,utlook 0andbook, 2454)55: <egistered 6urses QD
pagesR. /vailable from: http:..www.bls.gov.oco.ocos4>(.htm.........................................9>
5./merican 6urses /ssociation QInternetR. 2455 Qcited 2455 7ec >R. The 6ursing
"rocess: / 1ommon Thread /mongst /ll 6urses Q5 pageR. /vailable from:
http:..ana.nursingworld.org.Especiall-$orAou.tudent6urses.Thenursingprocess.asp!.
.........................................................................................................................................9>
2.1ape $ear 1ommunit- 1ollege QInternetR. +ndated Qcited 2455 7ec >R. Module 9:
6ursing "rocess Q(8 pagesR. /vailable from:
http:..cfcc.edu.pn.documents.Module9.pdf......................................................................9>
(.The 1enter for 1ritical Thinking and Moral 1riti*ue QInternetR. 2455 Qcited 2455 7ec >R.
1ritical Thinking: 'here to Fegin Q5 pageR. /vailable from:
http:..www.criticalthinking.org.pages.critical)thinking)where)to)begin.=CD......................9>
8.Ma-o /M, 7uncan 7. 6urse "erceptions of medication errors: what we need to know
for patient safet-. H 6urs 1are Gua. 2448&5C#(%:24C)25=. /vailable from:
http:..www.nursingcenter.com.librar-.Hournal/rticle.asp?/rticle@I7E95892(. ..............9>
9.Medi)mart QInternetR. 2455 Qcited 2455 7ec 52R. 6ursing Legal Issues: 0ow to "rotect
Aourself Q5 pageR. /vailable from: http:..www.medi)smart.com.nursing)articles.nursing)
law.legal)issues................................................................................................................9>
D.<esources in 6ursing QInternetR. 244> Qcited 2455 7ec >R. "haneuf M. 1linical
Hudgement: /n Essential Tool in the 6ursing "rofession Q54 pagesR. /vailable from:
http:..www.infiressources.ca.m-scriptorweb.scripto.asp?resultatE2(499(. ...................9>
=.<61entral.com QInternetR. 2455 Qcited 2455 7ec 59R. 'hat Is a 6ursing 1are "lan and
'h- Is It 6eeded? Q5 pageR. /vailable from: http:..www.rncentral.com.nursing)
librar-.careplans...............................................................................................................9>
>.*ue M, 1hipulu M, Mc:onigle 7. 244C Qcited 2455 7ec >R. 1linical decision making.
In: 0all M, 6oble /, mith , eds. / $oundation for 6eonatal 1are: / Multi)disciplinar-
:uide. ,!ford, +B& <adcliffe& pp. 2(9)295. /vailable from: http:..www.shop)
test.co.uk.books.samplechapter.58>(.0all@final@lowres@chap52)2Db28=c4rdL.pdf......9>
C.tate of 1onnecticut 7epartment of 7evelopmental ervices QInternetR. 244C Qcited
2455 7ec >R. 6ursing tandard: 6ursing "rocess I 6 4C.5 Q8 pagesR. /vailable from:
http:..www.ct.gov.dds.lib.dds.health.ns@4C@5@nursing@process.pdf. .............................9C
54.Tanner 1/. Thinking like a nurse: a research)based model of clinical judgment in
nursing. H 6urs Educ. 244D&89#D%:248)255. /vailable from:
http:..ahn.mnsu.edu.nursing.facult-formsandinfo.thinkinglikeanurse.pdf.......................9C
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare >
55.Thompson 1, 1ullum 6, Mc1aughan 7, heldon T, <a-nor ". 6urses, information
use, and clinical decision making: the real world potential for evidence)based decisions
in nursing. Evid Fased 6urs. 2448&=:D>)=2. /vailable from:
http:..ebn.bmj.com.content.=.(.D>.full..............................................................................9C
5./merican /cadem- of /mbulator- 1are 6ursing QInternetR. 2455 Qcited 2455 7ec 58R.
/bout //16 Q( pagesR. /vailable from: http:..aaacn.org.cgi)
bin.'eb,bjects.///16Main.woa.wa.viewection?s@idE54=(=8(C49.........................9C
2./merican /cadem- of /mbulator- 1are 6ursing QInternetR. 2455 Qcited 2455 7ec 58R.
/mbulator- 1are 6ursing 7efined Q2 pagesR. /vailable from: http:..aaacn.org.cgi)
bin.'eb,bjects.///16Main.woa.wa.viewection?
s@idE54=(=8(C49Pss@idE9(D>=(>24.............................................................................9C
(./merican /ssociation for Long Term 1are 6ursing QInternetR. 2454 Qcited 2455 7ec
59R. Eliopoulos 1. 'h- the Time 0as 1ome for an /ssociation for Long Term 1are
6ursing. /vailable from:
http:..ltcnursing.org.@webapp@558((>D.'h-@the@Time@0as@1ome@for@an@/ssociation
@for@Long@Term@1are@6ursing......................................................................................9C
8./merican "ublic 0ealth /ssociation QInternetR. 2455 Qcited 2455 7ec 59R. 7efinition
and Fackground Q2 pagesR. /vailable from:
http:..www.apha.org.membergroups.sections.aphasections.phn.about.defbackground.ht
m......................................................................................................................................9C
9./merican "ublic 0ealth /ssociation QInternetR. 2455 Qcited 2455 7ec 59R. The <ole of
"ublic 0ealth 6urses Q2 pagesR. /vailable from:
http:..www.apha.org.membergroups.sections.aphasections.phn.about.phnroles.htm.. .9C
D.Fureau of Labor tatistics, +.. 7epartment of Labor QInternetR. +pdated 244C 7ec 5=
Qcited 2455 7ec 59R. ,ccupational ,utlook 0andbook, 2454)55: <egistered 6urses QD
pagesR. /vailable from: http:..www.bls.gov.oco.ocos4>(.htm.........................................9C
=.0ughes <:, Flegen M/. Medication administration safet-. In: 0ughes <:, ed. "atient
afet- and Gualit-: /n Evidence)based 0andbook for 6urses. <ockville, M7: /genc-
for 0ealthcare <esearch and Gualit-&244>&chap (=.......................................................9C
>.Mar-land 6ursing 'orkforce 1ommission QInternetR. Ma- 244= Qcited 2455 7ec 58R.
:ugert- F, Maranda MH, Feachle- M, et al. 1hallenges and ,pportunities in
7ocumentation of the 6ursing 1are of "atients Q(9 pagesR. /vailable from:
http:..www.mbon.org.commission2.documenation@challenges.pdf................................D4
C.Medicare.gov QInternetR. +pdated 244C Mar 29 Qcited 2455 7ec 59R. 'hat is Long
Term 1are? Q2 pagesR. /vailable from:
http:..www.medicare.gov.longtermcare.static.home.asp.................................................D4
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare C
54.M-6ursing7egree.com QInternetR. 2455 Qcited 2455 7ec 59R. :ruver M3. 0ow to
Fecome a 0ome 0ealth 1are 6urse Q( pagesR. /vailable from:
http:..www.m-nursingdegree.com.home)health)care)nurse...........................................D4
55.6ational /ssociation of chool 6urses QInternetR. 2454 Qcited 2455 7ec 59R. The
1ase for chool 6ursing Q8 pagesR. /vailable from:
http:..www.nasn.org.portals.4.about.2454@The@1ase@for@chool@6ursing.pdf............D4
52.6urses for a 0ealthier Tomorrow QInternetR. +ndated Qcited 2455 7ec 58R. 1ritical)
1are 6urse Q9 pagesR. /vailable from: http:..www.nursesource.org.critical@care.html.. .D4
5(.,ccupational afet- and 0ealth /dministration, +.. 7epartment of Labor QInternetR.
+ndated Qcited 2455 7ec 59R. 6ursing in ,ccupational 0ealth Q2 pagesR. /vailable from:
http:..www.osha.gov.dts.oohn.ohn.html...........................................................................D4
58."owell)1ope :, 6elson /L, "atterson E. In: 0ughes <:, ed. "atient afet- and
Gualit-: /n Evidence)based 0andbook for 6urses. <ockville, M7: /genc- for
0ealthcare <esearch and Gualit-&244>&chap 94.............................................................D4
59.outh 1arolina 7epartment of 7isabilities and pecial 6eeds QInternetR. +pdated
244D Qcited 2455 7ec 59R. 6ursing 7ocumentation QD pagesR. /vailable from:
http:..ddsn.sc.gov.providers.manualsandguidelines.7ocuments.0ealth1are:uidelines.6
ursing7ocumentation.pdf. ...............................................................................................D4
5D.+niversit- of 1alifornia, an $rancisco QInternetR. 2455 Qcited 2455 7ec 59R. M
pecialt- /rea: /cute 1are 6urse "ractitioner Q( pagesR. /vailable from:
http:..nursing.ucsf.edu.programs.specialties.acute)care)nurse)practitioner)acnp..........D4
5=.+niversit- of outh $lorida QInternetR. +ndated Qcited 2455 7ec 59R. 'h- "ursue a
1areer in ,ccupational 0ealth 6ursing? QD pagesR. /vailable from:
http:..health.usf.edu.6<.rdonl-res.(C581(F2)9/87)875E)F2F5)
E21>(C>(/71/.4.,ccupational6ursing.pdf..................................................................D4
5>.'estbrook HI, <ob MI, 'oods /, "arr- 7. Errors in the administration of intravenous
medications in hospital and the role of correct procedures and nurse e!perience. FMH
Gual af. 2455& 24:542=)54(8. .......................................................................................D4
1omponent 2.+nit =.........................................................................................................D2
+nit <eferences...............................................................................................................D2
Lecture =a........................................................................................................................D2
5./non-mous. #244=%. 3alue)driven 0ealth 1are: / "urchase :uide, 3ersion 2.4.
'ashington, 71: The Leapfrog :roup. <etrieved from
http:..www.leapfroggroup.org.media.file.Emplo-er@"urchaser@:uide@49@55@4=.pdf.. .D2
2./ron, 7., P "ogach, L. #244C%. Transparenc- standards for diabetes performance
measures. Hournal of the /merican Medical /ssociation, (45, 254)252. ......................D2
(./sch, ., Berr, E., Beese-, H., /dams, H., etodji, 1., Malik, ., P Mc:l-nn, E. #244D%.
'ho is at greatest risk for receiving poor)*ualit- health care? 6ew England Hournal of
Medicine, (98, 558=)559D. .............................................................................................D2
8./sch, ., Mc:l-nn, E., 0ogan, M., 0a-ward, <., hekelle, "., <ubenstein, L., Berr, E.
#2448%. 1omparison of *ualit- of care for patients in the 3eterans 0ealth /dministration
and patients in a national sample. /nnals of Internal Medicine, 585, C(>)C89. .............D(
9./tlas, ., :rant, <., $erris, T., 1hang, A., P Farr-, M. #244C%. "atient)ph-sician
connectedness and *ualit- of primar- care. /nnals of Internal Medicine, 594, (29)((9.
.........................................................................................................................................D(
D.Faicker, B., P 1handra, /. #2448%. Medicare spending, the ph-sician workforce, and
beneficiariesK *ualit- of care. 0ealth /ffairs. <etrieved Han 2452 from
http:..www.healthaffairs.org.$IS.54.5(==.hlthaff.'8.5>8 ...............................................D(
=.1hang, H., 0a-s, <., hekelle, "., MacLean, 1., olomon, 7., <euben, 7., 'enger, 6.
#244D%. "atientsO global ratings of their health care are not associated with the technical
*ualit- of their care. /nnals of Internal Medicine, 588, DD9)D=2. ...................................D(
>.1hassin, M., P Loeb, H. #2455%. The ongoing *ualit- improvement journe-: ne!t stop,
high reliabilit-. 0ealth /ffairs, (4, 99C)9D>. ....................................................................D(
C.1hassin, M., Loeb, H., chmaltL, ., P 'achter, <. #2454%. /ccountabilit- measures))
using measurement to promote *ualit- improvement. 6ew England Hournal of Medicine,
(D(, D>()D>>. ..................................................................................................................D(
54.1hen, L., $arwell, '., P Hha, /. #244C%. "rimar- care visit duration and *ualit-: does
good care take longer? /rchives of Internal Medicine, 5DC, 5>DD)5>=2. .......................D(
55.7onabedian, /. #5C>>%. The *ualit- of care: how can it be assessed? Hournal of the
/merican Medical /ssociation, 2D4, 5=8()5=8>. ...........................................................D(
52.7onabedian, /. #Ed.%. #2442%. /n Introduction to Gualit- /ssurance in 0ealthcare.
1ambridge, M/: ,!ford +niversit- "ress........................................................................D(
5(.$isher, E., 'ennberg, 7., tukel, T., :ottlieb, 7., Lucas, $., P "inder, E. #244(a%.
The implications of regional variations in Medicare spending. "art 5: the content, *ualit-,
and accessibilit- of care. /nnals of Internal Medicine, 5(>, 2=()2>=. ...........................D(
58.$isher, E., 'ennberg, 7., tukel, T., :ottlieb, 7., Lucas, $., P "inder, E. #244(b%.
The implications of regional variations in Medicare spending. "art 2: health outcomes
and satisfaction with care. /nnals of Internal Medicine, 5(>, 2>>)2C>. .........................D(
59.$owler, $., :allagher, "., /nthon-, 7., Larsen, B., P kinner, H. #244>%. <elationship
between regional per capita Medicare e!penditures and patient perceptions of *ualit- of
care. Hournal of the /merican Medical /ssociation, 2CC, 284D)2852. ...........................D(
5D.:reenfield, ., P Baplan, . #2448%. 1reating a culture of *ualit-: the remarkable
transformation of the 7epartment of 3eterans /ffairs 0ealth 1are -stem. /nnals of
Internal Medicine, 585, (5D)(5>. ....................................................................................D(
5=.0artL, /., Buhn, E., P "ulido, H. #5CCC%. "restige of training programs and e!perience
of b-pass surgeons as factors in adjusted patient mortalit- rates. Medical 1are, (=, C()
54(. .................................................................................................................................D(
5>.0igashi, T., 'enger, 6., /dams, H., $ung, 1., <oland, M., Mc:l-nn, E., . . . hekelle,
". #244=%. <elationship between number of medical conditions and *ualit- of care. 6ew
England Hournal of Medicine, (9D, 28CD)2948. ..............................................................D(
5C.0olmboe, E., 'ang, A., Meehan, T., Tate, H., 0o, ., tarke-, B., P Lipner, <.
#244>%. /ssociation between maintenance of certification e!amination scores and
*ualit- of care for Medicare beneficiaries. /rchives of Internal Medicine, 5D>, 5(CD)
584(. ...............................................................................................................................D8
24.0ong, 1., /tlas, ., 1hang, A., ubramanian, ., /shburner, H., Farr-, M., P :rant,
<. #2454%. <elationship between patient panel characteristics and primar- care
ph-sician clinical performance rankings. Hournal of the /merican Medical /ssociation,
(48, 554=)555(. ..............................................................................................................D8
25.Beroack, M., Aoungberg, F., 1erese, H., Brsek, 1., "rellwitL, L., P Trevel-an, E.
#244=%. ,rganiLational factors associated with high performance in *ualit- and safet- in
academic medical centers. /cademic Medicine, >2, 55=>)55>D. ..................................D8
22.Landon, F., 6ormand, ., Flumenthal, 7., P 7ale-, H. #244(%. "h-sician clinical
performance assessment: prospects and barriers. Hournal of the /merican Medical
/ssociation, 2C4, 55>()55>C. .........................................................................................D8
2(.Lohr, B. #Ed.%. #5CC4%. Medicare: / trateg- for Gualit- /ssurance. 'ashington, 71:
6ational /cademies "ress...............................................................................................D8
28.LTpeL, L., 0icks, L., 1ohen, /., McBean, ., P 'eissman, H. #244C%. 0ospitalists and
the *ualit- of care in hospitals. /rchives of Internal Medicine, 5DC, 5(>C)5(C8. ...........D8
29.Mc:l-nn, E., /sch, ., /dams, H., Beese-, H., 0icks, H., 7e1ristofaro, /., P Berr, E.
#244(%. The *ualit- of healthcare delivered to adults in the +nited tates. 6ew England
Hournal of Medicine, (8>, 2D(9)2D89. ............................................................................D8
2D.6olte, E., P McBee, 1. #244>%. Measuring the health of nations: updating an earlier
anal-sis. 0ealth /ffairs, 2=, 9>)=5. .................................................................................D8
2=.6olte, E., P McBee, 1. #244>%. Measuring the health of nations: updating an earlier
anal-sis. 0ealth /ffairs, 2=, 9>)=5. .................................................................................D8
2>."eterson, E., <oe, M., Mulgund, H., 7eLong, E., L-tle, F., Frindis, <., . . . ,hman, E.
#244D%. /ssociation between hospital process performance and outcomes among
patients with acute coronar- s-ndromes. Hournal of the /merican Medical /ssociation,
2C9, 5C52)5C24. ..............................................................................................................D8
2C.<osenthal, M. #244>%. Fe-ond pa- for performance))emerging models of provider)
pa-ment reform. 6ew England Hournal of Medicine, (9C, 55C=)5244. ..........................D8
(4.<owe, H. #244D%. "a-)for)performance and accountabilit-: related themes in
improving health care. /nnals of Internal Medicine, 589, DC9)DCC. ...............................D8
(5.teinman, M., <osenthal, :., Landefeld, 1., Fertenthal, 7., P Baboli, ". #244C%.
/greement between drugs)to)avoid criteria and e!pert assessments of problematic
prescribing. /rchives of Internal Medicine, 5DC, 5(2D)5((2. .........................................D8
(2.Trivedi, /., Matula, ., Miake)L-e, I., :lassman, "., hekelle, "., P /sch, . #2455%.
-stematic review: comparison of the *ualit- of medical care in 3eterans /ffairs and
non)3eterans /ffairs settings. Medical 1are, 8C, =D)>>. ................................................D8
((.'ang, T., $onarow, :., 0ernandeL, /., Liang, L., Ellrodt, :., 6allamothu, F., . . .
"eterson, E. #244C%. The dissociation between door)to)balloon time improvement and
improvements in other acute m-ocardial infarction care processes and patient
outcomes. /rchives of Internal Medicine, 5DC, 5855)585C. ...........................................D8
(8.'eeks, '., :ottlieb, 7., 6-weide, 7., utherland, H., F-num, H., 1asalino, L., . . .
$isher, E. #2454%. 0igher health care *ualit- and bigger savings found at large
multispecialt- medical groups. 0ealth /ffairs, 2C, CC5)CC=. ..........................................D9
=.5 /dapted from 7onabedian, /. #Ed.%. #2442%. /n Introduction to Gualit- /ssurance in
0ealthcare. 1ambridge, M/: ,!ford +niversit- "ress. ..................................................D9
5./non-mous. #244D%. "erformance Measurement: /ccelerating Improvement.
'ashington, 71: 6ational /cademies "ress. ................................................................D9
2./non-mous. #2455%. 1M hould /ddress Inconsistencies in Its Two Incentive
"rograms That Encourage the +se of 0ealth Information Technolog-. 'ashington, 71:
:overnment /ccountabilit- ,ffice. <etrieved from
http:..www.gao.gov.new.items.d5559C.pdf .....................................................................D9
(.Ferwick, 7. #244>%. The science of improvement. Hournal of the /merican Medical
/ssociation, 2CC, 55>2)55>8. .........................................................................................D9
8.Flumenthal, 7., P Tavenner, M. #2454%. The Jmeaningful useM regulation for electronic
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare 5(
health records. 6ew England Hournal of Medicine, (D(, 945)948. .................................D9
9.7amberg, 1., orbero, M., Lovejo-, ., Lauderdale, B., 'ertheimer, ., mith, /., . . .
chn-er, 1. #2455%. /n Evaluation of the +se of "erformance Measures in 0ealthcare.
anta Monica, 1/: </67 1orp. <etrieved from
http:..www.rand.org.pubs.technical@reports.T<558>.html .............................................D9
D."ronovost, "., P Lilford, <. #2455%. / road map for improving the performance of
performance measures. 0ealth /ffairs, (4, 9DC)9=(. .....................................................D9
5./lschuler, L., Fennett, 1., Ballem, 1., Buhl, H., P Au, $. #244=%. Gualit- <eporting
7ocument /rchitecture #G<7/% Initiative ) "hase I $inal <eport. /nn /rbor, MI: 0ealth
Level even. <etrieved from http:..www.hl=.org.Librar-.1ommittees.pedsdata.G<7/
N24"haseN24IN24"ublicN24<eport.pdf .....................................................................D9
2./shworth, M., Medina, H., P Morgan, M. #244>%. Effect of social deprivation on blood
pressure monitoring and control in England: a surve- of data from the *ualit- and
outcomes framework. Fritish Medical Hournal, ((=, a24(4. ...........................................D9
(./uerbach, /., Landefeld, 1., P hojania, B. #244=%. The tension between needing to
improve care and knowing how to do it. 6ew England Hournal of Medicine, (9=, D4>)
D5(. .................................................................................................................................D9
8.Faker, 7., "ersell, ., Thompson, H., oman, 6., Furgner, B., Liss, 7., P Bmetik, B.
#244=%. /utomated review of electronic health records to assess *ualit- of care for
outpatients with heart failure. /nnals of Internal Medicine, 58D, 2=4)2==. ....................D9
9.Faron, <. #244=%. Gualit- improvement with an electronic health record: achievable,
but not automatic. /nnals of Internal Medicine, 58=, 98C)992. ......................................D9
D.Ferwick, 7. #244C%. Measuring ph-siciansO *ualit- and performance: adrift on Lake
'obegon. Hournal of the /merican Medical /ssociation, (42, 28>9)28>D. ...................DD
=.Fo-d, 1., 7arer, H., Foult, 1., $ried, L., Foult, L., P 'u, /. #2449%. 1linical practice
guidelines and *ualit- of care for older patients with multiple comorbid diseases:
implications for pa- for performance. Hournal of the /merican Medical /ssociation, 2C8,
=5D)=28. ..........................................................................................................................DD
>.Frook, <. #2454%. The end of the *ualit- improvement movement: long live improving
value. Hournal of the /merican Medical /ssociation, (48, 5>(5)5>(2. .........................DD
C.1ampbell, ., <eeves, 7., Bontopantelis, E., ibbald, F., P <oland, M. #244C%. Effects
of pa- for performance on the *ualit- of primar- care in England. 6ew England Hournal
of Medicine, (D5, (D>)(=>. .............................................................................................DD
54.1asalino, L., /le!ander, :., Hin, L., P BonetLka, <. #244=%. :eneral internistsO views
on pa-)for)performance and public reporting of *ualit- scores: a national surve-. 0ealth
/ffairs, 2D, 8C2)8CC..........................................................................................................DD
55.1ebul, <., Love, T., Hain, /., P 0ebert, 1. #2455%. Electronic health records and
*ualit- of diabetes care. 6ew England Hournal of Medicine, (D9, >29)>((. ..................DD
52.1han, B., $owles, H., P 'einer, H. #2454%. Electronic health records and reliabilit-
and validit- of *ualit- measures: a review of the literature. Medical 1are <esearch and
<eview, Epub ahead of print. ..........................................................................................DD
5(.7oran, T., $ullwood, 1., :ravelle, 0., <eeves, 7., Bontopantelis, E., 0iroeh, +., P
<oland, M. #244D%. "a-)for)performance programs in famil- practices in the +nited
Bingdom. 6ew England Hournal of Medicine, (99, (=9)(>8. .........................................DD
58.7oran, T., $ullwood, 1., <eeves, 7., :ravelle, 0., P <oland, M. #244>%. E!clusion of
patients from pa-)for)performance targets b- English ph-sicians. 6ew England Hournal
of Medicine, (9C, 2=8)2>8. .............................................................................................DD
59.$onarow, :., /braham, '., /lbert, 6., tough, '., :heorghiade, M., :reenberg, F.,
Aoung, H. #244=%. /ssociation between performance measures and clinical outcomes for
patients hospitaliLed with heart failure. Hournal of the /merican Medical /ssociation,
2C=, D5)=4. ......................................................................................................................DD
5D.$owles, H., Bind, E., /wwad, ., 'einer, H., P 1han, B. #244>%. "erformance
Measures +sing Electronic 0ealth <ecords: $ive 1ase tudies. 'ashington, 71:
1ommonwealth $und. <etrieved from
http:..www.commonwealthfund.org.publications.publications@show.htm?doc@idED>954(
.........................................................................................................................................DD
5=.$ung, 1., Lim, A., Mattke, ., 7amberg, 1., P hekelle, ". #244>%. -stematic
review: the evidence that publishing patient care performance data improves *ualit- of
care. /nnals of Internal Medicine, 58>, 555)52(. ...........................................................DD
5>.:lickman, ., ,u, $., 7eLong, E., <oe, M., L-tle, F., Mulgund, H., "eterson, E.
#244=%. "a- for performance, *ualit- of care, and outcomes in acute m-ocardial
infarction. Hournal of the /merican Medical /ssociation, 2C=, 2(=()2(>4. ...................DD
5C.0ibbard, H., :reene, H., P 7aniel, 7. #2454%. 'hat is *ualit- an-wa-? "erformance
reports that clearl- communicate to consumers the meaning of *ualit- of care. Medical
1are <esearch and <eview, Epub ahead of print. .........................................................DD
24.Hha, /., P Epstein, /. #244D%. The predictive accurac- of the 6ew Aork tate
coronar- arter- b-pass surger- report)card s-stem. 0ealth /ffairs, 29, >88)>99. .........DD
25.Hha, /., ,rav, E., Li, U., P Epstein, /. #244=%. The inverse relationship between
mortalit- rates and performance in the 0ospital Gualit- /lliance measures. 0ealth
/ffairs, 2D, 5548)5554. ...................................................................................................D=
22.Hha, /., ,rav, E., <idgwa-, /., Uheng, H., P Epstein, /. #244>%. 7oes the Leapfrog
program help identif- high)*ualit- hospitals? Hoint 1ommission Hournal on Gualit- and
"atient afet-, (8, (5>)(29. ...........................................................................................D=
2(.Bell-, /., Thompson, H., Tuttle, 7., Fenesch, 1., P 0ollowa-, <. #244>%. "ublic
reporting of *ualit- data for stroke: is it measuring *ualit-? troke, (C, ((D=)((=5. .....D=
28.BrumholL, 0., P Lee, T. #244>%. <edefining *ualit- )) implications of recent clinical
trials. 6ew England Hournal of Medicine, (9>, 29(=)29(C. ............................................D=
29.Landon, F., P 6ormand, . #244>%. "erformance measurement in the small office
practice: challenges and potential solutions. /nnals of Internal Medicine, 58>, (9()(9=.
.........................................................................................................................................D=
2D.Lee, ., P 'alter, L. #2455%. Gualit- indicators for older adults: preventing
unintended harms. Hournal of the /merican Medical /ssociation, (4D, 58>5)58>2. .....D=
2=.Lindenauer, "., <emus, 7., <oman, ., <othberg, M., Fenjamin, E., Ma, /., P
FratLler, 7. #244=%. "ublic reporting and pa- for performance in hospital *ualit-
improvement. 6ew England Hournal of Medicine, (9D, 8>D)8CD. ...................................D=
2>.Linder, H., Ma, H., Fates, 7., Middleton, F., P tafford, <. #244=%. Electronic health
record use and the *ualit- of ambulator- care in the +nited tates. /rchives of Internal
Medicine, 5D=, 5844)5849. .............................................................................................D=
2C.L-nn, H., Fail-, M., Fottrell, M., Hennings, F., Levine, <., 7avidoff, $., . . . Hames, F.
#244=%. The ethics of using *ualit- improvement methods in health care. /nnals of
Internal Medicine, 58D, DDD)D=(. ....................................................................................D=
(4.Mc7onald, <., 0arrison, ., 1heckland, B., 1ampbell, ., P <oland, M. #244=%.
Impact of financial incentives on clinical autonom- and internal motivation in primar-
care: ethnographic stud-. Fritish Medical Hournal, ((8, 5(9=)5(9C. .............................D=
(5.Mc7onald, <., P <oland, M. #244C%. "a- for performance in primar- care in England
and 1alifornia: comparison of unintended conse*uences. /nnals of $amil- Medicine, =,
525)52=. ..........................................................................................................................D=
(2.Miller, $., P Emanuel, E. #244>%. Gualit-)improvement research and informed
consent. 6ew England Hournal of Medicine, (9>, =D9)=D=. ...........................................D=
((.Milstein, /., P Lee, T. #244=%. 1omparing ph-sicians on efficienc-. 6ew England
Hournal of Medicine, (9=, 2D8C)2D92. ............................................................................D=
(8.Mohan, 3., P 0ersh, '. #2455%. E0<s and health care *ualit-: correlation with out)
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare 5D
of)date, differentl- purposed data does not e*uate with causalit-. /rchives of Internal
Medicine, 5=5, C92)C9(...................................................................................................D=
(9.6-weide, 7., 'eeks, '., :ottlieb, 7., 1asalino, L., P $isher, E. #244C%. <elationship
of primar- care ph-siciansO patient caseload with measurement of *ualit- and cost
performance. Hournal of the /merican Medical /ssociation, (42, 2888)2894. ..............D=
(D.,OFrien, ., 7elong, E., P "eterson, E. #244>%. Impact of case volume on hospital
performance assessment. /rchives of Internal Medicine, 5D>, 52==)52>8. ..................D>
(=.,lsen, L., /isner, 7., P Mc:innis, H. #Eds.%. #244=%. The Learning 0ealthcare -stem
) 'orkshop ummar-. 'ashington, 71: 6ational /cademies "ress.............................D>
(>."akhomov, ., Fjornsen, ., 0anson, "., P mith, . #244>%. Gualit- performance
measurement using the te!t of electronic medical records. Medical 7ecision Making, 2>,
8D2)8=4. ..........................................................................................................................D>
(C."akhomov, ., 0anson, "., Fjornsen, ., P mith, . #244>%. /utomatic classification
of foot e!amination findings using statistical natural language processing and machine
learning. Hournal of the /merican Medical Informatics /ssociation, Epub ahead of print.
.........................................................................................................................................D>
84."atterson, M., 0ernandeL, /., 0ammill, F., $onarow, :., "eterson, E., chulman, B.,
P 1urtis, L. #2454%. "rocess of care performance measures and long)term outcomes in
patients hospitaliLed with heart failure. Medical 1are, 8>, 254)25D. ..............................D>
85."awlson, L., cholle, ., P "owers, /. #244=%. 1omparison of administrative)onl-
versus administrative plus chart review data for reporting 0E7I h-brid measures.
/merican Hournal of Managed 1are, 5(, 99()99>. ........................................................D>
82."ersell, ., 7olan, 6., $riesema, E., Thompson, H., Baiser, 7., P Faker, 7. #2454%.
$re*uenc- of inappropriate medical e!ceptions to *ualit- measures. /nnals of Internal
Medicine, 592, 229)2(5. .................................................................................................D>
8(."ham, 0., chrag, 7., ,OMalle-, /., 'u, F., P Fach, ". #244=%. 1are patterns in
Medicare and their implications for pa- for performance. 6ew England Hournal of
Medicine, (9D, 55(4)55(C. .............................................................................................D>
88."orter, M. #2454%. 'hat is value in health care? 6ew England Hournal of Medicine,
(D(, 28>5)28>(. ..............................................................................................................D>
89."ronovost, "., :oeschel, 1., P 'achter, <. #244>%. The wisdom and justice of not
pa-ing for Vpreventable complicationsV. Hournal of the /merican Medical /ssociation,
2CC, 25C=)25CC. ..............................................................................................................D>
8D.<eeves, :., 'ang, T., <eid, B., /le!ander, B., 7ecker, 1., /hmad, 0., . . . "eterson,
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare 5=
E. #244>%. 7issociation between hospital performance of the smoking cessation
counseling *ualit- metric and cessation outcomes after m-ocardial infarction. /rchives
of Internal Medicine, 5D>, 2555)255=. ............................................................................D>
8=.cholle, ., <oski, H., /dams, H., 7unn, 7., Berr, E., 7ugan, 7., P Hensen, <. #244>%.
Fenchmarking ph-sician performance: reliabilit- of individual and composite measures.
/merican Hournal of Managed 1are, 58, >2C)>(>. ........................................................D>
8>.hih, /., 7avis, B., choenbaum, ., :authier, /., 6uLum, <., P Mc1arth-, 7.
#244>%. ,rganiLing the +.. 0ealth 1are 7eliver- -stem for 0igh "erformance.
'ashington, 71: 1ommonwealth $und. <etrieved from
http:..www.commonwealthfund.org.publications.publications@show.htm?doc@idEDC>5(C
.........................................................................................................................................D>
8C.n-der, L., P 6eubauer, <. #244=%. "a-)for)performance principles that promote
patient)centered care: an ethics manifesto. /nnals of Internal Medicine, 58=, =C2)=C8.
.........................................................................................................................................D>
94.Tu, H., 7onovan, L., Lee, 7., 'ang, H., /ustin, "., /lter, 7., P Bo, 7. #244C%.
Effectiveness of public report cards for improving the *ualit- of cardiac care: the
E$$E1T stud-: a randomiLed trial. Hournal of the /merican Medical /ssociation, (42,
2((4)2((=. ......................................................................................................................D>
95.3onnegut, M. #244=%. Is *ualit- improvement improving *ualit-? / view from the
doctorOs office. 6ew England Hournal of Medicine, (9=, 2D92)2D9(. .............................DC
92.'achter, <., $landers, ., $ee, 1., P "ronovost, ". #244>%. "ublic reporting of
antibiotic timing in patients with pneumonia: lessons from a flawed performance
measure. /nnals of Internal Medicine, 58C, 2C)(2..........................................................DC
9(.'ang, T., $onarow, :., 0ernandeL, /., Liang, L., Ellrodt, :., 6allamothu, F., . . .
"eterson, E. #244C%. The dissociation between door)to)balloon time improvement and
improvements in other acute m-ocardial infarction care processes and patient
outcomes. /rchives of Internal Medicine, 5DC, 5855)585C. ...........................................DC
98.'erner, <., P Fradlow, E. #244D%. <elationship between MedicareOs hospital
compare performance measures and mortalit- rates. Hournal of the /merican Medical
/ssociation, 2CD, 2DC8)2=42. .........................................................................................DC
99.'erner, <., :oldman, L., P 7udle-, <. #244>%. 1omparison of change in *ualit- of
care between safet-)net and non)safet-)net hospitals. Hournal of the /merican Medical
/ssociation, 2CC, 25>4)25>=. .........................................................................................DC
1omponent 2.+nit >.........................................................................................................=4
+nit <eferences...............................................................................................................=4
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare 5>
Lecture >a........................................................................................................................=4
5./merican Foard of Internal Medicine $oundation QInternetR. 1assel 1B. 25st centur-
medical professionalism: renewing the social contract Q5( pagesR. /vailable from:
http:..www.abimfoundation.org.<esource)
1enter.W.media.2N24@454>4C@1assel@professionalism.ash!.......................................=4
2./merican Foard of Internal Medicine $oundation QInternetR. +ndated Qcited 2455 7ec
24R. Medical professionalism in the new millennium: a ph-sician charter Q2 pagesR.
/vailable from:
http:..www.abimfoundation.org."rofessionalism.W.media.$>F=5$597E>F8>D9CC$5(ED
D2D4($297.ash!..............................................................................................................=4
(./ulisio M", /rnold <M. 0elping to address value conflicts or uncertainties: role of the
ethics committee. 1hest. 244>&5(8&85=)828...................................................................=4
8.Ethics <esource 1enter QInternetR. Ethics glossar-. Ma- 2C, 244C Qcited 2455 7ec 5CR.
Ethics glossar- Q9 pagesR. /vailable from: http:..www.ethics.org.resource.ethics)
glossar-. ..........................................................................................................................=4
9.:illon <. Medical ethics: four principles plus attention to scope. FMH.
5CC8&(4C#DC8>%:5>8)5>>.................................................................................................=5
D.:illon <. Ethics needs principles: four can encompass the restXand respect for
autonom- should be Jfirst among e*uals.M H Med Ethics. 244(&2C#9%:(4=)(52...............=5
=.The 0astings 1enter QInternetR. 244= Qcited 2455 7ec 24R. Hennings F, Fail- M/,
Fottrell M, L-nn H, eds. 0ealth 1are Gualit- Improvement: Ethical and <egulator-
Issues Q5>> pagesR. /vailable from:
http:..www.thehastingscenter.org.uploaded$iles."ublications.pecial@<eports.0ealth
N241areN24Gualit-N24Improvement.pdf.....................................................................=5
>.0istor- of Medicine 7ivision, 6ational Librar- of Medicine, 6ational Institutes of 0ealth
QInternetR. +pdated Hune 28, 2454 Qcited 2455 7ec 24R. :reek medicine: the 0ippocratic
oath Q5 pageR. /vailable from: http:..www.nlm.nih.gov.hmd.greek.greek@oath.html.......=5
C.Birk LM. "rofessionalism in medicine: definitions and considerations for teaching.
"roceedings #Fa-l +niv Med 1ent%. 244=&24:5()5D........................................................=5
54.+niversit- of 'ashington chool of Medicine QInternetR. +pdated /pril 55, 244> Qcited
2455 7ec 5CR. Mc1ormick T<. Ethics in medicine: principles of bioethics Q8 pagesR.
/vailable from: http:..depts.washington.edu.bioeth!.tools.princpl.html ..........................=5
55.+niversit- of 'ashington chool of Medicine QInternetR. +pdated 6ovember 5, 2454
Qcited 2455 7ec 5CR. "earlman </. Ethics in medicine: ethics committees and ethics
consultation Q( pagesR. /vailable from:
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare 5C
http:..depts.washington.edu.bioeth!.topics.ethics.html...................................................=5
>.5 $igure: $our basic principles of healthcare #11 FA)61)/ (.4, 2452%..................=5
>.2 Table: 6on)Maleficence #11 FA)61)/ (.4, 2452%...............................................=5
>.( $igure: Ethical dilemma #11 FA)61)/ (.4, 2452%................................................=5
5./asland ,:, $orde <. Impact of feeling responsible for adverse events on doctorsO
personal and professional lives: the importance of being open to criticism from
colleagues. Gual af 0ealth 1are. 2449&58#5%:5()5=.....................................................=5
2./merican Medical /ssociation QInternetR. 2455 Qcited 2455 7ec 25R. /M/ code of
ethics: fre*uentl- asked *uestions Q5 pageR. /vailable from: http:..www.ama)
assn.org.ama.pub.ph-sician)resources.medical)ethics.code)medical)ethics.fre*uentl-)
asked)*uestions.page. ....................................................................................................=5
(./ssociated "ress QInternetR. 7ecember 5C, 2455 Qcited 2455 7ec 22R. "ickler 6.
Hustice reports record false claims recoveries Q5 pageR. /vailable from:
http:..finance.-ahoo.com.news.Hustice)reports)record)false)apf)(DD4229>2C.html?!E4.
.........................................................................................................................................=5
8.Folsin , $aunce T, ,akle- H. "ractical virtue ethics: healthcare whistleblowing and
portable digital technolog-. H Med Ethics. 2449&(5#54%:D52)D5>....................................=5
9.1ouncil on Ethical and Hudicial /ffairs, /merican Medical /ssociation QInternetR. 244D
Qcited 2455 7ec 25R. 1ode of Ethics of the /merican Medical /ssociation QD( pagesR.
/vailable from: https:..catalog.ama)assn.org.ME7I/."roduct1atalog.m55444>4./M/
N241odeN24ofN24Ethics.pdf........................................................................................=2
D.1ouncil on Ethical and Hudicial /ffairs, /merican Medical /ssociation QInternetR.
+pdated 6ovember 244D Qcited 2455 7ec 25R. ,pinion E)9.49, J1onfidentialit-,M
/mendment Q8 pagesR. /vailable from: http:..www.ama)assn.org.resources.doc.code)
medical)ethics.949a.pdf ..................................................................................................=2
=.Ethics <esource 1enter QInternetR. Ma- 2C, 244C Qcited 2455 7ec 25R. Ethics glossar-
Q9 pagesR. /vailable from: http:..www.ethics.org.resource.ethics)glossar-.....................=2
>.$ederation of tate Medical Foards QInternetR. +pdated Ma- 2454 Qcited 7ec 22R.
Essentials of a Modern Medical and ,steopathic "ractice /ct Q(2 pagesR. 52th ed.
/vailable from: http:..www.fsmb.org.pdf.:<",L@essentials.pdf....................................=2
C.$ederation of tate Medical Foards QInternetR. +ndated Qcited 2455 7ec 22R. 'hat is a
state medical board? Q2 pagesR. /vailable from:
http:..www.fsmb.org.pdf.what@is@a@state@medical@board.pdf. ......................................=2
54.:runwald 0', 0oward 7, Mc1abe M, torm 17, <odrigueL M/. Misdiagnosis:
disclosing a colleagueKs error. H ,ncol "ract. H ,ncol "ract. 244>&8#(%:59>)5D4. .........=2
55.0affert- $'. Fe-ond curriculum reform: confronting medicineOs hidden curriculum.
/cad Med. 5CC>&=(#8%:84()84=.......................................................................................=2
52.,ffice of the 'histleblower "rotection "rogram, ,ccupational afet- and 0ealth
/dministration, +.. 7epartment of Labor QInternetR. +pdated 7ecember C, 2455 Qcited
2455 7ec 22R. The whistleblower protection program Q5 pageR. /vailable from:
http:..www.whistleblowers.gov.........................................................................................=2
5(.,hio tate Medical /ssociation QInternetR. +ndated Qcited 2455 7ec 25R.
Investigations b- the tate Medical Foard of ,hio: answers to fre*uentl-)asked
*uestions Q2 pagesR. /vailable from: http:..www.osma.org.files.documents.tools)and)
resources.medical)board)licensing)and)discipline.med)bd)investigation)brochure.pdf. =2
58.<hodes <, train HH. 'histleblowing in academic medicine. H Med Ethics.
2448&(4#5%:(9;(C.............................................................................................................=2
59.+niversit- of 'ashington chool of Medicine QInternetR. +pdated 244> Qcited 2455
7ec 25R. 3incler L/. Ethics in medicine: law and medical ethics Q5 pageR. /vailable from:
http:..depts.washington.edu.bioeth!.topics.law.html. .....................................................=2
5D.'ashington tate Medical /ssociation QInternetR. +pdated ,ctober 2449 Qcited 2455
7ec 25R. "rinciples of Medical Ethics and ,pinions and <eports of the Hudicial 1ouncil
of the 'ashington tate Medical /ssociation Q=5 pagesR. /vailable from:
http:..www.wsma.org.get$ile.cfm?mo@fileIdE9>=. ..........................................................=2
>.8 $igure: tandards of "rofessionalism #11 FA)61)/ (.4, 2452%. .........................=(
>.9 1hart: 0ealthcare fraud #11 FA)61)/ (.4, 2452%. .............................................=(
>.D Table: "rotection of whilstleblowers #11 FA)61)/ (.4, 2452%. ...........................=(
5.1ommittee on Fioethics, /merican /cadem- of "ediatrics. "olic- statement:
ph-sician refusal to provide information or treatment on the basis of claims of
conscience. "ediatrics. 244C&528#D%:5D>C)5DC(.............................................................=(
2.del 1armen M:, Hoffe . Informed consent for medical treatment and research: a
review. ,ncologist. 2449&54#>%:D(D)D85..........................................................................=(
(.Institute of Medicine QInternetR. 244C Qcited 2455 7ec 2=R. 1onflict of Interest in
Medical <esearch, Education, and "ractice Q8(D pagesR. /vailable from:
http:..www.ncbi.nlm.nih.gov.books.6FB22C82................................................................=(
8."ope TM. Legal briefing: conscience clauses and conscientious refusal. H 1lin Ethics.
2454&25#2%:5D()5=D.........................................................................................................=(
9.chneiderman LH, Hecker 6, Honsen /<. Medical futilit-: its meaning and ethical
implications. /nn Intern Med. 5CC4&552:C8C)C98............................................................=(
D.Till-ard /<. Ethics review: Jliving willsM and intensive careXan overview of the
/merican e!perience. 1ritical 1are. 244=&55#8%:25C......................................................=(
=.+niversit- of Minnesota 1enter for Fioethics QInternetR. 2449 Qcited 2455 7ec 2DR. End
of Life 1are: /n Ethical ,verview Q=9 pagesR. /vailable from:
http:..www.ahc.umn.edu.img.assets.2D548.End@of@Life.pdf..........................................=(
>.+niversit- of 'ashington chool of Medicine QInternetR. +pdated /pril 55, 244> Qcited
2455 7ec 2DR. Edwards B/. Ethics in medicine: informed consent Q5 pageR. /vailable
from: http:..depts.washington.edu.bioeth!.topics.consent.html.......................................=(
C.'orld 0ealth ,rganiLation <egional ,ffice for Europe QInternetR. 5CC4 Qcited 2455 7ec
2=R. 'hitehead M. The concepts and principles of e*uit- and health Q(5 pagesR.
/vailable from: http:..wh*libdoc.who.int.euro.)5CC(.E+<@I1"@<"7@858.pdf...............=(
54.'orld 0ealth ,rganiLation <egional ,ffice for Europe QInternetR. 244D Qcited 2455
7ec 2=R. 'hitehead M, 7ahlgren :. 1oncepts and principles for tackling social
ine*uities in health: levelling up, part 5 Q89 pagesR. /vailable from:
http:..www.euro.who.int.@@data.assets.pdf@file.4454.=8=(=.E>C(>(.pdf.......................=(
>.= Table: "ros and 1ons of medical futilit- #11 FA)61)/ (.4, 2452%. ......................=(
>.> Table: "ros and 1ons of advance directives #11 FA)61)/ (.4, 2452%. ...............=(
>.C Table: "rotection of whilstleblowers #11 FA)61)/ (.4, 2452%. ...........................=(
>.C Table: "rimar- and secondar- interests in medical practice #11 FA)61)/ (.4,
2452%. ..............................................................................................................................=(
5./merican 0ealth Information Management /ssociation QInternetR. +ndated Qcited 2455
7ec 2CR. /merican 0ealth Information Management /ssociation 1ode of Ethics Q5
pageR. /vailable from:
http:..librar-.ahima.org.!pedio.groups.public.documents.ahima.bok5@4282==.hcsp?
d7oc6ameEbok5@4282==...............................................................................................=(
2./merican Medical Informatics /ssociation QInternetR. +ndated draft Qcited 2455 7ec
2CR. Fiomedical informatics core competencies Q5 pageR. /vailable from:
http:..www.amia.org.biomedical)informatics)core)competencies. ..................................=8
(.Ethics <esource 1enter QInternetR. 7ecember 2454 Qcited 2455 7ec (4R. Flowing the
whistle on workplace misconduct Q5D pagesR. /vailable from:
http:..www.ethics.org.files.u9.'histleblower'".pdf ......................................................=8
8.0urdle H$, /dams , Frokel H, et al. / code of professional ethical conduct for /MI/.
H /m Med Inform /ssoc. 244=&58#8%:(C5)(C(.................................................................=8
9.Institute of Medicine QInternetR. 244C Qcited 2455 7ec 2CR. 1onflict of Interest in
Medical <esearch, Education, and "ractice Q8(D pagesR. /vailable from:
http:..www.ncbi.nlm.nih.gov.books.6FB22C82................................................................=8
D.Institute of Medicine QInternetR. "republication Qcited 2455 7ec (4R. 0ealth IT and
"atient afet-: Fuilding afer -stems for Fetter 1are Q5C= pagesR. /vailable from:
http:..www.nap.edu.catalog.php?record@idE5(2DC.........................................................=8
=.International Medical Informatics /ssociation QInternetR. +ndated Qcited 2455 7ec 2CR.
The IMI/ 1ode of Ethics for 0ealth Information "rofessionals Q54 pagesR. /vailable
from: http:..www.imia)medinfo.org.new2.pubdocs.Ethics@Eng.pdf. ...............................=8
>.,ffice of the 6ational 1oordinator for 0ealth Information Technolog-, +..
7epartment of 0ealth and 0uman ervices QInternetR. ,ctober 2455 Qcited 2455 7ec
2CR. /bout ,61 Q5 pageR. /vailable from:
http:..healthit.hhs.gov.portal.server.pt.communit-.healthit@hhs@gov@@onc.5244...........=8
C.amuel 0', Uaiane ,<, obse- 7. Towards a definition of health informatics ethics.
In: "roceedings of the $irst /1M International 0ealth Informatics -mposium. 6ew
Aork: /ssociation for 1omputing Machiner-, 2454. /vailable from:
http:..hwsamuel.com.wp)content.uploads.acmihi2454.pdf..............................................=8
>.54 $igure: 1onflicts of interest #11 FA)61)/ (.4, 2452%..........................................=8
>.55 $igure: 7uties to patients #11 FA)61)/ (.4, 2452%. ..........................................=8
........................................................................................................................................=8
1omponent 2.+nit C.........................................................................................................=9
+nit <eferences...............................................................................................................=9
Lecture Ca........................................................................................................................=9
5./1L+. #nd.%. 3ideo depicting a piLLa compan- having access to a customerKs medical
records. http:..www.aclu.org.ordering)piLLa. Last accessed Han 2452.......................=9
2./c*uisti, /., P :ross, <. #244C%. "redicting ocial ecurit- numbers from public data.
"roceedings of the 6ational /cadem- of ciences, 54D, 54C=9)54C>4. .......................=9
(./non-mous. #2449%. 6ational 1onsumer 0ealth "rivac- urve- 2449. ,akland, 1/:
1alifornia 0ealth 1are $oundation. <etrieved from http:..www.chcf.org.topics.view.cfm?
itemI7E559DC8 ...............................................................................................................=9
8./non-mous. #244=%. 7ata "rotection in the European +nion. Frussels, Felgium:
European 1ommission. <etrieved from
http:..ec.europa.eu.justice@home.fsj.privac-.inde!@en.htm ...........................................=9
9./non-mous. #2454c%. The 0ealth Information ecurit- and "rivac- 1ollaboration
#0I"1%. 'ashington, 71: 7epartment of 0ealth and 0uman ervices. <etrieved from
http:..healthit.hhs.gov.portal.server.pt?openE952PmodeE2PcachedEtruePobjI7E5284
.........................................................................................................................................=9
D./non-mous. #2455a%. 0ealth Information Technolog- P "rivac-. "hiladelphia, "/:
/merican 1ollege of "h-sicians. <etrieved from
http:..www.acponline.org.advocac-.where@we@stand.polic-.hit@privac-.pdf .................=D
=./non-mous. #2455b%. econd /nnual Fenchmark tud- on "atient "rivac- and 7ata
ecurit-. Traverse 1it-, MI: "onemon Institute. <etrieved from
http:..www2.ide!pertscorp.com.ponemon)stud-)2455. ..................................................=D
>.1assa, 1., chmidt, F., Bohane, I., P Mandl, B. #244>%. M- sisterOs keeper?: genomic
research and the identifiabilit- of siblings. FM1 Medical :enomics, 5, (2. <etrieved
from http:..www.biomedcentral.com.5=99)>=C8.5.(2 .....................................................=D
C.1ohn, . #244D%. "rivac- and 1onfidentialit- in the 6ationwide 0ealth Information
6etwork. 'ashington, 71: 6ational 1ommittee for 3ital and 0ealth tatistics. <etrieved
from http:..www.ncvhs.hhs.gov.4D4D22lt.htm .................................................................=D
54.1ohn, . #244>%. Individual control of sensitive health information accessible via the
6ationwide.......................................................................................................................=D
55.7etmer, 7. #2454%. /ctivating a full architectural model: improving health through
robust population health records. Hournal of the /merican Medical Informatics
/ssociation, 5=, (D=)(DC. ...............................................................................................=D
52.ElEmam, B., 6eri, E., Honker, E., okolova, M., "e-ton, L., 6eisa, /., P cassa, T.
#2454%. The inadvertent disclosure of personal health information through peer)to)peer
file sharing programs. Hournal of the /merican Medical Informatics /ssociation, 5=, 58>)
59>. .................................................................................................................................=D
5(.:ostin, L., P 0odge, H. #2442%. "ersonal privac- and common goods: a framework
for balancing under the national health information privac- rule. Minnesota Law <eview,
>D, 58(C)58=C. <etrieved from
http:..papers.ssrn.com.sol(.7eliver-.cfm.<6@I7(8D94D@code425548D(4.pdf .........=D
58.0all, M., P chulman, B. #244C%. ,wnership of medical information. Hournal of the
/merican Medical /ssociation, (45, 52>2)52>8. ...........................................................=D
59.0odge, H., :ostin, L., P Hacobson, ". #5CCC%. Legal issues concerning electronic
health information: privac-, *ualit-, and liabilit-. Hournal of the /merican Medical
/ssociation, 2>2, 58DD)58=5. .........................................................................................=D
5D.Bete-ian, /. #2454, /pril 59, 2454%. 7igital "hotocopiers Loaded 'ith ecrets. 1F
6ews. <etrieved from
http:..www.cbsnews.com.stories.2454.48.5C.eveningnews.mainD8528(C.shtml ..........=D
5=.Lee, 1., P :oldfarb, U. #244D, Hune (4, 244D%. tolen 3/ Laptop and 0ard 7rive
<ecovered, 'ashington "ost, p. /45. <etrieved from
http:..www.washingtonpost.com.wp)
d-n.content.article.244D.4D.2C./<244D4D2C44(92.html ...............................................=D
5>.Lumle-, T., P <ice, B. #2454%. "otential for revealing individual)level information in
genome)wide association studies. Hournal of the /merican Medical /ssociation, (4(,
>9C)>D4. ..........................................................................................................................=D
5C.Mc:uire, /., P :ibbs, <. #244D%. 6o longer de)identified. cience, (52, (=4)(=5. . .==
24.Malin, F., P weene-, L. #2449%. 0ow #not% to protect genomic data privac- in a
distributed network: using trail re)identification to evaluate and design anon-mit-
protection s-stems. Hournal of Fiomedical Informatics, (=, 5=C)5C2. ............................==
25."onemon, L., P Bam, <. #2454%. Fenchmark tud- on "atient "rivac- and 7ata
ecurit-. Traverse 1it-, MI: "onemon Institute. <etrieved from
http:..www2.ide!pertscorp.com.ponemonstud- ..............................................................==
22."ritts, H., P 1onnor, B. #244=%. The Implementation of E)consent Mechanismsin
Three 1ountries: 1anada, England, and the 6etherlands. 'ashington, 71: ubstance
/buse and Mental 0ealth ervices /dministration. <etrieved from
http:..ihcrp.georgetown.edu.pdfs.prittse)consent.pdf .....................................................==
2(.<odwin, M. #244C%. The case for public ownership of patient data. Hournal of the
/merican Medical /ssociation, (42, >D)>>. ...................................................................==
28.<ojas)Furke, H. #244D, Hanuar- 2=, 244D%. "rovidence critics push for safer records,
The ,regonian. <etrieved from
http:..www.oregonlive.com.news.oregonian.inde!.ssf?.base.news.55(>((85252(2C94.!
mlPcollE= ........................................................................................................................==
29.<othstein, M., P Talbott, M. #244D%. 1ompelled disclosure of health information:
protecting against the greatest potential threat to privac-. Hournal of the /merican
Medical /ssociation, 2C9, 2>>2)2>>9. ............................................................................==
2D.weene-, L. #5CC=%. :uaranteeing anon-mit- when sharing medical data, the
7atafl- -stem. "roceedings of the 5CC= /MI/ /nnual $all -mposium, 6ashville, T6,
95)99. ..............................................................................................................................==
2=.'right, /., P ittig, 7. #244=a%. Encr-ption characteristics of two +F)based
personal health record devices. Hournal of the /merican Medical Informatics
/ssociation, 58, (C=)(CC. ...............................................................................................==
2>.'right, /., P ittig, 7. #244=b%. ecurit- threat posed b- +F)based personal health
records. /nnals of Internal Medicine, 58D, (58)(59.El Emam, 244=..............................==
C.5 $igure 5 /dapted from weene-, L. #5CC=%. :uaranteeing anon-mit- when
sharing medical data, the 7atafl- -stem. "roceedings of the 5CC= /MI/ /nnual $all
-mposium, 6ashville, T6, 95)99. .................................................................................==
5./llan, /. #2449%. "assword /ging 1an Furden an /lread-)'eak /uthentication
Method. tamford, 1T: :artner. .....................................................................................==
2./non-mous. #5CC=%. $or the <ecord: "rotecting Electronic 0ealth Information.
'ashington, 71: 6ational /cademies "ress. ................................................................==
(./non-mous. #2442%. ecure 0ash ignature tandard. :aithersburg, M7: 6ational
Institute for tandards and Technolog-. <etrieved Han 2452 from
http:..csrc.nist.gov.publications.fips.fips5>4)2.fips5>4)2withchangenotice.pdf ..............==
8./non-mous. #244>b%. Mitigating medical identit- theft. Hournal of /0IM/, =C#=%, D()
DC. <etrieved Han 2452 from
http:..librar-.ahima.org.!pedio.groups.public.documents.ahima.bok5@4(C49>.hcsp?
d7oc6ameEbok5@4(C49> ..............................................................................................==
9.7aemen, H., P <ijmen, 3. #2442%. The 7esign of <ijndael: /E ) The /dvanced
Encr-ption tandard. Ferlin, :erman-: pringer)3erlag. ...............................................=>
D.0erLig, T. #Ed.%. #2454%. Information ecurit- in 0ealthcare ) Managing <isk. 1hicago,
IL: 0ealthcare Information Management -stems ociet-.............................................=>
=."abrai, /. #244>, Hanuar- 2(, 244>%. The ingle ign),n olution. 0P06Os Most
'ired MagaLine. <etrieved Han 2452 from
http:..www.hhnmostwired.com.hhnmostwired@app.jsp.articledispla-.jsp?
dcrpathE006M,T'I<E7./rticle.data.$all244=.4>452(M'@,nline@"abraiPdomainE
006M,T'I<E7 ..........................................................................................................=>
>.<indfleisch, T. #5CC=%. "rivac-, information technolog-, and healthcare.
1ommunications of the /1M, 84#>%, C()544. .................................................................=>
C.<othfeder, H. #5CC2%. "rivac- for ale: 0ow 1omputeriLation 0as Made Ever-oneOs
"rivate Life /n ,pen ecret. 6ew Aork: imon P chuster. .........................................=>
54.'agner, <., /llan, /., P 0eiser, H. #2449%. Eight ecurit- "ractices ,ffer More 3alue
Than "assword /ging. tamford, 1T: :artner. ..............................................................=>
C.2 1hart. $low of information in healthcare #<indfleisch, 5CC=%..................................=>
C.( 1hart. 0ealth information securit- is a trade)off #11 FA)61)/ (.4, 2452%...........=>
5./non-mous. #244=b%. ecurit- 545 for 1overed Entities. Faltimore, M7: 1enters for
Medicare and Medicaid ervices. <etrieved from
http:..www.hhs.gov.ocr.privac-.hipaa.administrative.securit-rule.securit-545.pdf ........=>
2./non-mous. #244Ca%. 244C 0IM /nal-tics <eport: Evaluating 0ITE10Ks Impact on
0ealthcare "rivac- and ecurit-. 1hicago, IL: 0IM /nal-tics. <etrieved from
http:..haprod.himssanal-tics.org.docs.I7@E!perts@55594C.pdf .....................................=>
(./non-mous. #244Cb%. Impact of the /merican <ecover- P <einvestment /ct of 244C
on 0I"// "rivac- P ecurit-. Feaverton, ,<: Fridgefront. <etrieved from
http:..www.hipaar!.net.downloads./<</@0I"//@'hite@"aper.pdf .............................=>
8./rmstrong, 7., Bline)<ogers, E., Hani, ., :oldman, E., $ang, H., Mukherjee, 7., . . .
Eagle, B. #2449%. "otential impact of the 0I"// privac- rule on data collection in a
registr- of patients with acute coronar- s-ndrome. /rchives of Internal Medicine, 5D9,
5529)552C. ......................................................................................................................=>
9./ssociation of /merican "h-sicians and urgeons, Inc. #nd.%. ,ath of 0ippocrates&
7eclaration of :eneva of the 'M/. <etrieved Han 2452 from:
http:..www.aapsonline.org.ethics.oaths.htm. ..................................................................=>
D.Freese, "., P Furman, '. #2449%. <eadabilit- of notice of privac- forms used b- major
health care institutions. Hournal of the /merican Medical /ssociation, 2C(, 59C()59C8.
.........................................................................................................................................=>
=.0ouser, ., 0ouser, 0., P hewchuk, <. #244=%. /ssessing the effects of the 0I"//
privac- rule on release of patient information b- healthcare facilities. "erspectives in
0ealth Information Management, 2(#8%, 5. <etrieved from
http:..www.pubmedcentral.nih.gov.articlerender.fcgi?pubmedidE5>4DD(95 .................=C
>.Bamoie, F., P 0odge, H. #2448%. 0I"//Os implications for public health polic- and
practice: guidance from the 171. "ublic 0ealth <eports, 55C, 25D)25C. ......................=C
C.Le-va, 1., P Le-va, 7. #2455%. 0I"// urvival :uide for "roviders: "rivac- P ecurit-
<ules, Third Edition. Largo, $L: 0ITE10 urvival :uide. ..............................................=C
54.Mc:raw, 7. #244C%. <ethinking the <ole of 1onsent in "rotecting 0ealth Information
"rivac-. 'ashington, 71: 1enter for 7emocrac- P Technolog-. <etrieved from
http:..www.cdt.org.healthprivac-.244C452D1onsent.pdf ................................................=C
55.Mc:raw, 7., 7empse-, H., 0arris, L., P :oldman, H. #244C%. "rivac- as an enabler,
not an impediment: building trust into health information e!change. 0ealth /ffairs, 2>,
85D)82=. ..........................................................................................................................=C
52.6ass, ., Levit, L., P :ostin, L. #Eds.%. #244C%. Fe-ond the 0I"// "rivac- <ule:
Enhancing "rivac-, Improving 0ealth Through <esearch. 'ashington, 71: 6ational
/cademies "ress.............................................................................................................=C
5(.6ess, <. #244=%. Influence of the 0I"// "rivac- <ule on health research. Hournal of
the /merican Medical /ssociation, 2C>, 25D8)25=4. .....................................................=C
5./non-mous. #244=%. ecurit- 545 for 1overed Entities. Faltimore, M7: 1enters for
Medicare and Medicaid ervices. <etrieved Han 2452 from
http:..www.hhs.gov.ocr.privac-.hipaa.administrative.securit-rule.securit-545.pdf. .......=C
2./non-mous. #2454%. :uidance on <isk /nal-sis <e*uirements under the 0I"//
ecurit- <ule. 'ashington, 71: 7epartment of 0ealth and 0uman ervices. <etrieved
Han 2452 from
http:..www.hhs.gov.ocr.privac-.hipaa.administrative.securit-rule.rafinalguidancepdf.pdf.
.........................................................................................................................................=C
1omponent 2.+nit 54.......................................................................................................>4
+nit <eferences...............................................................................................................>4
Lecture 54a......................................................................................................................>4
5./uerbach, /., Landefeld, 1., et al. #244=%. The tension between needing to improve
care and knowing how to do it. 6ew England Hournal of Medicine, (9=: D4>)D5(..........>4
2.7onabedian, /. #5C>>%. The *ualit- of care: how can it be assessed? Hournal of the
/merican Medical /ssociation, 2D4: 5=8()5=8>.............................................................>4
(.Bohn, L., 1orrigan, H., et al., eds. #2444%. To Err Is 0uman: Fuilding a afer 0ealth
-stem. 'ashington, 71. 6ational /cademies "ress....................................................>4
8.BrumholL, 0. and Lee, T. #244>%. <edefining *ualit- )) implications of recent clinical
trials. 6ew England Hournal of Medicine, (9>: 29(=)29(C..............................................>4
9.Leape, L. #2444%. Institute of Medicine medical error figures are not e!aggerated.
Hournal of the /merican Medical /ssociation, 2>8: C9)C=..............................................>4
D.Mc:l-nn, E., /sch, ., et al. #244(%. The *ualit- of 0ealthcare delivered to adults in
the +nited tates. 6ew England Hournal of Medicine, (8>: 2D(9)2D89..........................>4
=.6olte, E. and McBee, 1. #244>%. Measuring the health of nations: updating an earlier
anal-sis. 0ealth /ffairs, 2=: 9>)=5...................................................................................>5
>.chimmel EM. The 0aLards of 0ospitaliLation. /nn Intern Med Hanuar- 5, 5CD8
D4:544)554.......................................................................................................................>5
C.o!, 0. and 'oloshin, . #2444%. 0ow man- deaths are due to medical error? :etting
the number right. Effective 1linical "ractice, D: 2==)2>(.................................................>5
54.The tate of 0ealthcare Gualit-: 244C. 'ashington, 71, 6ational 1ommittee for
Gualit- /ssurance. http:..www.nc*a.org.tabid.>(D.7efault.asp!....................................>5
5.$onarow, :., /braham, '., et al. #244=%. /ssociation between performance measures
and clinical outcomes for patients hospitaliLed with heart failure. Hournal of the
/merican Medical /ssociation, 2C=: D5)=4.....................................................................>5
2.$owles, H., Bind, E., et al. #244>%. "erformance Measures +sing Electronic 0ealth
<ecords: $ive 1ase tudies. 'ashington, 71, 1ommonwealth $und.
http:..www.commonwealthfund.org.publications.publications@show.htm?doc@idED>954(
.........................................................................................................................................>5
(.Institute of Medicine #2444%. VTo Err Is 0uman: Fuilding a afer 0ealth -stem
#2444%V. The 6ational /cademies "ress. http:..books.nap.edu.openbook.php?
isbnE4(4C4D>(=5 ...........................................................................................................>5
8.Hoint 1ommission 7o 6ot +se List at
http:..www.jointcommission.org.assets.5.5>.,fficial@7oN246otN24+se@List@
N24D@54.pdf ...................................................................................................................>5
9.Landon, F., 6ormand, ., et al. #244(%. "h-sician clinical performance assessment:
prospects and barriers. Hournal of the /merican Medical /ssociation, 2C4: 55>()55>C.
.........................................................................................................................................>5
D.Leape LL. Error in Medicine. H/M/. 5CC8&2=2#2(%:5>95)5>9=....................................>5
=.Lindenauer, "., <emus, 7., et al. #244=%. "ublic reporting and pa- for performance in
hospital *ualit- improvement. 6ew England Hournal of Medicine, (9D: 8>D)8CD............>5
>.L-nn, H., Fail-, M., et al. #244=%. The ethics of using *ualit- improvement methods in
healthcare. /nnals of Internal Medicine, 58D: DDD)D=(...................................................>5
C.Measuring hand h-giene monograph from the Hoint 1ommission at
http:..www.jointcommission.org.assets.5.5>.hh@monograph.pdf #would assign onl-
portion of this document for reading%...............................................................................>5
54.+niversal protocol at http:..www.jointcommission.org.assets.5.5>.+"@"oster.pdf ...>5
5.7ohert- 6$, Bing M. #2449%. $rom technical to socio)technical change: tackling the
human and organiLational aspects of s-stems development projects. European Hournal
of Information -stems .58, 5;9......................................................................................>5
2.Mc:l-nn, E., /sch, ., et al. #244(%. The *ualit- of healthcare delivered to adults in
the +nited tates. 6ew England Hournal of Medicine, (8>: 2D(9)2D89..........................>5
(.Miller, T., Frennan, T., et al. #244C%. 0ow can we make more progress in measuring
ph-siciansO performance to improve the value of care? 0ealth /ffairs, 2>: 582C)58(=.. >2
8.ociotechnical s-stems at http:..en.wikipedia.org.wiki.ociotechnical@s-stems ........>2
9.Tang, "., <alston, M., et al. #244=%. 1omparison of methodologies for calculating
*ualit- measures based on administrative data versus clinical data from an electronic
health record s-stem: implications for performance measures. Hournal of the /merican
Medical Informatics /ssociation, 58: 54)59.....................................................................>2
D.Timeline of medicine and medical technolog- at
http:..en.wikipedia.org.wiki.Timeline@of@medicine@and@medical@technolog- ...............>2
=.3onnegut, M. #244=%. Is *ualit- improvement improving *ualit-? / view from the
doctorOs office. 6ew England Hournal of Medicine, (9=: 2D92)2D9(...............................>2
>.'orld 0ealth organiLation 99th 'orld 0ealth /ssembl-. Gualit- of care: patient
safet-. <eport b- the ecretariat, 2442
http:..apps.who.int.gb.archive.pdf@files.'0/99.ea995(.pdf ..........................................>2
1omponent /cron-m :lossar-........................................................................................>(
1reative 1ommons /ttribution)6on1ommercial)hare/like (.4 +nported ....................>9
.............................................................................................................................................
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare (4
Component !"er"ie#
$or individuals not familiar with healthcare, this component addresses job e!pectations
in healthcare settings. It discusses how care is organiLed within a practice setting,
privac- laws, and professional and ethical issues encountered in the workplace.
Component !$%ecti"es
/t the completion of this component, the student will be able to:
5. 7escribe the major t-pes of clinical personnel involved in healthcare, including their
education and training, certification and licensure, and t-pical roles in healthcare.
2. 7escribe the major t-pes of settings in which healthcare occurs including ambulator-
care, acute and emergenc- care, hospital based and critical care, and communit-
health and public health settings.
(. 7escribe the major processes of information gathering, anal-sis, and documentation
used b- clinicians to detect, understand, and prevent or treat diseases.
8. :ive e!amples and e!plain the differences between common forms of care deliver-
including episodic one)on)one care, multidisciplinar- care, interdisciplinar- care,
care of chronic conditions, population based care, disease management, long)term
care, and end of life care.
9. 7escribe the role of communit- health and public health in managing illness
outbreaks, epidemics, and pandemics.
D. +nderstand the basic principles of evidence)based practice, including the application
of the best evidence in clinical decision)making.
=. 7escribe common forms of *ualit- measurement, performance improvement, and
incentive pa-ment schemes meant to influence care deliver-.
>. 7iscuss the role of medical ethics and professional values in care deliver- including
such issues as ethical conflicts, and health disparities.
C. +nderstand the concepts underl-ing the application of privac-, confidentialit-, and
securit- to health care practice and information technolog-, being able to help
individuals and organiLations adhere to the 0I"// "rivac- and ecurit- <ules.
Component &uthors
&ssigne' Institution
,regon 0ealth P cience +niversit-
Team (ea'
3ishnu Mohan, M7
)rimar* Contri$uting &uthors
"aul :orman, M7
Tim 0ickman, M7
+niversit- of Missouri, Bansas 1it-
3ishnu Mohan, M7
'illiam 0ersh, M7
(ecture arration
3oiceover Talent
1onnie Fowman
http:..www.conniebowman.com

Soun' +ngineer
Mike 1ollins, :lenwood ound
Faltimore, M7 . 'ashington, 71
http:..www.glenwoodsound.com
Team Mem$ers
helb- /cteson, MEd
Instructional pecialist
1orke- 7evlin, F$/, "M"
"roject Manager
'illiam 0ersh, M7
"rincipal Investigator
"rofessor and 1hair of the 7epartment of Medical Informatics
6athan kidmore, F/
Instructional 7esign /ssistant
1hris 'eldon, F
'eb pecialist
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare ((
,isclaimer
These materials were prepared under the sponsorship of an agency of the United
States )overnment( Neither the United States )overnment nor any agency thereof, nor
any of their employees, ma*es any warranty, e+press or implied, or assumes any legal
liability or responsibility for the accuracy, completeness, or usefulness of any
information, apparatus, product, or process disclosed, or represents that its use would
not infringe privately owned rights( ,eference herein to any specific commercial
product, process, or service by trade name, trademar*, manufacturer, or otherwise
does not necessarily constitute or imply its endorsement, recommendation, or favoring
by the United States )overnment or any agency thereof( The views and opinions of
authors e+pressed herein do not necessarily state or reflect those of the United States
)overnment or any agency thereof(

-i*ewise, the above also applies to the urriculum Development enters .including
olumbia University, Du*e University, /ohns Hop*ins University, Oregon Health &
Science University, University of "labama at 0irmingham, and their affiliated entities1(
The information contained in the Health !T 2or*force urriculum materials is intended
to be accessible to all( To help ma*e this possible, the materials are provided in a
variety of file formats( Some people may not find the 3lash video and (S23 files
accessible and should instead utili4e the 5ower5oint slides together with the (mp6
audio file and7or 2ord transcript to access the lectures( 3or more information, please
visit the website of the National Training and Dissemination enter at http877www(onc9
ntdc(org or http877www(onc9ntdc(info to set up a profile and view the full accessibility
statement(
Component 2/-nit 1
-nit Title
&n !"er"ie# of the Culture of Healthcare
-nit ,escription
This introductor- unit discusses some of the underl-ing concepts of health, culture, and
how health informatics applications can be used to stud- culture.
-nit !$%ecti"es
F- the end of this unit the student will be able to:
5. 7istinguish between disease and illness. #Lecture a%
2. 7iscuss the relationship between health and the healthcare s-stem.
#Lecture a, b%
(. 7efine OcultureO in the classic sense, as well as in the modern sense of the
term, and what it means for culture to be partial, plural, and relative.
#Lecture a, b%
8. E!plain the concept of Ocultural competenceO. #Lecture a%
9. E!plain the concepts and distinguish between OcultureO, Ocultural safet-O,
and Osafet- cultureO, as applied to organiLations. #Lecture a%
D. Fe aware of the multiple cultures that interact in healthcare deliver-.
#Lecture a, b%
=. 7efine OacculturationO and how it relates to working in healthcare settings.
#Lecture a%
>. Fe able to give e!amples of health informatics applications of the stud- of
culture. #Lecture a, b%
-nit Topics / (ecture Titles
5. 'hat is meant b- Vthe culture of healthcareV
2. Learning more about the culture of healthcare
-nit .eferences
(ecture 1a
5. Fateson, M. 1. #5C>C, 6ovember%. 0ealth as artifact. /ournal of 5rofessional
Nursing, '#D%, (22)(29.
2. ulture 9 #%&& :eSH Descriptor Data. #2455%. <etrieved 7ecember 58, 2455,
from 6ational Librar- of Medicine ) Medical ubject 0eadings website:
http:..www.nlm.nih.gov.cgi.mesh.2455.MF@cgi
(. Bleinman, /., Eisenberg, L., P :ood, F. #5C=>, $ebruar- 5%. 1ulture, Illness, and
1are ) 1linical Lessons from /nthropologic and 1ross)1ultural <esearch. "nnals
of !nternal :edicine, ;;#2%, 295)29>.
8. 2hat !s ultural ompetency< #2449, ,ctober 5C%. <etrieved 6ovember 24,
2455, from +.. 7epartment of 0ealth P 0uman ervices website:
http:..minorit-health.hhs.gov.templates.browse.asp!?lvlE2PlvlI7E55
(ecture 1a Charts/ Ta$les an' 0igures
5.5 1hart: http877www(healthsentinel(com7=oomla7images7stories7graphs7us9deaths9
&>%%9&>?'(=pg. #n.d.%. <etrieved 6ovember 24, 2455, from 0ealth entinel website:
http:..www.healthsentinel.com. +sed with "ermission.
2.2 $igure: 'agner, E. 0. #5CC>%. hronic disease management8 2hat will it ta*e to
improve care for chronic illness< <etrieved from Improving 1hronic Illness 1are
website: http:..www.improvingchroniccare.org.change.model.components.html. +sed
with "ermission.
(ecture 1a Images
lide 55: :orman, ". #"hotographer%. #n.d.%. Q+ntitled images of healthcare
professionalsR, <etreived from author, +sed with "ermission.
(ecture 1$
5. /gar, M. #5CC5%. The biculture in bilingual. Language in ociet-, 24 , pp 5D=)5>2
doi:54.545=.448=84894445D294
2. Feuscart)Uephir, M. 1., "elavo, ., /nceau!, $., Meau!, H., 7egroisse, M., P
7egoulet, ". #2449, /ugust%. Impact of 1",E on doctor;nurse cooperation for
the medication ordering and administration process. !nternational /ournal of
:edical !nformatics, @$#=)>%, D2C)D85. <etrieved from
http:..www.sciencedirect.com.science.article.pii.5(>D949D4944459>
(. Foutin)$oster 1, $oster H1, Bonopasek L. "h-sician, know th-self: The
professional culture of medicine as a framework for teaching cultural
competence. "cad :ed 244>&>(#5%:54D;55.
8. FruLLi, H. $. #244D, $ebruar-%. "erspective: The 'ords 1ount X <adiolog- and
Medical Linguistics. New Angland /ournal of :edicine, 6'$, DD9)DD=.
9. $afchamps 7, Aoung 1A, Tang "1. Modelling work practices: input to the design
of a ph-sicianOs workstation. "roc /nnu -mp 1omput /ppl Med
1are. 5CC5:=>>;=C2.
D. $ors-th, 7. <. #5CCC%.)roup dynamics #(rd ed.%. Felmont, 1/: 'adsworth.
=. $ors-the 7E, Fuchanan F:, ,sheroff H/, Miller </. E!panding the concept of
medical information: an observational stud- of ph-siciansO information
needs. 1omput Fiomed <es.5CC2 /pr&29#2%:5>5;244.
>. 0o, 7., Siao, A., 3aid-a, 3., P 0u, ". #244=%. 1ommunication and ense)Making
in Intensive 1are: /n ,bservation tud- of Multi)7isciplinar- <ounds to 7esign
1omputeriLed upporting Tools. ":!" "nnual Symposium 5roceedings "rchive,
(2C;(((. <etrieved from http:..www.ncbi.nlm.nih.gov.pmc.articles."M12D99C24.
C. Bleinman, /., P Fenson, ". #244D%. /nthropolog- in the clinic: The problem of
cultural competenc- and how to fi! it. 5ublic -ibrary of Science
:edicine, (, 5D=(;5D=D.
54. "atterson, E. ., 1ook, <. I., P <ender, M. L. #2442%. Improving "atient afet- b-
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare (D
Identif-ing ide Effects from Introducing Far 1oding in Medication
/dministration. / "m :ed !nform "ssoc, >, 984)99(.
55. "aul, ./., <edd-, M.1.: +nderstanding together: sensemaking in collaborative
information seeking. In: "roceedings of the 2454 /1M 1onference on 1omputer
upported 1ooperative 'ork, pp. (25;((4. /1M, avannah #2454%
52. aikh, F. T. #n.d.%. Supercourse. <etrieved 6ovember 24, 2455, from
http:..pitt.edu website: http:..pitt.edu.Wsuper5.lecture.lecC(25.445.htm
5(. 3entres, '., Booienga, ., 3uckovic, 6., Marlin, <., 6-gren, "., P tewart, 3.
#244D, March%. "h-sicians, "atients, and the Electronic 0ealth <ecord: /n
Ethnographic /nal-sis. "nnals of 3amily :edicine, $#2%, 528)5(5. <etrieved from
http:..www.annfammed.org.content.8.2.528.short
58. 3uckovic, 6. 0., Lavelle, M., P :orman, ". #2448, eptember%. Eavesdropping
as 6ormative Fehavior in a 1ardiac Intensive 1are +nit. National "ssociation for
Healthcare Buality, '9)5 ) '9)D. <etrieved from www.nah*.org.journal
(ecture 1$ Charts/ Ta$les an' 0igures
5.( Table: :orman, ". #n.d.% $ield tudies to upport 0IT 7esign and Evaluation ;
E!amples. <etrieved from author, +sed with "ermission.
-nit Suggeste' .ea'ings
5. /gar. 1ulture: 1an Aou Take It /n-where? Invited Lecture "resented at the
:evirtL :raduate chool of Education, +niversit- of 1alifornia at anta Farbara.
International Hournal of Gualitative Methods #244>% vol. 9 #2% pp. 5)52.
2. Foutin)$oster et al. 3iewpoint: ph-sician, know th-self: the professional culture of
medicine as a framework for teaching cultural competence. /cademic Medicine
#244>% vol. >( #5% pp. 54D
(. Bleinman et al. 1ulture, illness, and care: clinical lessons from anthropologic and
cross)cultural research. /nnals of Internal Medicine #5C=>% #>>% pp. 295)29>
8. Bleinman and Fenson. /nthropolog- in the clinic: The problem of cultural
competenc- and how to fi! it. "Lo Med #244D% vol. ( #54% pp. e2C8
9. Uhang et al. afet- culture: / concept in chaos. 0uman $actors and Ergonomics
ociet- /nnual Meeting "roceedings #2442% vol. 8D #59% pp. 5848)584>
Stu'ent &pplication &cti"ities
comp2@unit5@discuss.doc
comp2@unit5@discuss@ke-.doc
comp2@unit5@self@assess.doc
comp2@unit5@self@assess@ke-.doc
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare (=
Component 2/-nit 2
-nit Title
Health )rofessionals 1 the )eople in Healthcare
-nit ,escription
This unit discusses the health professionals who deliver healthcare and the training
needed to work in these professions. The following professionals are described in this
unit: ph-sicians, nurses, advanced practice nurses, ph-sician assistants, pharmacists,
therapists, allied health professionals, paramedics, EMTs, dental professionals, mental
health professionals, and social workers.
-nit !$%ecti"es
5. 7efine terms used in healthcare including clinician, patient, disease, and
s-ndrome and in health professionalsK education and training. #Lecture a%
2. 7escribe the education, training, certification, licensure and roles of
ph-sicians including those in primar- care and other specialties. #Lecture
a%
(. 7escribe the education, training, certification, licensure and roles of
nurses, advanced practice nurses, L"6s, M/Ks and Medication /ids. .
#Lecture b%
ph-sician assistants, pharmacists, therapists, allied health professionals.
#Lecture c%
paramedics, EMTs, dental professionals, mental health professionals, and
social workers. #Lecture c%
-nit Topics / (ecture Titles
5. Introduction and "h-sicians
2. 6ursing "rofessionals
(. "h-sician assistants, "harmacists, Therapists, Technicians, "aramedics, 7ental
"rofessionals, Mental 0ealth "rofessionals, 1are 1oordinators
-nit .eferences
(ecture 2a
5. /ccreditation 1ouncil for :raduate Medical Education. #2454%. Number of
accredited programs for the current academic year .#%&%9#%&&1( <etrieved from
http:..www.acgme.org.adspublic.reports.accredited@programs.asp
2. /merican Foard of Medical pecialties. #2454%. How a physician becomes board
certified( <etrieved from
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare (>
http:..www.abms.org.'ho@'e@0elp.1onsumers.process.asp!
(. /merican Medical /ssociation. #2454%. Health professions( <etrieved from
http:..www.ama)assn.org.ama.pub.education)careers.careers)health)care.shtml
8. /merican Medical /ssociation. #2454%.1areers in healthcare <etrieved from
http:..www.ama)assn.org.ama.pub.education)careers.careers)health)
care.director-.shtml
9. /merican Medical /ssociation. #2454%. Health professions associations(
<etrieved from http:..www.ama)assn.org.ama.pub.education)careers.careers)
health)care.health)professions)associations.shtml
D. /merican Medical /ssociation. #2454%. Health professions education accrediting
agencies( <etrieved from http:..www.ama)assn.org.ama.pub.education)
careers.careers)health)care.health)professions)education.shtml
=. /merican Medical /ssociation. #2454%. Health care income ranges( <etrieved
from http:..www.ama)assn.org.ama.pub.education)careers.careers)health)
care.health)care)income.shtml
>. E!plore 0ealth careers. #2454%. 1areer e+plorer( <etrieved from
http:..www.e!plorehealthcareers.org.en.inde!.asp!
C. 0ealth careers in Michgan. #2454%. Health careers videos( <etrieved from
http:..www.michigan.gov.healthcareers.4,5D4=,=)225)(C=82@(C89=))),44.html
54. 0</: Fureau of 0ealth "rofessions. #2454%. National center for health
wor*force analysis8 health wor*force personnel factboo*. <etrieved from
http:..bhpr.hrsa.gov.healthworkforce.reports.factbook.htm
55. Medline "lus. #2454%. Health occupations( <etrieved from
http:..www.nlm.nih.gov.medlineplus.healthoccupations.html
52. Merriam)'ebster Medical 7ictionar-. #2454% #various terminolog- definitions%
<etrieved from http:..www.nlm.nih.gov.medlineplus.mplusdictionar-.html
5(. 6ational Institutes of 0ealth. #2454%. Office of science education lifewor*sC8
e+plore health and medical science careers( <etrieved from
http:..science.education.nih.gov.Life'orks.nsf.feature.inde!.htm
58. 6ational Institutes of 0ealth. #2454%. Office of science education lifewor*sC8
e+plore health and medical science careers(. "lphabetical list( <etrieved from
http:..science.education.nih.gov.Life'orks.nsf.alpha.htm
e+plore health and medical science careers( Aducation reDuirements. <etrieved
from http:..science.education.nih.gov.Life'orks.nsf.education.htm
5D. 6ational Institutes of 0ealth. #2454%. Office of science education lifewor*sC8
e+plore health and medical science careers( Interest area( <etrieved from
http:..science.education.nih.gov.Life'orks.nsf.interestarea.htm
5=. 6ational Institutes of 0ealth. #2454%. Office of science education lifewor*sC8
e+plore health and medical science careers( :edian salary( <etrieved from
http:..science.education.nih.gov.Life'orks.nsf.salar-.htm
2.5 $igure 0ickman, T. #2454% <etrieved from author, +sed with "ermission.
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare (C
(ecture 2$
5. /merican Medical /ssociation. #2454%. Health professions( <etrieved from
(. /merican Medical /ssociation. #2454%. Health professions associations(
8. /merican Medical /ssociation. #2454%. Health professions education accrediting
9. /merican Medical /ssociation. #2454%. Health care income ranges( <etrieved
D. E!plore 0ealth careers. #2454%. 1areer e+plorer( <etrieved from
=. 0ealth careers in Michgan. #2454%. Health careers videos( <etrieved from
>. 0</: Fureau of 0ealth "rofessions. #2454%. National center for health
C. Medline "lus. #2454%. Health occupations( <etrieved from
(ecture 2c
5. /merican Medical /ssociation. #2454%. Health professions( <etrieved from
(. /merican Medical /ssociation. #2454%. Health professions associations(
8. /merican Medical /ssociation. #2454%. Health professions education accrediting
9. /merican Medical /ssociation. #2454%. Health care income ranges( <etrieved
D. E!plore 0ealthcareers. #2454%. 1areer e+plorer( <etrieved from
=. 0ealth careers in Michgan. #2454%. Health careers videos( <etrieved from
>. 0</: Fureau of 0ealth "rofessions. #2454%. National center for health
C. Medline "lus. #2454%. Health occupations( <etrieved from
59. 6ational <egistr- of Emergenc- Medical Technicians. #2454%. National A:S
certification e+aminations( ,etrieved from http877www(nremt(org
-nit Suggeste' .ea'ings
5. /bood . Gualit- improvement initiative in nursing homes: the /6/ acts in an
advisor- role. /m H 6urs QInternetR. 2442 Hun Qcited 2442 /ug 52R&542#D%:Qabout 5
p.R. /vailable from:
http:..www.nursingworld.org./H6.2442.june.'awatch.htm/rticle
2. 1arlson FM. 0uman embr-olog- and developmental biolog-. (rd ed. t. Louis:
Mosb-& 2448.
comp2@unit2@activit-.doc
comp2@unit2@activit-@ke-.doc
Component 2/-nit 3
-nit Title
Healthcare Settings 1 The )laces 2here Care is ,eli"ere'
-nit ,escription
This unit describes healthcare deliver- sites including outpatient care, hospitals, tertiar-
care centers, academic medical centers, the 3/ healthcare s-stem, the militar- health
s-stem, the Indian health service, and non)traditional deliver- sites such as school)
based, communit-)based, and emplo-er)based sites. It also specificall- e!amines the
structure, function and interrelationship between healthcare settings.
-nit !$%ecti"es
5. 7ifferentiate the range of care deliver- organiLations, including primar-
care, specialt- care, tertiar- care, inpatient and outpatient facilities, long)
term care hospitals, and long)term care facilities #Lecture a%
2. /nal-Le the organiLation of healthcare deliver- from the perspective of a
Jcontinuum of care,M such as ambulator- services, in)patient care, long)
term care, and end)of)life care #Lecture a%
(. Evaluate the similarities and differences of communit- hospitals, teaching
hospitals, and communit- health clinics #Lecture a%
8. 7escribe the various departments and services offered b- an outpatient
clinic, communit- hospital, academic medical center, and long)term care
facilit- #Lecture b%
9. E!plain the wa-s in which these departments interact and the services
relate #Lecture b%
D. peculate on the data and information that are created and used b-
people in these departments #Lecture b%
=. 7escribe wa-s in which medical and.or information technolog- has
improved interdepartmental communication and how that has improved
the patient e!perience #Lecture b%
-nit Topics/(ectures
5. <ange of care
2. 1ontinuum of care
(. 7epartments and services
8. Interrelationships
9. Medical data use and impact
-nit .eferences
(ecture 3a
1. /merican 0ospital /ssociate. #2455.% $ast facts on + hospitals. <etrieved from
http://###.aha.org/research/rc/stat3stu'ies/fast3facts.shtml
2. 1enters for Medicare and Medicaid ervices. #2455%. 'hat are long)term care
hospitals? <etrieved from
http://###.me'icare.go"/pu$lications/pu$s/p'f/11345.p'f
3. 7epartment of 0ealth and 0uman ervices, 6ational 1learing 0ouse for Long
Term 1are Information. #2455%. ervices and providers. <etrieved from
http://###.longtermcare.go"/(TC/Main6Site/-n'erstan'ing/Ser"ices/In'e7.
asp7
8. 7epartment of 3eterans /ffairs. #2455% /bout the 30/ #3eterans 0ealth
/dministration%. <etrieved from http:..www.va.gov.health.about30/.asp
8. 7onaldson M, Aord- B7, Lohr B6, 3anselow, Eds& 1ommittee on the $uture of
"rimar- 1are, Institute of Medicine. #5CCD%. "rimar- care: /mericas health in a
new era. 'ashington, 71: 6ational /cadem- "ress. p. (5)(2. <etrieved from:
http://###.nap.e'u/catalog.php9recor'6i':8182.
;. 0ealthcare trateg- :roup. Emplo-er health clinics)threat and opportunit-.
<etrieved from
http://###.healthcarestrateg*group.com/ne#sletters/article.php9
sho#:emplo*er6health6clinics666threat6an'6opportunit*
5. 0ealth <esources and 0ealth /dministration, Fureau of 0ealth "rofessions.
#2455%. 'hat is a health center? <etrieved from
http://$phc.hrsa.go"/a$out/in'e7.html
>. Indian 0ealth ervices, 7epartment of 0ealth and 0uman ervices. #2445%.
Indian 0ealth ervice: / *uick look retrieved from
http:..www.ihs.gov."ublic/ffairs.I0Frochure.GuickLook2455.asp.
<. Hournal of the /merican Medical /ssociation.#2455%. :lossar- of methodologic
terms. <etrieved from http://%ama.ama3
assn.org/site/misc/auinst6term.7html=tertiar*
54. Bane <L. #2455%. $inding the right level of posthospital care: J'e didnKtK realiLe
there was an- other optionM. The Hournal of the /merican Medical /ssociation,
(49#(%, 2>8)2C(.
55. Militar- 0ealth -stem, + 7epartment of 7efense. /bout M0. <etrieved from
http:..www.health.mil./bout@M0.,rganiLations.Inde!.asp!
52. 6ational /ssembl- on chool)Fased 0ealth 1are. #2455% /bout school)based
health. <etrieved from
http:..www.nasbhc.org.site.c.ckLGBb,3LkBDE.b.=92>C(9.k.>8E/./bout@F01s
.htm
13. "alliative 1are /ustralia. 244>. "alliative and End of Life 1are: :lossar- of
terms. <etrieved from
http://###.palliati"ecare.org.au/)ortals/4;/'ocs/pu$lications/)C&
>20?lossar*.p'f
(ecture 3a Charts/ Ta$les@ 0igures
(.5 $igure: 0ickman #2452%. <epresents the range of care deliver- and the referral
patterns between the t-pes of care of deliver- organiLations. #11 FA)61)/ (.4%.
(ecture 3$
1. Longnecker 7E, "atton M, 7ickler <M. #244=%. <oles and responsibilities of 1hief
Medical ,fficers in member organiLations of the /ssociation of the /merican
Medical 1olleges. /cademic Medicine, >2#(%, 29>)2D(. <etrieved Han 2452 from
http://%ournals.l##.com/aca'emicme'icine/0ullte7t/2005/03000/.oles6an'6
.esponsi$ilities6of6Chief6Me'ical.<.asp7.
2. Medicare "a-ment /dvisor- 1ommittee. #2448%. 1hapter =: Information
technolog- in health care. In <eport to the 1ongress: new approaches in
Medicare. <etrieved Han 2452 from: http://###.me'pac.go"/pu$lications
>8Ccongressional6reports>8CAune046ch5.p'f.
3. cribd. #2455%. ,rganiLational structure of a hospital. <etrieved Han 2452 from
http://###.scri$'.com/'oc/20BB410B/!rganiCational3Structure3of3a3
Hospital.
8. hortliffe E0, Farnett :,. #244D% Fiomedical data: their ac*uisition and use In:
hortliffe E0, 1imino HH, eds. Fiomedical 1omputer /pplications in 0ealth 1are
and Fiomedicine. (rd ed. 6ew Aork, 6A: pringer& 244D: p84()88(.
8. +nited 0ospital $und. #244>%. $amil- care giver guide. 0ospital admission: how
to plan and what to e!pect during the sta-. <etrieved Han 2452 from
http://###.ne7tstepincare.org/uploa's/0ile/Hospital6&'missions.p'f.
;. +niversit- of <ochester Medical 1enter. #2455%. trong Memorial 0ospital
organiLational chart. <etrieved Han 2452 from
http://###.urmc.rochester.e'u/strong3
nursing/a$out/'ocuments/ursing!rgChart.p'f.
(ecture 3$ Images
(.2 1hart: E!ample of a healthcare organiLational structure #0ickman 2452, 11 FA)
61)/ (.4%.
comp2@unit(@activit-.doc
comp2@unit(@activit-@ke-.doc
comp2@unit(@discuss.doc
comp2@unit(@discuss@ke-.doc
comp2@unit(@self@assess.doc
comp2@unit(@self@assess@ke-.doc
Component 2/-nit 4
-nit Title
Healthcare )rocesses an' ,ecision MaDing
-nit ,escription
This unit describes the process used b- a clinician to make a diagnosis and determine a
care plan. This includes gathering information from the patient as well as other objective
and subjective sources, managing and organiLing the information, comparing the
information to known states of disease, and developing a care plan for the patient.
-nit !$%ecti"es
5. 7escribe the elements of the Oclassic paradigmO of the clinical process
#Lecture a%.
2. List the t-pes of information used b- clinicians when the- care for patients
#Lecture a%.
(. 7escribe the steps re*uired to manage information during the patient)
clinician interaction #Lecture a, b, c%.
8. List the different information structures or formats used to organiLe clinical
information #Lecture b%.
9. E!plain what is meant b- the Oh-pothetico)deductiveO reasoning process
#Lecture a, b%.
D. E!plain the difference between observations, findings, s-ndromes, and
diseases #Lecture a, b, c%.
=. 7escribe techni*ues or approaches used b- clinicians to reach a
diagnosis #Lecture a, b, c, d, e%.
>. List the major t-pes of factors that clinicians consider when devising a
management plan for a patientOs condition, in addition to the diagnosis and
recommended treatment #Lecture e%.
5. The clinical process ) overview of the classic paradigm
2. :athering data and anal-Ling findings
(. Making a diagnosis
8. 1hoosing therap-
9. 1ommunicating the plan
(ecture 4a
1. Evans, 7/ and "atel, 3. #5C>C% 1ognitive cience in Medicine: Fiomedical
modeling. MIT "ress, 1ambridge, M/ <etrieved from
http://portal.acm.org/citation.cfm9i':858522
2. $riedman, 1". #244C%. / J$undamental theoremM of biomedical informatics.
Hournal of the /merican Medical Informatics . <etrieved from
http://%amia.$m%.com/content/1;/2/1;<.short
(. :orman, "6. #5CC9% Information needs of ph-sicians. Hournal of the /merican
ociet- for Information cience and Technolog-
8. 0unter, BM. 7octorsO #5CC5% stories: The narrative structure of medical
knowledge. "rinceton +niversit- "ress #5CC5%
9. Bassirer, " and Bopelman, I. Learning clinical reasoning. pp. ((2.
D. Tumult-, "hilip /., #nd.% Guotation. J7isease hides its secrets in a casual
parenthesisM
(ecture 4a Charts/ Ta$les/ 0igures
8.5 Table: T-pes of information that clinicians utiliLe when making decisions
8.2 Table: 1omparison of the classic paradigm with the operating room.
8.( Table: 1omparison of the classic paradigm with the operating room and acute
comple! illness.
8.8 Table: 1omparison of the classic paradigm with the operating room, acute comple!
illness and emergenc- dept.
(ecture 4$
5. Elstein et al. #5C>5%& Medical problem)solving. /cademic Medicine.
2. Elstein /, chwartL /. #2442 Mar 2(%& (28 1linical problem solving and
diagnostic decision making: selective review of the cognitive literature. FMH.
#=((C%:=2C)(2.
(. Evans 7/, :add 1. #5C>C%& Managing coherence and conte!t in medical
problem)solving discourse. In: Evans 7/, "atel 3L, eds. 1ognitive science in
medicine: Fiomedical modeling. 1ambridge, M/: MIT "ress& 255)299.
4. :orman, "6. #5CC>%& Information seeking of primar- care ph-sicians: <etrieved
from conceptual models and empirical studies at
http://informationr.net/isic/ISIC1<<B/<B6?orman.p'f.
(ecture 4$ Charts/ Ta$les/ 0igures
8.D Table: 0ierarch- for clinical data . Evans, 7./., and :add, 1..,#5C>C%& Managing
coherence and conte!t in medical problem)solving discourse. In: Evans 7/, "atel 3L,
eds. 1ognitive science in medicine: Fiomedical modeling. 1ambridge, M/: MIT "ress&
255)299.
8.= Table: 7epiction of how the 0ierarch- for 1linical 7ata might work for man with
Edema, or swelling of the ankles
(ecture 4c
5. Folstad 'M. #244=% Introduction to Fa-esian tatistics. 'ile-)Interscience& 2
edition .
2. Elstein /, chwartL /. 1 #2442% linical problem solving and diagnostic decision
making: selective review of the cognitive literature. FMH. (28#=((C%:=2C)(2.
(. Bassirer, " and Bopelman, #5CC5% I. Learning clinical reasoning. pp. ((2.
(ecture 4'
5. :awande., /, #2442%. 1omplications: / -oung surgeonOs notes on an imperfect
science. 0enr- 0olt and 1ompan-, LL1.
2. 'eed, LL. #5CD>%. Medical records that guide and teach. 6ew England Hournal of
Medicine.
3. 'ikipedia #2455% 7ecision anal-sis, retrieved from
http://en.#iDipe'ia.org/#iDi/,ecision6anal*sis.
(ecture 4' Charts/ Ta$les/ 0igures
8.> $igure: The comple! and d-namic processes that are in pla- when a patient care
problem has to be translated into problem management b- the clinician. Mohan, 3.
#2454%
8.C 1hart: 7ecision /nal-sis 1hart. Mills #5CC5%
http://###.nlm.nih.go"/nichsr/hta101/tree18.%pg. <etrieved 6ov. 2454 from the
6ational Librar- of Medicine website http://###.nlm.nih.go".
8.54 Table: Evolving Management "lan. Mohan, 3. #2454%
(ecture 4e
5. 1onan 7o-le /. ilver FlaLe. The Memoirs of herlock 0olmes #5>C(%
2. Evans, 7. /., P :add, 1. . #5C>C%. Managing coherence and conte!t in medical
problem solving discourse. In 7. /. Evans P 3. L. "atel #Eds.%, 1ognitive science
in medicine: Fiomedical modeling #p. 258%. 1ambridge, M/: MIT "ress.
(. $eldman M, 1hristensen H. Fehavioral Medicine: / :uide for 1linical "ractice,
Third Edition. Mc:raw)0ill Medical& ( edition #244=%
8. Le- ". 1ommunicating with patients: Improving communication, satisfaction and
compliance. "s-cholog- and medicine series. 6ew Aork, 6A, +: 1room 0elm.
#5C>>%
(ecture 4e Images
lide (: 1orner, T. 1. #5C49%.
http://commons.wikimedia.org/wiki/File:Sir_William_Osler.jpg. <etrieved
6ovember 2455, from 'ikimedia 1ommons website: http://commons.#iDime'ia.org.
"ublic domain image #"7)+%.
Component 2/-nit 8
-nit Title
+"i'ence3Ease' )ractice
-nit ,escription
This unit describes the application of evidence)based medicine #EFM%. The discussion
begins with the framing of clinical *uestions that can be answered b- appropriate
evidence. It then demonstrates how to find and appl- the best evidence for answering
four major t-pes of clinical *uestions: interventions, diagnosis, harm, and prognosis.
The unit also introduces summariLing of evidence #s-stematic reviews% as well as
clinical practice guidelines and concludes with a discussion of the limitations of EFM.
-nit !$%ecti"es
5. 7efine the ke- tenets of evidence)based medicine #EFM% and its role in
the culture of healthcare #Lecture a, b%
2. 1onstruct answerable clinical *uestions and criticall- appraise evidence
answering them #Lecture b%
(. /ppl- EFM for intervention studies, including the phrasing of answerable
*uestions, finding evidence to answer them, and appl-ing them to given
clinical situations #Lecture c%
8. +nderstand EFM applied to the other ke- clinical *uestions of diagnosis,
harm, and prognosis #Lecture d, e%
9. 7iscuss the benefits and limitations to summariLing evidence #Lecture f%
D. 7escribe how to implement EFM in clinical settings through clinical
practice guidelines and decision anal-sis #Lecture g%
-nit Topics/(ecture
5. 7efinitions and application of #EFM%
2. Interventions
(. 7iagnosis
8. 0arm and prognosis
9. ummariLing evidence
D. "utting evidence into practice
-nit .eferences
(ecture 8a
5. /non-mous. #2445%. 1rossing the Gualit- 1hasm: / 6ew 0ealth -stem for the
25st 1entur-. 'ashington, 71: 6ational /cademies "ress.
2. /non-mous. #244Ca%. $ederal 1oordinating 1ouncil for 1omparative
Effectiveness <esearch ) <eport to the "resident and the 1ongress. 'ashington,
71: 7epartment of 0ealth and 0uman ervices. <etrieved from
http:..www.hhs.gov.recover-.programs.cer.cerannualrpt.pdf
(. /non-mous. #244Cb%. Initial 6ational "riorities for 1omparative Effectiveness
<esearch. 'ashington, 71: Institute of Medicine. <etrieved from
http:..www.iom.edu.<eports.244C.1omparativeEffectiveness<esearch"riorities.a
sp!
8. /non-mous. #244Cc%. Initial 6ational "riorities for 1omparative Effectiveness
<esearch. 'ashington, 71: 6ational /cademies "ress. <etrieved from
http:..www.nap.edu.catalog.php?record@idE52D8>
9. 1ohen, /., tavri, "., P 0ersh, '. #2448%. / categoriLation and anal-sis of the
criticisms of evidence)based medicine. International Hournal of Medical
Informatics, =(, (9)8(.
D. 7escriptions of methodological details and challenges for EFM( .#%%@1( In
:edical are E Supplement # .8=:54%.
=. Eden, H., 'heatle-, F., Mc6eil, F., P o!, 0. #Eds.%. #244>%. Bnowing 'hat
'orks in 0ealth 1are: / <oadmap for the 6ation. 'ashington, 71: 6ational
/cademies "ress.
>. Bida, T. #244D%. 7onKt Felieve Ever-thing Aou Think: The D Fasic Mistakes 'e
Make in Thinking. /mherst, 6A: "rometheus Fooks.
C. Luce, F., Bramer, H., :oodman, ., 1onnor, H., Tunis, ., 'hicher, 7., P
chwartL, H. #244C%. <ethinking randomiLed clinical trials for comparative
effectiveness research: the need for transformational change. /nnals of Internal
Medicine, 595, 24D)24C.
54. 'ashington, /., P Lipstein, . #2455%. The "atient)1entered ,utcomes <esearch
Institute X promoting better information, decisions, and health. 6ew England
Hournal of Medicine, (D9, e(5. <etrieved from
http:..www.nejm.org.doi.full.54.549D.6EHMp554C84=
(ecture 8$
1. entre for Avidence 0ased :edicine 9 Homepage. #n.d.%. <etrieved 7ecember
58, 2455, from 1entre for Evidence Fased Medicine website:
http://###.ce$m.net/
2. entre for Avidence90ased :edicine, Toronto 9 Homepage. #n.d.%. <etrieved
7ecember 58, 2455, from BT 1learninghouse website:
http://Dtclearinghouse.ca/ce$m/
3. entre for Health Avidence 9 Homepage. #n.d.%. <etrieved 7ecember 58, 2455,
from 1entre for 0ealth Evidence website: http://###.cche.net/
8. 1lanc-, 1., P Eisenberg, H. #5CC>%. ,utcomes research: measuring the end
results of health care. cience, 2>2, 289)28D.
9. 7i1enso, /., Fa-le-, L., P 0a-nes, <. #244C%. /1" Hournal 1lub. Editorial:
/ccessing preappraised evidence: fine)tuning the 9 model into a D model.
/nnals of Internal Medicine, 595#D%, H1()2, H1()(.
;. Avidence 0ased :edicine. #244C, 6ovember 55%. <etrieved 7ecember 58, 2455,
from 6etting the Evidence ) Flog website:
http://###.nettingthee"i'ence.org.uD/
=. :u-att, :., <ennie, 7., Meade, M., P 1ook, 7. #244>a%. +sersO :uides to the
Medical Literature: / Manual for Evidence)Fased 1linical "ractice. 6ew Aork,
6A: Mc:raw)0ill.
>. :u-att, :., <ennie, 7., Meade, M., P 1ook, 7. #244>b%. +sersO :uides to the
Medical Literature: Essentials of Evidence)Fased 1linical "ractice. 6ew Aork,
6A: Mc:raw)0ill.
C. 0a-nes, <. #5CCC%. 1an it work? 7oes it work? Is it worth it? Fritish Medical
Hournal, (5C, D92)D9(.
54. 0a-nes, <. #2445%. ,f studies, s-ntheses, s-nopses, and s-stems: the V8V
evolution of services for finding current best evidence. /1" Hournal 1lub, 5(8,
/55)/5(.
55. 0a-nes, <. #244D%. ,f studies, s-ntheses, s-nopses, summaries, and s-stems:
the V9V evolution of information services for evidence)based healthcare
decisions. Evidence)Fased Medicine, 55, 5D2)5D8.
52. 0ersh, '. #5CCC%. V/ world of knowledge at -our fingertipsV: the promise, realit-,
and future directions of on)line information retrieval. /cademic Medicine, =8, 284)
28(.
5(. Mulrow, 1., 1ook, 7., P 7avidoff, $. #5CC=%. -stematic reviews: critical links in
the great chain of evidence. /nnals of Internal Medicine, 52D, (>C)(C5.
14. 5ub:ed Health Homepage. #n.d.%. <etrieved 7ecember 58, 2455, from +
6ational Librar- of Medicine website:
http://###.nc$i.nlm.nih.go"/pu$me'health/
18. 5ub:ed Homepage. #n.d.%. <etrieved 7ecember 58, 2455, from 6ational
Institutes of 0ealth ) + 6ational Librar- of Medicine website:
http://###.nc$i.nlm.nih.go"/pu$me'/
5D. lawson, 7., P haughness-, /. #2449%. Teaching evidence)based medicine:
should we be teaching information management instead? /cademic Medicine,
>4, D>9)D>C.
5=. traus, ., <ichardson, '., :lasLiou, "., P 0a-nes, <. #2449%. Evidence Fased
Medicine: 0ow to "ractice and Teach EFM, Third Edition. 6ew Aork, 6A:
1hurchill Livingstone.
(ecture 8$ Charts/ Ta$les an' 0igures
9.5 $igure: /dapted from Mulrow, 5CC=% Mulrow, 1., 1ook, 7., P 7avidoff, $. #5CC=%.
-stematic reviews: critical links in the great chain of evidence. /nnals of Internal
Medicine, 52D, (>C)(C5.
9.2 $igure: /dapted from 0a-neKs J8M model of the 0ierarch- of Evidence: 0a-nes, <.
#2445%. ,f studies, s-ntheses, s-nopses, and s-stems: the V8V evolution of services for
finding current best evidence. /1" Hournal 1lub, 5(8, /55)/5(.
9.( $igure: /dapted from 0a-neKs J8M model of the 0ierarch- of Evidence with t-pes
and sources of evidence: 0a-nes, <. #2445% ,f studies, s-ntheses, s-nopses, and
s-stems: the V8V evolution of services for finding current best evidence. /1" Hournal
1lub, 5(8, /55)/5(.
(ecture 8c
5. /non-mous. #5C8>%. treptom-cin treatment of pulmonar- tuberculosis. Fritish
Medical Hournal, (4, =DC)=>2.
2. /non-mous. #2442%. <isks and benefits of estrogen plus progestin in health-
postmenopausal women ) principal results from the 'omenOs 0ealth Initiative
randomiLed controlled trial. Hournal of the /merican Medical /ssociation, 2>>,
(25)(((.
(. Fenson, B., P 0artL, /. #2444%. / comparison of observational studies and
randomiLed, controlled trials. 6ew England Hournal of Medicine, (82, 5>=>)5>>D.
8. 7ouglas, <., 1halker, E., P Treac-, F. #2444%. 3itamin 1 for preventing and
treating the common cold. 1ochrane 7atabase of -stematic <eviews, 2,
17444C>4.
9. Epstein, /., 0allstrom, /., <ogers, '., Liebson, "., eals, /., /nderson, H., . . .
'-se, 7. #5CC(%. Mortalit- following ventricular arrh-thmia suppression b-
encainide, flecainide, and moriciLine after m-ocardial infarction. The original
design concept of the 1ardiac /rrh-thmia uppression Trial #1/T%. Hournal of
the /merican Medical /ssociation, 2=4, 2895)2899.
D. $ukase, B., Bato, M., Bikuchi, ., Inoue, B., +emura, 6., ,kamoto, ., . . . /saka,
M. #244>%. Effect of eradication of 0elicobacter p-lori on incidence of
metachronous gastric carcinoma after endoscopic resection of earl- gastric
cancer: an open)label, randomised controlled trial. Lancet, (=2, (C2)(C=.
=. 0umphre-, L., 1han, F., P o!, 0. #2442%. "ostmenopausal hormone
replacement therap- and the primar- prevention of cardiovascular disease.
/nnals of Internal Medicine, 5(=, 2=()2>8.
>. Ioannidis, H. #2449%. 1ontradicted and initiall- stronger effects in highl- cited
clinical research. Hournal of the /merican Medical /ssociation, 2C8, 25>)22>.
C. Lindemann, M. #5CCC%. Medicine and ociet- in Earl- Modern Europe.
1ambridge, England: 1ambridge +niversit- "ress.
54. Lowe, H. #2442%. Estrogen plus progestin increased coronar- heart disease and
breast cancer events in postmenopausal women. /1" Hournal 1lub, 5(=, 85.
55. Moher, 7., "ham, F., Hones, /., 1ook, 7., Hadad, /., Moher, M., . . . Blassen, T.
#5CC>%. 7oes *ualit- of reports of randomised trials affect estimates of
intervention efficac- reported in meta)anal-ses? Lancet, (92, D4C)D5(.
52. oares, 0., Bumar, /., 7aniels, ., wann, ., 1antor, /., 0oLo, I., . . .
7julbegovic, F. #2449%. Evaluation of new treatments in radiation oncolog-: are
the- better than standard treatments? Hournal of the /merican Medical
/ssociation, 2C(, C=4)C=>.
(ecture 8'
5. 1hou, <., 1roswell, H., 7ana, T., Fougatsos, 1., FlaLina, I., $u, <., . . . Lin, B.
#2455%. creening for prostate cancer: a review of the evidence for the +..
"reventive ervices Task $orce. /nnals of Internal Medicine, Epub ahead of
print.
2. $olsom, /., 1hambless, L., Fallant-ne, 1., 1oresh, H., 0eiss, :., 'u, B., . . .
harrett, /. #244D%. /n assessment of incremental coronar- risk prediction using
1)reactive protein and other novel risk markers: the atherosclerosis risk in
communities stud-. /rchives of Internal Medicine, 5DD, 5(D>)5(=(.
(. :u-att, :., <ennie, 7., Meade, M., P 1ook, 7. #244>%. +sersO :uides to the
6A: Mc:raw)0ill.
8. 0arris, :. #2455, ,ctober D, 2455%. +.. "anel a-s 6o to "rostate creening for
0ealth- Men, 6ew Aork Times. <etrieved from
http:..www.n-times.com.2455.54.4=.health.4=prostate.html
9. Bolata, :. #244C, 6ovember 22, 244C%. Fehind 1ancer :uidelines, Guest for
7ata, 6ew Aork Times. <etrieved from
http:..www.n-times.com.244C.55.2(.health.2(cancer.html
D. Lafata, H., impkins, H., Lamerato, L., "oisson, L., 7ivine, :., P Hohnson, 1.
#2448%. The economic impact of false)positive cancer screens. 1ancer,
Epidemiolog-, Fiomarkers, P "revention, 5(, 252D)25(2.
=. 6elson, 0., T-ne, B., 6aik, /., Fougatsos, 1., 1han, F., P 0umphre-, L. #244C%.
creening for breast cancer: an update for the +.. "reventive ervices Task
$orce. /nnals of Internal Medicine, 595, =2=)=(=.
>. chwartL, L., 'oloshin, ., $owler, $., P 'elch, 0. #2448%. Enthusiasm for
cancer screening in the +nited tates. Hournal of the /merican Medical
/ssociation, 2C5, =5)=>.
C. 'ells, "., /nderson, 7., <odger, M., :insberg, H., Bearon, 1., :ent, M., . . .
0irsh, H. #2444%. 7erivation of a simple clinical model to categoriLe patients
probabilit- of pulmonar- embolism: increasing the models utilit- with the
impli<E7 7)dimer. Thrombosis and 0aemostasis, >(, 85D)824.
54. 'ells, "., ,wen, 1., 7oucette, ., $ergusson, 7., P Tran, 0. #244D%. 7oes this
patient have deep vein thrombosis? Hournal of the /merican Medical
/ssociation, 2C9, 5CC)24=.
(ecture 8' Charts/ Ta$les an' 0igures
9.8 $igure: adapted from :u-att, :., <ennie, 7., Meade, M., P 1ook, 7. #244>%. +sersO
:uides to the Medical Literature: Essentials of Evidence)Fased 1linical "ractice. 6ew
Aork, 6A: Mc:raw)0ill.
(ecture 8e
5. :abriel, ., ,O$allon, '., Burland, L., Feard, 1., 'oods, H., P Melton, L. #5CC8%.
<isk of connective)tissue diseases and other disorders after breast implantation.
New Angland /ournal of :edicine, 66%, 5DC=)5=42.
2. :ardin, H., chumacher, 7., 1onstantine, :., 7avis, B., Leung, 1., P <eid, 1.
#2444%. 3alvular abnormalities and cardiovascular status following e!posure to
de!fenfluramine or phentermine.fenfluramine. /ournal of the "merican :edical
"ssociation, #;6, 5=4()5=4C.
(. Hohansson, H., /ndren, ,., /ndersson, ., 7ickman, "., 0olmberg, L.,
Magnuson, /., P /dami, 0. #2448%. 6atural histor- of earl-, localiLed prostate
cancer. /ournal of the "merican :edical "ssociation, #>&, 2=5()2=5C.
8. MacMahon, F., Aen, ., Trichopoulos, 7., 'arren, B., P 6ardi, :. #5C>5%. 1offee
and cancer of the pancreas. New Angland /ournal of :edicine, 6%$, D(4)D((.
9. Magee, L., MaLLotta, "., P Boren, :. #2442%. Evidence)based view of safet- and
effectiveness of pharmacologic therap- for nausea and vomiting of pregnanc-
#63"%. "merican /ournal of Obstetrics and )ynecology, &;?, 29D)2D5.
D. Marlow, 6., 'olke, 7., P Fracewell, M. #2449%. 6eurologic and developmental
disabilit- at si! -ears of age after e!tremel- preterm birth. New Angland /ournal
of :edicine, 6'#, C)5C.
=. wan, . #2444%. Intrauterine e!posure to dieth-lstilbestrol: long)term effects in
humans. "cta 5athologica, :icrobiologica et !mmunologica Scandinavica, &%;,
=C()>48.
>. Uheng, '., McLaughlin, H., :ridle-, :., Fjelke, E., chuman, L., ilverman, 7., . .
. $raumeni, H. #5CC(%. / cohort stud- of smoking, alcohol consumption, and
dietar- factors for pancreatic cancer #+nited tates%. ancer auses & ontrol8
, $, 8==)8>2.
(ecture 8e Charts/ Ta$les an' 0igures
9.9 1hart: urvival 1urve, /dapted from 7unn, . #2442%. urvival 1urves: The Fasics:
1ancer:uide.
(ecture 8f
5. /non-mous. #244C%. Effects of a pol-pill #"ol-cap% on risk factors in middle)aged
individuals without cardiovascular disease #TI"%: a phase II, double)blind,
randomised trial. Lancet, (=(, 5(85)5(95.
2. 7ickersin, B. #5CC=%. 0ow important is publication bias? / s-nthesis of available
data. /I7 Education and "revention, C, 59)25.
(. $einstein, /. #5CC9%. Meta)anal-sis: statistical alchem- for the 25st centur-.
Hournal of 1linical Epidemiolog-, 8>, =5)=C.
8. $ranco, ,., Fonneu!, L., deLaet, 1., "eeters, /., te-erberg, E., P Mackenbach,
H. #2448%. The pol-meal: a more natural, safer, and probabl- tastier #than the
pol-pill% strateg- to reduce cardiovascular disease b- more than =9N. Fritish
Medical Hournal, (2C, 558=)5594.
9. :u-att, :., <ennie, 7., Meade, M., P 1ook, 7. #244>%. +sersO :uides to the
Medical Literature: / Manual for Evidence)Fased 1linical "ractice. 6ew Aork,
6A: Mc:raw)0ill.
D. 0a-nes, <. #2445%. ,f studies, s-ntheses, s-nopses, and s-stems: the V8V
evolution of services for finding current best evidence. "5 /ournal lub, &6$,
/55)/5(.
=. 0elfand, M., Morton, ., :uallar, E., P Mulrow, 1. #2449%. 1hallenges of
ummariLing Fetter Information for Fetter 0ealth: The Evidence)based "ractice
1enter E!perience. /nnals of Internal Medicine, 582#52 ) "art 2%.
B. 0ersh, '., 0elfand, M., 'allace, H., Braemer, 7., "atterson, "., hapiro, ., P
:reenlick, M. #2445%. 1linical outcomes resulting from telemedicine interventions:
a s-stematic review. FM1 Medical Informatics and 7ecision Making, 5, 9.
<etrieved from http://###.$iome'central.com/14523;<45/1/8
C. 0ersh, '., 0elfand, M., 'allace, H., Braemer, 7., "atterson, "., hapiro, ., P
:reenlick, M. #2442%. / s-stematic review of the efficac- of telemedicine for
making diagnostic and management decisions. Hournal of Telemedicine and
Telecare, >, 5C=)24C.
54. 0ersh, '., 0ickam, 7., everance, ., 7ana, T., Brages, B., P 0elfand, M.
#244D%. 7iagnosis, access, and outcomes: update of a s-stematic review on
telemedicine services. Hournal of Telemedicine P Telecare, 52#upp 2%, ()(5.
55. 0opa-ian, B. #2445%. The need for caution in interpreting high *ualit- s-stematic
reviews. Fritish Medical Hournal, (2(, D>5)D>8.
52. Law, M., 'ald, 6., Morris, H., P Hordan, <. #244(%. 3alue of low dose combination
treatment with blood pressure lowering drugs: anal-sis of (98 randomised trials.
Fritish Medical Hournal, (2D, 582=)58(5.
5(. Law, M., 'ald, 6., P <udnicka, /. #244(%. Guantif-ing effect of statins on low
densit- lipoprotein cholesterol, ischaemic heart disease, and stroke: s-stematic
review and meta)anal-sis. Fritish Medical Hournal, (2D, 582()582=.
58. Levin, /. #2445%. The 1ochrane 1ollaboration. /nnals of Internal Medicine, 5(9,
(4C)(52.
59. "o-nard, T., Munteanu, M., <atLiu, 3., Fenhamou, A., Martino, 3. 7., Taieb, H., P
,polon, ". #2442%. Truth survival in clinical research: an evidence)based
re*uiem? /nnals of Internal Medicine, 5(D, >>>)>C9.
5D. 'ald, 7., Law, M., P Morris, H. #2442%. 0omoc-steine and cardiovascular
disease: evidence on causalit- from a meta)anal-sis. Fritish Medical Hournal,
(29, 5242)524D.
5=. 'ald, 6., P Law, M. #244(%. / strateg- to reduce cardiovascular disease b- more
than >4N. Fritish Medical Hournal, (2D, 585C)582(.
(ecture 8g
5. Fo-d, 1., 7arer, H., Foult, 1., $ried, L., Foult, L., P 'u, /. #2449%. 1linical
practice guidelines and *ualit- of care for older patients with multiple comorbid
diseases: implications for pa- for performance. Hournal of the /merican Medical
/ssociation, 2C8, =5D)=28.
2. 1abana, M., <and, 1., "owe, 6., 'u, /., 'ilson, M., /bboud, "., P <ubin, 0.
#5CCC%. 'h- donOt ph-sicians follow clinical practice guidelines? / framework for
improvement. Hournal of the /merican Medical /ssociation, 2>2, 589>)58D9.
(. 1houdhr-, 6., telfo!, 0., P 7etsk-, /. #2442%. <elationships between authors of
clinical practice guidelines and the pharmaceutical industr-. Hournal of the
/merican Medical /ssociation, 2>=, D52)D5=.
8. 7iamond, :., P Baul, . #244>%. The disconnect between practice guidelines and
clinical practice ) stressed out. Hournal of the /merican Medical /ssociation, (44,
5>5=)5>5C.
9. :abba-, H., P leMa-, /. #2448%. Evidence based guidelines or collectivel-
constructed Vmindlines?V Ethnographic stud- of knowledge management in
primar- care. Fritish Medical Hournal, (2C, 545(.
D. :u-att, :., <ennie, 7., Meade, M., P 1ook, 7. #244>%. +sersO :uides to the
6A: Mc:raw)0ill.
=. 0ibble, /., Banka, 7., "enchion, 7., P "ooles, $. #5CC>%. :uidelines in general
practice: the new Tower of Fabel? Fritish Medical Hournal, (5=, >D2)>D(.
>. Lin, :., 7udle-, <., Lucas, $., Malenka, 7., 3ittinghoff, E., P <edberg, <. #244>%.
$re*uenc- of stress testing to document ischemia prior to elective percutaneous
coronar- intervention. Hournal of the /merican Medical /ssociation, (44, 5=D9)
5==(.
C. Maviglia, ., Uielstorff, <., "aterno, M., Teich, H., Fates, 7., P Buperman, :.
#244(%. /utomating comple! guidelines for chronic disease: lessons learned.
Hournal of the /merican Medical Informatics /ssociation, 54, 598)5D9.
54. ,hno)Machado, L., :ennari, H., Murph-, ., Hain, 6., Tu, ., ,liver, 7., Farnett,
:. #5CC>%. The :uideLine Interchange $ormat: a model for representing
guidelines. Hournal of the /merican Medical Informatics /ssociation, 9, (9=)(=2.
(ecture 8g Charts/ Ta$les an' 0igures
9.D 1hart: E!ample guideline algorithm for the flu shot #0ersh, 2454%
9.= 1hart: 7ecision anal-sis for anticoagulation in atrial fibrillation ; adapted from
#:-att, 244>%
Component 2/-nit ;
-nit Title
ursing Care )rocesses
-nit ,escription
This unit describes the processes used b- a nurse in making clinical decisions and
assessing patients. It also describes how nurses are trained, where the- work and the
procedures that the- perform.
-nit !$%ecti"es
5. Learn what nurses do and how the- are trained #Lecture a%
2. Learn how nurses make clinical decisions and assess patients #Lecture b%
(. Learn about the settings where nurses work #Lecture a, c%
8. Learn about the procedures that nurses perform #Lecture c%
5. 6ursing roles, responsibilities and work settings
2. 6ursing process including clinical judgement and patient assessment& legal and
societal e!pectations& roles in improving patient care
(. 6ursing routines and procedures including invasive procedures, administering
medication, documenting procedures and technolog-
-nit .eferences
(ecture ;a
1. /merican /cadem- of 6urse "ractitioners QInternetR. 244= Qcited 2455 7ec 5R.
$re*uentl- /sked Guestions: 'h- 1hoose a 6urse "ractitioner as -our
0ealthcare "rovider? Q( pagesR. /vailable from:
http://###.npfin'er.com/faF.p'f.
2. /merican Medical Informatics /ssociation QInternetR. +ndated Qcited 2455 7ec 9R:
6ursing Informatics Q5 pageR. /vailable from:
http://###.amia.org/programs/#orDing3groups/nursing3informatics.
3. /merican 6urses /ssociation QInternetR. 2455 Qcited 2455 7ec 9R. 0ow to
Fecome a 6urse Q5 pageR. /vailable from:
http://nursing#orl'.org/+speciall*0orGou/2hat3is3ursing/Tools3Gou3
ee'/.egistere'urse(icensing.html.
4. /merican 6urses /ssociation QInternetR. 2455 Qcited 2455 7ec 5R. 'hat 6urses
7o Q5 pageR. /vailable from:
http://###.nursing#orl'.org/+speciall*0orGou/2hat3is3ursing/Tools3Gou3
ee'/.s&)s.html.
8. /merican 6urses /ssociation, 1enter for 1ontinuing Education and "rofessional
7evelopment QInternetR. 2455 Qcited 2455 7ec DR: Frowse 1E: ubject Q2 pagesR.
/vailable from: http://ananursece.healthstream.com/)ages/Categor*.asp79
categor*:Su$%ectHcat:&&Hor'er$*:,ispla*ameH'ir:&SC.
;. /merican 6urses 1redentialing 1enter QInternetR. 2455 Qcited 2455 7ec DR: /611
1ertification 1enter Q2 pagesR. /vailable from:
http://###.nursecre'entialing.org/Certification.asp7=specialt*.
5. Fureau of Labor tatistics, +.. 7epartment of Labor QInternetR. +pdated 244C
7ec 5= Qcited 2455 7ec 5R. ,ccupational ,utlook 0andbook, 2454)55 Edition:
Licensed "ractical and Licensed 3ocational 6urses Q( pagesR. /vailable from:
http://###.$ls.go"/oco/ocos102.htm.
B. Fureau of Labor tatistics, +.. 7epartment of Labor QInternetR. +pdated 244C
7ec 5= Qcited 2455 7ec 5R. ,ccupational ,utlook 0andbook, 2454)55:
<egistered 6urses QD pagesR. /vailable from:
http://###.$ls.go"/oco/ocos0B3.htm.
(ecture ;$
1. /merican 6urses /ssociation QInternetR. 2455 Qcited 2455 7ec >R. The 6ursing
"rocess: / 1ommon Thread /mongst /ll 6urses Q5 pageR. /vailable from:
http://ana.nursing#orl'.org/+speciall*0orGou/Stu'enturses/Thenursingpr
ocess.asp7.
2. 1ape $ear 1ommunit- 1ollege QInternetR. +ndated Qcited 2455 7ec >R. Module 9:
6ursing "rocess Q(8 pagesR. /vailable from:
http://cfcc.e'u/pn/'ocuments/Mo'ule8.p'f.
3. The 1enter for 1ritical Thinking and Moral 1riti*ue QInternetR. 2455 Qcited 2455
7ec >R. 1ritical Thinking: 'here to Fegin Q5 pageR. /vailable from:
http://###.criticalthinDing.org/pages/critical3thinDing3#here3to3$egin/5<;.
4. Ma-o /M, 7uncan 7. 6urse "erceptions of medication errors: what we need to
know for patient safet-. H 6urs 1are Gua. 2448&5C#(%:24C)25=. &"aila$le from:
http :// ###.nursingcenter.com/li$rar*/Aournal&rticle.asp9
&rticle6I,:814823.
8. Medi)mart QInternetR. 2455 Qcited 2455 7ec 52R. 6ursing Legal Issues: 0ow to
"rotect Aourself Q5 pageR. /vailable from: http://###.me'i3smart.com/nursing3
articles/nursing3la#/legal3issues.
;. <esources in 6ursing QInternetR. 244> Qcited 2455 7ec >R. "haneuf M. 1linical
Hudgement: /n Essential Tool in the 6ursing "rofession Q54 pagesR. /vailable
from: http:// ###.infiressources.ca/m*scriptor#e$/scripto.asp9
resultat:230883.
5. <61entral.com QInternetR. 2455 Qcited 2455 7ec 59R. 'hat Is a 6ursing 1are "lan
and 'h- Is It 6eeded? Q5 pageR. /vailable from:
http://###.rncentral.com/nursing3li$rar*/careplans.
B. *ue M, 1hipulu M, Mc:onigle 7. 244C Qcited 2455 7ec >R. 1linical decision
making. In: 0all M, 6oble /, mith , eds. " 3oundation for Neonatal are8 "
:ulti9disciplinary )uide( ,!ford, +B& <adcliffe& pp. 2(9)295. /vailable from:
http://###.shop3
test.co.uD/$ooDs/samplechapter/14B3/Hall6final6lo#res6chap123
2;$245c0r'C.p'f.
<. tate of 1onnecticut 7epartment of 7evelopmental ervices QInternetR. 244C
Qcited 2455 7ec >R. 6ursing tandard: 6ursing "rocess I 6 4C.5 Q8 pagesR.
/vailable from:
http://###.ct.go"/''s/li$/''s/health/ns60<616nursing6process.p'f.
10. Tanner 1/. Thinking like a nurse: a research)based model of clinical
judgment in nursing. H 6urs Educ. 244D&89#D%:248)255. /vailable from:
http://ahn.mnsu.e'u/nursing/facult*formsan'info/thinDingliDeanurse.p'f.
11. Thompson 1, 1ullum 6, Mc1aughan 7, heldon T, <a-nor ". 6urses,
information use, and clinical decision making: the real world potential for
evidence)based decisions in nursing. Evid Fased 6urs. 2448&=:D>)=2. /vailable
from: http://e$n.$m%.com/content/5/3/;B.full.
(ecture ;c
1. /merican /cadem- of /mbulator- 1are 6ursing QInternetR. 2455 Qcited 2455 7ec
58R. /bout //16 Q( pagesR. /vailable from: http://aaacn.org/cgi3
$in/2e$!$%ects/&&&CMain.#oa/#a/"ie#Section9s6i':1053543<08.
2. /merican /cadem- of /mbulator- 1are 6ursing QInternetR. 2455 Qcited 2455 7ec
58R. /mbulator- 1are 6ursing 7efined Q2 pagesR. /vailable from:
http://aaacn.org/cgi3$in/2e$!$%ects/&&&CMain.#oa/#a/"ie#Section9
s6i':1053543<08Hss6i':83;B53B20.
3. /merican /ssociation for Long Term 1are 6ursing QInternetR. 2454 Qcited 2455
7ec 59R. Eliopoulos 1. 'h- the Time 0as 1ome for an /ssociation for Long
Term 1are 6ursing. /vailable from:
http://ltcnursing.org/6#e$app611433B;/2h*6the6Time6Has6Come6for6an6
&ssociation6for6(ong6Term6Care6ursing.
4. /merican "ublic 0ealth /ssociation QInternetR. 2455 Qcited 2455 7ec 59R.
7efinition and Fackground Q2 pagesR. /vailable from:
http://###.apha.org/mem$ergroups/sections/aphasections/phn/a$out/'ef$
acDgroun'.htm.
8. /merican "ublic 0ealth /ssociation QInternetR. 2455 Qcited 2455 7ec 59R. The
<ole of "ublic 0ealth 6urses Q2 pagesR. /vailable from:
http://###.apha.org/mem$ergroups/sections/aphasections/phn/a$out/phnr
oles.htm.
;. Fureau of Labor tatistics, +.. 7epartment of Labor QInternetR. +pdated 244C
7ec 5= Qcited 2455 7ec 59R. ,ccupational ,utlook 0andbook, 2454)55:
<egistered 6urses QD pagesR. /vailable from:
http://###.$ls.go"/oco/ocos0B3.htm.
=. 0ughes <:, Flegen M/. Medication administration safet-. In: 0ughes <:, ed.
5atient Safety and Buality8 "n Avidence9based Handboo* for Nurses( <ockville,
M7: /genc- for 0ealthcare <esearch and Gualit-&244>&chap (=.
B. Mar-land 6ursing 'orkforce 1ommission QInternetR. Ma- 244= Qcited 2455 7ec
58R. :ugert- F, Maranda MH, Feachle- M, et al. 1hallenges and ,pportunities in
7ocumentation of the 6ursing 1are of "atients Q(9 pagesR. /vailable from:
http://###.m$on.org/commission2/'ocumenation6challenges.p'f.
<. Medicare.gov QInternetR. +pdated 244C Mar 29 Qcited 2455 7ec 59R. 'hat is Long
Term 1are? Q2 pagesR. /vailable from:
http://###.me'icare.go"/longtermcare/static/home.asp.
10. M-6ursing7egree.com QInternetR. 2455 Qcited 2455 7ec 59R. :ruver M3.
0ow to Fecome a 0ome 0ealth 1are 6urse Q( pagesR. /vailable from:
http://###.m*nursing'egree.com/home3health3care3nurse.
11. 6ational /ssociation of chool 6urses QInternetR. 2454 Qcited 2455 7ec
59R. The 1ase for chool 6ursing Q8 pagesR. /vailable from:
http://###.nasn.org/portals/0/a$out/20106The6Case6for6School6ursing.p
'f.
12. 6urses for a 0ealthier Tomorrow QInternetR. +ndated Qcited 2455 7ec 58R.
1ritical)1are 6urse Q9 pagesR. /vailable from:
http://###.nursesource.org/critical6care.html.
13. ,ccupational afet- and 0ealth /dministration, +.. 7epartment of Labor
QInternetR. +ndated Qcited 2455 7ec 59R. 6ursing in ,ccupational 0ealth Q2
pagesR. /vailable from: http://###.osha.go"/'ts/oohn/ohn.html.
58. "owell)1ope :, 6elson /L, "atterson E. In: 0ughes <:, ed. 5atient Safety
and Buality8 "n Avidence9based Handboo* for Nurses( <ockville, M7: /genc-
for 0ealthcare <esearch and Gualit-&244>&chap 94.
18. outh 1arolina 7epartment of 7isabilities and pecial 6eeds QInternetR.
+pdated 244D Qcited 2455 7ec 59R. 6ursing 7ocumentation QD pagesR. /vailable
from:
http://''sn.sc.go"/pro"i'ers/manualsan'gui'elines/,ocuments/HealthCare
?ui'elines/ursing,ocumentation.p'f.
1;. +niversit- of 1alifornia, an $rancisco QInternetR. 2455 Qcited 2455 7ec
59R. M pecialt- /rea: /cute 1are 6urse "ractitioner Q( pagesR. /vailable from:
http://nursing.ucsf.e'u/programs/specialties/acute3care3nurse3practitioner3
acnp.
15. +niversit- of outh $lorida QInternetR. +ndated Qcited 2455 7ec 59R. 'h-
"ursue a 1areer in ,ccupational 0ealth 6ursing? QD pagesR. /vailable from:
http://health.usf.e'u/./r'onl*res/3<14C3E238&4,34,1+3E2E13
+2CB3<B3&,C&/0/!ccupationalursing.p'f.
5>. 'estbrook HI, <ob MI, 'oods /, "arr- 7. Errors in the administration of
intravenous medications in hospital and the role of correct procedures and nurse
e!perience. 0:/ Bual Saf( 2455& 24:542=)54(8.
comp2@unitD@discuss.doc
comp2@unitD@discuss@ke-.doc
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare D4
comp2@unitD@self@assess.doc
comp2@unitD@self@assess@ke-.doc
comp2@unitD@references.doc
Component 2/-nit 5
-nit Title
Iualit* Measurement an' )erformance
-nit ,escription
This unit describes the concepts of *ualit- measurement and performance
improvement. The unit begins b- setting the conte!t of known *ualit- problems in
healthcare and then describes how *ualit- is measured and efforts to improve it. The
unit also discusses the role of information technolog-, incentives for *ualit-
improvement, and *ualit- measurement under meaningful use.
-nit !$%ecti"es
5. 7efine healthcare *ualit- and the major t-pes of *ualit- measures:
structural, process, and outcome measures #Lecture a%
2. 7escribe the current state of healthcare *ualit- in the +nited tates
#Lecture a%
(. 7iscuss the current healthcare *ualit- measures used in various
healthcare settings in the +, including those re*uired for the 0ITE10
meaningful use program #Lecture b%
8. 7escribe the role of information technolog- in measuring and improving
healthcare *ualit- #Lecture c%
9. 7escribe the results of current healthcare *ualit- efforts in the + #Lecture
c%
5. 7efinitions and framework for assessing *ualit-
2. 'hat is known about healthcare *ualit-
(. 1urrent *ualit- measures in use
8. <ole of IT and informatics
9. <esults of current approaches to *ualit- assessment
-nit .eferences
(ecture 5a
1. /non-mous. #244=%. 3alue)driven 0ealth 1are: / "urchase :uide, 3ersion 2.4.
'ashington, 71: The Leapfrog :roup. <etrieved from
http://###.leapfroggroup.org/me'ia/file/+mplo*er6)urchaser6?ui'e608611
605.p'f .
2. /ron, 7., P "ogach, L. #244C%. Transparenc- standards for diabetes performance
measures. /ournal of the "merican :edical "ssociation, 6%&, 254)252.
(. /sch, ., Berr, E., Beese-, H., /dams, H., etodji, 1., Malik, ., P Mc:l-nn, E.
#244D%. 'ho is at greatest risk for receiving poor)*ualit- health care? New
Angland /ournal of :edicine, 6'$, 558=)559D.
8. /sch, ., Mc:l-nn, E., 0ogan, M., 0a-ward, <., hekelle, "., <ubenstein, L.,
Berr, E. #2448%. 1omparison of *ualit- of care for patients in the 3eterans 0ealth
/dministration and patients in a national sample. "nnals of !nternal :edicine,
&$&, C(>)C89.
9. /tlas, ., :rant, <., $erris, T., 1hang, A., P Farr-, M. #244C%. "atient)ph-sician
connectedness and *ualit- of primar- care. "nnals of !nternal :edicine, &'%,
(29)((9.
;. Faicker, B., P 1handra, /. #2448%. Medicare spending, the ph-sician workforce,
and beneficiariesK *ualit- of care. Health "ffairs. <etrieved Han 2452 from
http://###.healthaffairs.org/0IJ/10.1355/hlthaff.24.1B4
=. 1hang, H., 0a-s, <., hekelle, "., MacLean, 1., olomon, 7., <euben, 7.,
'enger, 6. #244D%. "atientsO global ratings of their health care are not associated
with the technical *ualit- of their care. "nnals of !nternal :edicine, &$$, DD9)D=2.
>. 1hassin, M., P Loeb, H. #2455%. The ongoing *ualit- improvement journe-: ne!t
stop, high reliabilit-. 0ealth /ffairs, (4, 99C)9D>.
C. 1hassin, M., Loeb, H., chmaltL, ., P 'achter, <. #2454%. /ccountabilit-
measures))using measurement to promote *ualit- improvement. 6ew England
Hournal of Medicine, (D(, D>()D>>.
54. 1hen, L., $arwell, '., P Hha, /. #244C%. "rimar- care visit duration and *ualit-:
does good care take longer? "rchives of !nternal :edicine, &?>, 5>DD)5>=2.
55. 7onabedian, /. #5C>>%. The *ualit- of care: how can it be assessed? Hournal of
the /merican Medical /ssociation, 2D4, 5=8()5=8>.
52. 7onabedian, /. #Ed.%. #2442%. /n Introduction to Gualit- /ssurance in
0ealthcare. 1ambridge, M/: ,!ford +niversit- "ress.
5(. $isher, E., 'ennberg, 7., tukel, T., :ottlieb, 7., Lucas, $., P "inder, E. #244(a%.
The implications of regional variations in Medicare spending. "art 5: the content,
*ualit-, and accessibilit- of care. "nnals of !nternal :edicine, &6;, 2=()2>=.
58. $isher, E., 'ennberg, 7., tukel, T., :ottlieb, 7., Lucas, $., P "inder, E. #244(b%.
The implications of regional variations in Medicare spending. "art 2: health
outcomes and satisfaction with care. "nnals of !nternal :edicine, &6;, 2>>)2C>.
59. $owler, $., :allagher, "., /nthon-, 7., Larsen, B., P kinner, H. #244>%.
<elationship between regional per capita Medicare e!penditures and patient
perceptions of *ualit- of care. /ournal of the "merican :edical "ssociation, #>>,
284D)2852.
5D. :reenfield, ., P Baplan, . #2448%. 1reating a culture of *ualit-: the remarkable
transformation of the 7epartment of 3eterans /ffairs 0ealth 1are -stem.
"nnals of !nternal :edicine, &$&, (5D)(5>.
5=. 0artL, /., Buhn, E., P "ulido, H. #5CCC%. "restige of training programs and
e!perience of b-pass surgeons as factors in adjusted patient mortalit- rates.
:edical are, 6@, C()54(.
5>. 0igashi, T., 'enger, 6., /dams, H., $ung, 1., <oland, M., Mc:l-nn, E., . . .
hekelle, ". #244=%. <elationship between number of medical conditions and
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare D(
*ualit- of care. New Angland /ournal of :edicine, 6'?, 28CD)2948.
5C. 0olmboe, E., 'ang, A., Meehan, T., Tate, H., 0o, ., tarke-, B., P Lipner, <.
#244>%. /ssociation between maintenance of certification e!amination scores and
*ualit- of care for Medicare beneficiaries. "rchives of !nternal :edicine, &?;,
5(CD)584(.
24. 0ong, 1., /tlas, ., 1hang, A., ubramanian, ., /shburner, H., Farr-, M., P
:rant, <. #2454%. <elationship between patient panel characteristics and primar-
care ph-sician clinical performance rankings. /ournal of the "merican :edical
"ssociation, 6%$, 554=)555(.
25. Beroack, M., Aoungberg, F., 1erese, H., Brsek, 1., "rellwitL, L., P Trevel-an, E.
#244=%. ,rganiLational factors associated with high performance in *ualit- and
safet- in academic medical centers. "cademic :edicine, ;#, 55=>)55>D.
22. Landon, F., 6ormand, ., Flumenthal, 7., P 7ale-, H. #244(%. "h-sician clinical
performance assessment: prospects and barriers. /ournal of the "merican
:edical "ssociation, #>%, 55>()55>C.
2(. Lohr, B. #Ed.%. #5CC4%. :edicare8 " Strategy for Buality "ssurance. 'ashington,
71: 6ational /cademies "ress.
28. LTpeL, L., 0icks, L., 1ohen, /., McBean, ., P 'eissman, H. #244C%. 0ospitalists
and the *ualit- of care in hospitals. "rchives of !nternal :edicine, &?>, 5(>C)
5(C8.
29. Mc:l-nn, E., /sch, ., /dams, H., Beese-, H., 0icks, H., 7e1ristofaro, /., P Berr,
E. #244(%. The *ualit- of healthcare delivered to adults in the +nited tates. 6ew
England Hournal of Medicine, (8>, 2D(9)2D89.
2D. 6olte, E., P McBee, 1. #244>%. Measuring the health of nations: updating an
earlier anal-sis. 0ealth /ffairs, 2=, 9>)=5.
2=. 6olte, E., P McBee, 1. #244>%. Measuring the health of nations: updating an
earlier anal-sis. Health "ffairs, #@, 9>)=5.
2>. "eterson, E., <oe, M., Mulgund, H., 7eLong, E., L-tle, F., Frindis, <., . . . ,hman,
E. #244D%. /ssociation between hospital process performance and outcomes
among patients with acute coronar- s-ndromes. /ournal of the "merican :edical
"ssociation, #>', 5C52)5C24.
2C. <osenthal, M. #244>%. Fe-ond pa- for performance))emerging models of
provider)pa-ment reform. New Angland /ournal of :edicine, 6'>, 55C=)5244.
(4. <owe, H. #244D%. "a-)for)performance and accountabilit-: related themes in
improving health care. "nnals of !nternal :edicine, &$', DC9)DCC.
(5. teinman, M., <osenthal, :., Landefeld, 1., Fertenthal, 7., P Baboli, ". #244C%.
/greement between drugs)to)avoid criteria and e!pert assessments of
problematic prescribing. "rchives of !nternal :edicine, &?>, 5(2D)5((2.
(2. Trivedi, /., Matula, ., Miake)L-e, I., :lassman, "., hekelle, "., P /sch, .
#2455%. -stematic review: comparison of the *ualit- of medical care in 3eterans
/ffairs and non)3eterans /ffairs settings. :edical are, $>, =D)>>.
((. 'ang, T., $onarow, :., 0ernandeL, /., Liang, L., Ellrodt, :., 6allamothu, F., . . .
"eterson, E. #244C%. The dissociation between door)to)balloon time improvement
and improvements in other acute m-ocardial infarction care processes and
patient outcomes. "rchives of !nternal :edicine, &?>, 5855)585C.
(8. 'eeks, '., :ottlieb, 7., 6-weide, 7., utherland, H., F-num, H., 1asalino, L., . . .
$isher, E. #2454%. 0igher health care *ualit- and bigger savings found at large
multispecialt- medical groups. Health "ffairs, #>, CC5)CC=.
=.5 /dapted from 7onabedian, /. #Ed.%. #2442%. "n !ntroduction to Buality "ssurance in
Healthcare. 1ambridge, M/: ,!ford +niversit- "ress.
(ecture 5$
5. /non-mous. #244D%. "erformance Measurement: /ccelerating Improvement.
'ashington, 71: 6ational /cademies "ress.
2. /non-mous. #2455%. 1M hould /ddress Inconsistencies in Its Two Incentive
"rograms That Encourage the +se of 0ealth Information Technolog-.
'ashington, 71: :overnment /ccountabilit- ,ffice. <etrieved from
http://###.gao.go"/ne#.items/'1118<.p'f
(. Ferwick, 7. #244>%. The science of improvement. Hournal of the /merican
Medical /ssociation, 2CC, 55>2)55>8.
8. Flumenthal, 7., P Tavenner, M. #2454%. The Jmeaningful useM regulation for
electronic health records. 6ew England Hournal of Medicine, (D(, 945)948.
8. 7amberg, 1., orbero, M., Lovejo-, ., Lauderdale, B., 'ertheimer, ., mith,
/., . . . chn-er, 1. #2455%. /n Evaluation of the +se of "erformance Measures in
0ealthcare. anta Monica, 1/: </67 1orp. <etrieved from
http://###.ran'.org/pu$s/technical6reports/T.114B.html
D. "ronovost, "., P Lilford, <. #2455%. / road map for improving the performance of
performance measures. 0ealth /ffairs, (4, 9DC)9=(.
(ecture 5c
1. /lschuler, L., Fennett, 1., Ballem, 1., Buhl, H., P Au, $. #244=%. Gualit- <eporting
7ocument /rchitecture #G<7/% Initiative ) "hase I $inal <eport. /nn /rbor, MI:
0ealth Level even. <etrieved from
http://###.hl5.org/(i$rar*/Committees/pe's'ata/I.,&>20)hase>20I
>20)u$lic>20.eport.p'f
2. /shworth, M., Medina, H., P Morgan, M. #244>%. Effect of social deprivation on
blood pressure monitoring and control in England: a surve- of data from the
*ualit- and outcomes framework. 0ritish :edical /ournal, 66@, a24(4.
(. /uerbach, /., Landefeld, 1., P hojania, B. #244=%. The tension between
needing to improve care and knowing how to do it. New Angland /ournal of
:edicine, 6'@, D4>)D5(.
8. Faker, 7., "ersell, ., Thompson, H., oman, 6., Furgner, B., Liss, 7., P Bmetik,
B. #244=%. /utomated review of electronic health records to assess *ualit- of care
for outpatients with heart failure. "nnals of !nternal :edicine, &$?, 2=4)2==.
9. Faron, <. #244=%. Gualit- improvement with an electronic health record:
achievable, but not automatic. /nnals of Internal Medicine, 58=, 98C)992.
D. Ferwick, 7. #244C%. Measuring ph-siciansO *ualit- and performance: adrift on
Lake 'obegon. Hournal of the /merican Medical /ssociation, (42, 28>9)28>D.
=. Fo-d, 1., 7arer, H., Foult, 1., $ried, L., Foult, L., P 'u, /. #2449%. 1linical
practice guidelines and *ualit- of care for older patients with multiple comorbid
diseases: implications for pa- for performance. /ournal of the "merican :edical
"ssociation, #>$, =5D)=28.
>. Frook, <. #2454%. The end of the *ualit- improvement movement: long live
improving value. /ournal of the "merican :edical "ssociation, 6%$, 5>(5)5>(2.
C. 1ampbell, ., <eeves, 7., Bontopantelis, E., ibbald, F., P <oland, M. #244C%.
Effects of pa- for performance on the *ualit- of primar- care in England. New
Angland /ournal of :edicine, 6?&, (D>)(=>.
54. 1asalino, L., /le!ander, :., Hin, L., P BonetLka, <. #244=%. :eneral internistsO
views on pa-)for)performance and public reporting of *ualit- scores: a national
surve-. Health "ffairs, #?, 8C2)8CC
55. 1ebul, <., Love, T., Hain, /., P 0ebert, 1. #2455%. Electronic health records and
*ualit- of diabetes care. 6ew England Hournal of Medicine, (D9, >29)>((.
52. 1han, B., $owles, H., P 'einer, H. #2454%. Electronic health records and reliabilit-
and validit- of *ualit- measures: a review of the literature. :edical are
,esearch and ,eview, Epub ahead of print.
5(. 7oran, T., $ullwood, 1., :ravelle, 0., <eeves, 7., Bontopantelis, E., 0iroeh, +.,
P <oland, M. #244D%. "a-)for)performance programs in famil- practices in the
+nited Bingdom. New Angland /ournal of :edicine, 6'', (=9)(>8.
58. 7oran, T., $ullwood, 1., <eeves, 7., :ravelle, 0., P <oland, M. #244>%. E!clusion
of patients from pa-)for)performance targets b- English ph-sicians. New
Angland /ournal of :edicine, 6'>, 2=8)2>8.
59. $onarow, :., /braham, '., /lbert, 6., tough, '., :heorghiade, M., :reenberg,
F., Aoung, H. #244=%. /ssociation between performance measures and clinical
outcomes for patients hospitaliLed with heart failure. /ournal of the "merican
:edical "ssociation, #>@, D5)=4.
1;. $owles, H., Bind, E., /wwad, ., 'einer, H., P 1han, B. #244>%.
"erformance Measures +sing Electronic 0ealth <ecords: $ive 1ase tudies.
'ashington, 71: 1ommonwealth $und. <etrieved from
http://###.common#ealthfun'.org/pu$lications/pu$lications6sho#.htm9
'oc6i':;B8103
5=. $ung, 1., Lim, A., Mattke, ., 7amberg, 1., P hekelle, ". #244>%. -stematic
review: the evidence that publishing patient care performance data improves
*ualit- of care. "nnals of !nternal :edicine, &$;, 555)52(.
5>. :lickman, ., ,u, $., 7eLong, E., <oe, M., L-tle, F., Mulgund, H., "eterson, E.
#244=%. "a- for performance, *ualit- of care, and outcomes in acute m-ocardial
infarction. /ournal of the "merican :edical "ssociation, #>@, 2(=()2(>4.
5C. 0ibbard, H., :reene, H., P 7aniel, 7. #2454%. 'hat is *ualit- an-wa-?
"erformance reports that clearl- communicate to consumers the meaning of
*ualit- of care. :edical are ,esearch and ,eview, Epub ahead of print.
24. Hha, /., P Epstein, /. #244D%. The predictive accurac- of the 6ew Aork tate
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare DD
coronar- arter- b-pass surger- report)card s-stem. Health "ffairs, #', >88)>99.
25. Hha, /., ,rav, E., Li, U., P Epstein, /. #244=%. The inverse relationship between
mortalit- rates and performance in the 0ospital Gualit- /lliance measures.
Health "ffairs, #?, 5548)5554.
22. Hha, /., ,rav, E., <idgwa-, /., Uheng, H., P Epstein, /. #244>%. 7oes the
Leapfrog program help identif- high)*ualit- hospitals? /oint ommission /ournal
on Buality and 5atient Safety, 6$, (5>)(29.
2(. Bell-, /., Thompson, H., Tuttle, 7., Fenesch, 1., P 0ollowa-, <. #244>%. "ublic
reporting of *ualit- data for stroke: is it measuring *ualit-? Stro*e, 6>, ((D=)
((=5.
28. BrumholL, 0., P Lee, T. #244>%. <edefining *ualit- )) implications of recent clinical
trials. New Angland /ournal of :edicine, 6';, 29(=)29(C.
29. Landon, F., P 6ormand, . #244>%. "erformance measurement in the small office
practice: challenges and potential solutions. "nnals of !nternal :edicine, &$;,
(9()(9=.
2D. Lee, ., P 'alter, L. #2455%. Gualit- indicators for older adults: preventing
unintended harms. /ournal of the "merican :edical "ssociation, 6%?, 58>5)
58>2.
2=. Lindenauer, "., <emus, 7., <oman, ., <othberg, M., Fenjamin, E., Ma, /., P
FratLler, 7. #244=%. "ublic reporting and pa- for performance in hospital *ualit-
improvement. New Angland /ournal of :edicine, 6'?, 8>D)8CD.
2>. Linder, H., Ma, H., Fates, 7., Middleton, F., P tafford, <. #244=%. Electronic
health record use and the *ualit- of ambulator- care in the +nited tates.
"rchives of !nternal :edicine, &?@, 5844)5849.
2C. L-nn, H., Fail-, M., Fottrell, M., Hennings, F., Levine, <., 7avidoff, $., . . . Hames,
F. #244=%. The ethics of using *ualit- improvement methods in health care.
"nnals of !nternal :edicine, &$?, DDD)D=(.
(4. Mc7onald, <., 0arrison, ., 1heckland, B., 1ampbell, ., P <oland, M. #244=%.
Impact of financial incentives on clinical autonom- and internal motivation in
primar- care: ethnographic stud-. 0ritish :edical /ournal, 66$, 5(9=)5(9C.
(5. Mc7onald, <., P <oland, M. #244C%. "a- for performance in primar- care in
England and 1alifornia: comparison of unintended conse*uences. "nnals of
3amily :edicine, @, 525)52=.
(2. Miller, $., P Emanuel, E. #244>%. Gualit-)improvement research and informed
consent. New Angland /ournal of :edicine, 6';, =D9)=D=.
((. Milstein, /., P Lee, T. #244=%. 1omparing ph-sicians on efficienc-. New Angland
/ournal of :edicine, 6'@, 2D8C)2D92.
(8. Mohan, 3., P 0ersh, '. #2455%. E0<s and health care *ualit-: correlation with
out)of)date, differentl- purposed data does not e*uate with causalit-. "rchives of
!nternal :edicine, &@&, C92)C9(.
(9. 6-weide, 7., 'eeks, '., :ottlieb, 7., 1asalino, L., P $isher, E. #244C%.
<elationship of primar- care ph-siciansO patient caseload with measurement of
*ualit- and cost performance. /ournal of the "merican :edical "ssociation, 6%#,
2888)2894.
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare D=
(D. ,OFrien, ., 7elong, E., P "eterson, E. #244>%. Impact of case volume on hospital
performance assessment. "rchives of !nternal :edicine, &?;, 52==)52>8.
(=. ,lsen, L., /isner, 7., P Mc:innis, H. #Eds.%. #244=%. The -earning Healthcare
System 9 2or*shop Summary. 'ashington, 71: 6ational /cademies "ress.
(>. "akhomov, ., Fjornsen, ., 0anson, "., P mith, . #244>%. Gualit-
performance measurement using the te!t of electronic medical records. :edical
Decision :a*ing, #;, 8D2)8=4.
(C. "akhomov, ., 0anson, "., Fjornsen, ., P mith, . #244>%. /utomatic
classification of foot e!amination findings using statistical natural language
processing and machine learning. /ournal of the "merican :edical !nformatics
"ssociation, Epub ahead of print.
84. "atterson, M., 0ernandeL, /., 0ammill, F., $onarow, :., "eterson, E., chulman,
B., P 1urtis, L. #2454%. "rocess of care performance measures and long)term
outcomes in patients hospitaliLed with heart failure. :edical are, $;, 254)25D.
85. "awlson, L., cholle, ., P "owers, /. #244=%. 1omparison of administrative)onl-
versus administrative plus chart review data for reporting 0E7I h-brid
measures. "merican /ournal of :anaged are, &6, 99()99>.
82. "ersell, ., 7olan, 6., $riesema, E., Thompson, H., Baiser, 7., P Faker, 7.
#2454%. $re*uenc- of inappropriate medical e!ceptions to *ualit- measures.
"nnals of !nternal :edicine, &'#, 229)2(5.
8(. "ham, 0., chrag, 7., ,OMalle-, /., 'u, F., P Fach, ". #244=%. 1are patterns in
Medicare and their implications for pa- for performance. New Angland /ournal of
:edicine, 6'?, 55(4)55(C.
88. "orter, M. #2454%. 'hat is value in health care? New Angland /ournal of
:edicine, 6?6, 28>5)28>(.
89. "ronovost, "., :oeschel, 1., P 'achter, <. #244>%. The wisdom and justice of
not pa-ing for Vpreventable complicationsV. /ournal of the "merican :edical
"ssociation, #>>, 25C=)25CC.
8D. <eeves, :., 'ang, T., <eid, B., /le!ander, B., 7ecker, 1., /hmad, 0., . . .
"eterson, E. #244>%. 7issociation between hospital performance of the smoking
cessation counseling *ualit- metric and cessation outcomes after m-ocardial
infarction. "rchives of !nternal :edicine, &?;, 2555)255=.
8=. cholle, ., <oski, H., /dams, H., 7unn, 7., Berr, E., 7ugan, 7., P Hensen, <.
#244>%. Fenchmarking ph-sician performance: reliabilit- of individual and
composite measures. "merican /ournal of :anaged are, &$, >2C)>(>.
4B. hih, /., 7avis, B., choenbaum, ., :authier, /., 6uLum, <., P
Mc1arth-, 7. #244>%. ,rganiLing the +.. 0ealth 1are 7eliver- -stem for 0igh
"erformance. 'ashington, 71: 1ommonwealth $und. <etrieved from
'oc6i':;<B13<
8C. n-der, L., P 6eubauer, <. #244=%. "a-)for)performance principles that promote
patient)centered care: an ethics manifesto. "nnals of !nternal :edicine, &$@,
=C2)=C8.
94. Tu, H., 7onovan, L., Lee, 7., 'ang, H., /ustin, "., /lter, 7., P Bo, 7. #244C%.
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare D>
Effectiveness of public report cards for improving the *ualit- of cardiac care: the
E$$E1T stud-: a randomiLed trial. /ournal of the "merican :edical "ssociation,
6%#, 2((4)2((=.
95. 3onnegut, M. #244=%. Is *ualit- improvement improving *ualit-? / view from the
doctorOs office. 6ew England Hournal of Medicine, (9=, 2D92)2D9(.
92. 'achter, <., $landers, ., $ee, 1., P "ronovost, ". #244>%. "ublic reporting of
antibiotic timing in patients with pneumonia: lessons from a flawed performance
measure. /nnals of Internal Medicine, 58C, 2C)(2
9(. 'ang, T., $onarow, :., 0ernandeL, /., Liang, L., Ellrodt, :., 6allamothu, F., . . .
"eterson, E. #244C%. The dissociation between door)to)balloon time improvement
and improvements in other acute m-ocardial infarction care processes and
patient outcomes. "rchives of !nternal :edicine, &?>, 5855)585C.
98. 'erner, <., P Fradlow, E. #244D%. <elationship between MedicareOs hospital
compare performance measures and mortalit- rates. /ournal of the "merican
:edical "ssociation, #>?, 2DC8)2=42.
99. 'erner, <., :oldman, L., P 7udle-, <. #244>%. 1omparison of change in *ualit-
of care between safet-)net and non)safet-)net hospitals. /ournal of the "merican
:edical "ssociation, #>>, 25>4)25>=.
comp2@unit=@discuss.doc
comp2@unit=@discuss@ke-.doc
comp2@unit=@self@assess.doc
comp2@unit=@self@assess@ke-.doc
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare DC
Component 2/-nit B
-nit Title
+thics H )rofessionalism
-nit Description
This unit describes the traditions and values that guide ph-sicians, nurses, and allied
health professionals. It e!plores medical ethics, professionalism and legal duties and
applies ethics and professionalism to specific topics, including health informatics.
-nit !$%ecti"es
5. "rovide an orientation to ideas about medical ethics and professionalism
#Lecture a%
2. E!plore the relationships among ethical ideals, professionalism, and legal
duties #Lecture a, b%
(. /ppl- the general principles of ethics and professionalism to specific
topics #Lecture c, d%
8. E!amine ethical issues in health informatics #Lecture d%
5. Ethics and professionalism
2. Ethical and legislative standards and how the- interact
(. 1ontemporar- topics in medical ethics
8. Ethical issues in health informatics
-nit .eferences
(ecture Ba
1. /merican Foard of Internal Medicine $oundation QInternetR. 1assel 1B. 25st
centur- medical professionalism: renewing the social contract Q5( pagesR.
/vailable from: http://###.a$imfoun'ation.org/.esource3
Center/K/me'ia/2>206010B0<6Cassel6professionalism.ash7.
2. /merican Foard of Internal Medicine $oundation QInternetR. +ndated Qcited 2455
7ec 24R. Medical professionalism in the new millennium: a ph-sician charter Q2
pagesR. /vailable from:
http://###.a$imfoun'ation.org/)rofessionalism/K/me'ia/0BE51018,+BE4B
;8<<013+;;2;03028,.ash7.
(. /ulisio M", /rnold <M. 0elping to address value conflicts or uncertainties: role of
the ethics committee. hest( 244>&5(8&85=)828.
4. Ethics <esource 1enter QInternetR. Ethics glossar-. Ma- 2C, 244C Qcited 2455 7ec
5CR. Ethics glossar- Q9 pagesR. /vailable from:
http://###.ethics.org/resource/ethics3glossar*.
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare =4
9. :illon <. Medical ethics: four principles plus attention to scope. 0:/(
5CC8&(4C#DC8>%:5>8)5>>.
D. :illon <. Ethics needs principles: four can encompass the restXand respect for
autonom- should be Jfirst among e*uals.M / :ed Athics( 244(&2C#9%:(4=)(52.
5. The 0astings 1enter QInternetR. 244= Qcited 2455 7ec 24R. Hennings F, Fail- M/,
Fottrell M, L-nn H, eds. Health are Buality !mprovement8 Athical and
,egulatory !ssues Q5>> pagesR. /vailable from:
http://###.thehastingscenter.org/uploa'e'0iles/)u$lications/Special6.epo
rts/Health>20Care>20Iualit*>20Impro"ement.p'f.
B. 0istor- of Medicine 7ivision, 6ational Librar- of Medicine, 6ational Institutes of
0ealth QInternetR. +pdated Hune 28, 2454 Qcited 2455 7ec 24R. :reek medicine:
the 0ippocratic oath Q5 pageR. /vailable from:
http://###.nlm.nih.go"/hm'/greeD/greeD6oath.html.
C. Birk LM. "rofessionalism in medicine: definitions and considerations for teaching.
5roceedings .0ayl Univ :ed ent1( 244=&24:5()5D.
10. +niversit- of 'ashington chool of Medicine QInternetR. +pdated /pril 55,
244> Qcited 2455 7ec 5CR. Mc1ormick T<. Ethics in medicine: principles of
bioethics Q8 pagesR. /vailable from:
http://'epts.#ashington.e'u/$ioeth7/tools/princpl.html
11. +niversit- of 'ashington chool of Medicine QInternetR. +pdated 6ovember 5,
2454 Qcited 2455 7ec 5CR. "earlman </. Ethics in medicine: ethics committees
and ethics consultation Q( pagesR. /vailable from:
http://'epts.#ashington.e'u/$ioeth7/topics/ethics.html.
(ecture Ba Charts/ Ta$les/ 0igures
>.5 $igure: $our basic principles of healthcare #11 FA)61)/ (.4, 2452%.
>.2 Table: 6on)Maleficence #11 FA)61)/ (.4, 2452%.
>.( $igure: Ethical dilemma #11 FA)61)/ (.4, 2452%.
(ecture B$
5. /asland ,:, $orde <. Impact of feeling responsible for adverse events on
doctorsO personal and professional lives: the importance of being open to criticism
from colleagues. Bual Saf Health are( 2449&58#5%:5()5=.
2. /merican Medical /ssociation QInternetR. 2455 Qcited 2455 7ec 25R. /M/ code of
ethics: fre*uentl- asked *uestions Q5 pageR. /vailable from: http://###.ama3
assn.org/ama/pu$/ph*sician3resources/me'ical3ethics/co'e3me'ical3
ethics/freFuentl*3asDe'3Fuestions.page.
3. /ssociated "ress QInternetR. 7ecember 5C, 2455 Qcited 2455 7ec 22R. "ickler 6.
Hustice reports record false claims recoveries Q5 pageR. /vailable from:
http://finance.*ahoo.com/ne#s/Austice3reports3recor'3false3apf3
3;;0228B2<.html97:0.
8. Folsin , $aunce T, ,akle- H. "ractical virtue ethics: healthcare whistleblowing
and portable digital technolog-. / :ed Athics( 2449&(5#54%:D52)D5>.
8. 1ouncil on Ethical and Hudicial /ffairs, /merican Medical /ssociation QInternetR.
244D Qcited 2455 7ec 25R. ode of Athics of the "merican :edical "ssociation
QD( pagesR. /vailable from: https://catalog.ama3
assn.org/M+,I&/)ro'uctCatalog/m11000B0/&M&>20Co'e>20of
>20+thics.p'f.
;. 1ouncil on Ethical and Hudicial /ffairs, /merican Medical /ssociation QInternetR.
+pdated 6ovember 244D Qcited 2455 7ec 25R. ,pinion E)9.49, J1onfidentialit-,M
"mendment Q8 pagesR. /vailable from: http://###.ama3
assn.org/resources/'oc/co'e3me'ical3ethics/808a.p'f .
5. Ethics <esource 1enter QInternetR. Ma- 2C, 244C Qcited 2455 7ec 25R. Ethics
glossar- Q9 pagesR. /vailable from: http://###.ethics.org/resource/ethics3
glossar*.
B. $ederation of tate Medical Foards QInternetR. +pdated Ma- 2454 Qcited 7ec 22R.
Assentials of a :odern :edical and Osteopathic 5ractice "ct Q(2 pagesR. 52
th
ed.
/vailable from: http://###.fsm$.org/p'f/?.)!(6essentials.p'f.
<. $ederation of tate Medical Foards QInternetR. +ndated Qcited 2455 7ec 22R.
'hat is a state medical board? Q2 pagesR. /vailable from:
http://###.fsm$.org/p'f/#hat6is6a6state6me'ical6$oar'.p'f.
54. :runwald 0', 0oward 7, Mc1abe M, torm 17, <odrigueL M/.
Misdiagnosis: disclosing a colleagueKs error. H ,ncol "ract. / Oncol 5ract(
244>&8#(%:59>)5D4.
55. 0affert- $'. Fe-ond curriculum reform: confronting medicineOs hidden
curriculum. "cad :ed( 5CC>&=(#8%:84()84=.
12. ,ffice of the 'histleblower "rotection "rogram, ,ccupational afet- and
0ealth /dministration, +.. 7epartment of Labor QInternetR. +pdated 7ecember
C, 2455 Qcited 2455 7ec 22R. The whistleblower protection program Q5 pageR.
/vailable from: http://###.#histle$lo#ers.go".
13. ,hio tate Medical /ssociation QInternetR. +ndated Qcited 2455 7ec 25R.
Investigations b- the tate Medical Foard of ,hio: answers to fre*uentl-)asked
*uestions Q2 pagesR. /vailable from:
http://###.osma.org/files/'ocuments/tools3an'3resources/me'ical3$oar'3
licensing3an'3'iscipline/me'3$'3in"estigation3$rochure.p'f.
58. <hodes <, train HH. 'histleblowing in academic medicine. / :ed Athics(
2448&(4#5%:(9;(C.
18. +niversit- of 'ashington chool of Medicine QInternetR. +pdated 244>
Qcited 2455 7ec 25R. 3incler L/. Ethics in medicine: law and medical ethics Q5
pageR. /vailable from: http://'epts.#ashington.e'u/$ioeth7/topics/la#.html.
1;. 'ashington tate Medical /ssociation QInternetR. +pdated ,ctober 2449 Qcited
2455 7ec 25R. 5rinciples of :edical Athics and Opinions and ,eports of the
/udicial ouncil of the 2ashington State :edical "ssociation Q=5 pagesR.
/vailable from: http://###.#sma.org/get0ile.cfm9mo6fileI':8B5.
(ecture B$ Charts/ Ta$les/ 0igures
>.8 $igure: tandards of "rofessionalism #11 FA)61)/ (.4, 2452%.
>.9 1hart: 0ealthcare fraud #11 FA)61)/ (.4, 2452%.
>.D Table: "rotection of whilstleblowers #11 FA)61)/ (.4, 2452%.
(ecture Bc
5. 1ommittee on Fioethics, /merican /cadem- of "ediatrics. "olic- statement:
ph-sician refusal to provide information or treatment on the basis of claims of
conscience. 5ediatrics( 244C&528#D%:5D>C)5DC(.
2. del 1armen M:, Hoffe . Informed consent for medical treatment and
research: a review. Oncologist( 2449&54#>%:D(D)D85.
3. Institute of Medicine QInternetR. 244C Qcited 2455 7ec 2=R. onflict of !nterest
in :edical ,esearch, Aducation, and 5ractice Q8(D pagesR. /vailable from:
http://###.nc$i.nlm.nih.go"/$ooDs/EL22<42.
8. "ope TM. Legal briefing: conscience clauses and conscientious refusal. /
lin Athics( 2454&25#2%:5D()5=D.
9. chneiderman LH, Hecker 6, Honsen /<. Medical futilit-: its meaning and
ethical implications( "nn !ntern :ed( 5CC4&552:C8C)C98.
D. Till-ard /<. Ethics review: Jliving willsM and intensive careXan overview of
the /merican e!perience. ritical are( 244=&55#8%:25C.
5. +niversit- of Minnesota 1enter for Fioethics QInternetR. 2449 Qcited 2455 7ec
2DR. And of -ife are8 "n Athical Overview Q=9 pagesR. /vailable from:
http://###.ahc.umn.e'u/img/assets/2;104/+n'6of6(ife.p'f.
B. +niversit- of 'ashington chool of Medicine QInternetR. +pdated /pril 55,
244> Qcited 2455 7ec 2DR. Edwards B/. Ethics in medicine: informed consent
Q5 pageR. /vailable from:
http://'epts.#ashington.e'u/$ioeth7/topics/consent.html.
<. 'orld 0ealth ,rganiLation <egional ,ffice for Europe QInternetR. 5CC4 Qcited
2455 7ec 2=R. 'hitehead M. The concepts and principles of e*uit- and health
Q(5 pagesR. /vailable from: http://#hFli$'oc.#ho.int/euro/3
1<<3/+-.6IC)6.),6414.p'f.
10. 'orld 0ealth ,rganiLation <egional ,ffice for Europe QInternetR. 244D Qcited
2455 7ec 2=R. 'hitehead M, 7ahlgren :. 1oncepts and principles for tackling
social ine*uities in health: levelling up, part 5 Q89 pagesR. /vailable from:
http://###.euro.#ho.int/66'ata/assets/p'f6file/0010/54535/+B<3B3.p'f.
(ecture Bc Charts/ Ta$les/ 0igures
>.= Table: "ros and 1ons of medical futilit- #11 FA)61)/ (.4, 2452%.
>.> Table: "ros and 1ons of advance directives #11 FA)61)/ (.4, 2452%.
>.C Table: "rotection of whilstleblowers #11 FA)61)/ (.4, 2452%.
>.C Table: "rimar- and secondar- interests in medical practice #11 FA)61)/ (.4,
2452%.
(ecture B'
1. /merican 0ealth Information Management /ssociation QInternetR. +ndated Qcited
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare =(
2455 7ec 2CR. /merican 0ealth Information Management /ssociation 1ode of
Ethics Q5 pageR. /vailable from:
http://li$rar*.ahima.org/7pe'io/groups/pu$lic/'ocuments/ahima/$oD160242
55.hcsp9',ocame:$oD16024255.
2. /merican Medical Informatics /ssociation QInternetR. +ndated draft Qcited 2455
7ec 2CR. Fiomedical informatics core competencies Q5 pageR. /vailable from:
http://###.amia.org/$iome'ical3informatics3core3competencies.
3. Ethics <esource 1enter QInternetR. 7ecember 2454 Qcited 2455 7ec (4R. Flowing
the whistle on workplace misconduct Q5D pagesR. /vailable from:
http://###.ethics.org/files/u8/2histle$lo#er2).p'f .
8. 0urdle H$, /dams , Frokel H, et al. / code of professional ethical conduct for
/MI/( / "m :ed !nform "ssoc( 244=&58#8%:(C5)(C(.
8. Institute of Medicine QInternetR. 244C Qcited 2455 7ec 2CR. onflict of !nterest in
:edical ,esearch, Aducation, and 5ractice Q8(D pagesR. /vailable from:
http://###.nc$i.nlm.nih.go"/$ooDs/EL22<42.
;. Institute of Medicine QInternetR. "republication Qcited 2455 7ec (4R. Health !T and
5atient Safety8 0uilding Safer Systems for 0etter are Q5C= pagesR. /vailable
from: http://###.nap.e'u/catalog.php9recor'6i':132;<.
5. International Medical Informatics /ssociation QInternetR. +ndated Qcited 2455 7ec
2CR. The IMI/ 1ode of Ethics for 0ealth Information "rofessionals Q54 pagesR.
/vailable from: http://###.imia3me'info.org/ne#2/pu$'ocs/+thics6+ng.p'f.
B. ,ffice of the 6ational 1oordinator for 0ealth Information Technolog-, +..
7epartment of 0ealth and 0uman ervices QInternetR. ,ctober 2455 Qcited 2455
7ec 2CR. /bout ,61 Q5 pageR. /vailable from:
http://healthit.hhs.go"/portal/ser"er.pt/communit*/healthit6hhs6go"66onc/1
200.
<. amuel 0', Uaiane ,<, obse- 7. Towards a definition of health informatics
ethics. In: 5roceedings of the 3irst ": !nternational Health !nformatics
Symposium( 6ew Aork: /ssociation for 1omputing Machiner-, 2454. /vailable
from: http://h#samuel.com/#p3content/uploa's/acmihi2010.p'f.
(ecture B' Charts/ Ta$les/ 0igures
>.54 $igure: 1onflicts of interest #11 FA)61)/ (.4, 2452%.
>.55 $igure: 7uties to patients #11 FA)61)/ (.4, 2452%.

comp2@unit>@discuss.doc
comp2@unit>@discuss@ke-.doc
comp2@unit>@self@assess.doc
comp2@unit>@self@assess@ke-.doc
Component 2/-nit <
-nit Title
)ri"ac* H Securit*
-nit ,escription
This unit defines privac-, confidentialit-, and securit- of health information, including the
0I""/ "rivac- and ecurit- <ules.
-nit !$%ecti"es
5. 7efine and discern the differences between privac-, confidentialit-, and
securit- #Lecture a%
2. 7iscuss the major methods for protecting privac- and confidentialit-,
including through the use of information technolog- #Lecture b%
(. 7escribe and appl- privac-, confidentialit-, and securit- under the tenets
of 0I"// "rivac- <ule #Lecture c%
8. 7escribe and appl- privac-, confidentialit-, and securit- under the tenets
of the 0I"// ecurit- <ule #Lecture d%
5. 7efinitions of privac-, confidentialit-, and securit-
2. Tools for protecting privac- and confidentialit-
(. 0I"// "rivac- <ule
8. 0I"// ecurit- <ule
-nit .eferences
(ecture <a
1. /1L+. #nd.%. 3ideo depicting a piLLa compan- having access to a customerKs
medical records. http://###.aclu.org/or'ering3piCCa. Last accessed Han
2452.
2. /c*uisti, /., P :ross, <. #244C%. "redicting ocial ecurit- numbers from public
data. 5roceedings of the National "cademy of Sciences, &%?, 54C=9)54C>4.
3. /non-mous. #2449%. 6ational 1onsumer 0ealth "rivac- urve- 2449. ,akland,
1/: 1alifornia 0ealth 1are $oundation. <etrieved from
http://###.chcf.org/topics/"ie#.cfm9itemI,:118;<4
4. /non-mous. #244=%. 7ata "rotection in the European +nion. Frussels, Felgium:
European 1ommission. <etrieved from
http://ec.europa.eu/%ustice6home/fs%/pri"ac*/in'e76en.htm
8. /non-mous. #2454c%. The 0ealth Information ecurit- and "rivac- 1ollaboration
#0I"1%. 'ashington, 71: 7epartment of 0ealth and 0uman ervices.
<etrieved from http://healthit.hhs.go"/portal/ser"er.pt9
open:812Hmo'e:2Hcache':trueHo$%I,:1240
;. /non-mous. #2455a%. 0ealth Information Technolog- P "rivac-. "hiladelphia,
"/: /merican 1ollege of "h-sicians. <etrieved from
http://###.acponline.org/a'"ocac*/#here6#e6stan'/polic*/hit6pri"ac*.p'f
5. /non-mous. #2455b%. econd /nnual Fenchmark tud- on "atient "rivac- and
7ata ecurit-. Traverse 1it-, MI: "onemon Institute. <etrieved from
http://###2.i'e7pertscorp.com/ponemon3stu'*32011/
B. 1assa, 1., chmidt, F., Bohane, I., P Mandl, B. #244>%. M- sisterOs keeper?:
genomic research and the identifiabilit- of siblings. 0: :edical )enomics, &,
(2. <etrieved from http://###.$iome'central.com/15883B5<4/1/32
<. 1ohn, . #244D%. "rivac- and 1onfidentialit- in the 6ationwide 0ealth Information
6etwork. 'ashington, 71: 6ational 1ommittee for 3ital and 0ealth tatistics.
<etrieved from http://###.nc"hs.hhs.go"/0;0;22lt.htm
54. 1ohn, . #244>%. Individual control of sensitive health information accessible via
the 6ationwide
55. 7etmer, 7. #2454%. /ctivating a full architectural model: improving health through
robust population health records. /ournal of the "merican :edical !nformatics
"ssociation, &@, (D=)(DC.
52. ElEmam, B., 6eri, E., Honker, E., okolova, M., "e-ton, L., 6eisa, /., P cassa,
T. #2454%. The inadvertent disclosure of personal health information through
peer)to)peer file sharing programs. /ournal of the "merican :edical !nformatics
"ssociation, &@, 58>)59>.
13. :ostin, L., P 0odge, H. #2442%. "ersonal privac- and common goods: a
framework for balancing under the national health information privac- rule.
:innesota -aw ,eview, ;?, 58(C)58=C. <etrieved from
http://papers.ssrn.com/sol3/,eli"er*.cfm/SS.6I,34;80;6co'e021104;30.
p'f
58. 0all, M., P chulman, B. #244C%. ,wnership of medical information. /ournal of
the "merican :edical "ssociation, 6%&, 52>2)52>8.
59. 0odge, H., :ostin, L., P Hacobson, ". #5CCC%. Legal issues concerning electronic
health information: privac-, *ualit-, and liabilit-. /ournal of the "merican :edical
"ssociation, #;#, 58DD)58=5.
1;. Bete-ian, /. #2454, /pril 59, 2454%. 7igital "hotocopiers Loaded 'ith
ecrets. 0S News. <etrieved from
http://###.c$sne#s.com/stories/2010/04/1</e"eningne#s/main;41243<.sht
ml
15. Lee, 1., P :oldfarb, U. #244D, Hune (4, 244D%. tolen 3/ Laptop and 0ard
7rive <ecovered, 2ashington 5ost, p. /45. <etrieved from
http://###.#ashingtonpost.com/#p3
'*n/content/article/200;/0;/2</&.200;0;2<00382.html
5>. Lumle-, T., P <ice, B. #2454%. "otential for revealing individual)level information
in genome)wide association studies. /ournal of the "merican :edical
"ssociation, 6%6, >9C)>D4.
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare =D
5C. Mc:uire, /., P :ibbs, <. #244D%. 6o longer de)identified. Science, 6&#, (=4)(=5.
24. Malin, F., P weene-, L. #2449%. 0ow #not% to protect genomic data privac- in a
distributed network: using trail re)identification to evaluate and design anon-mit-
protection s-stems. /ournal of 0iomedical !nformatics, 6@, 5=C)5C2.
21. "onemon, L., P Bam, <. #2454%. Fenchmark tud- on "atient "rivac- and
7ata ecurit-. Traverse 1it-, MI: "onemon Institute. <etrieved from
http://###2.i'e7pertscorp.com/ponemonstu'*
22. "ritts, H., P 1onnor, B. #244=%. The Implementation of E)consent
Mechanismsin Three 1ountries: 1anada, England, and the 6etherlands.
'ashington, 71: ubstance /buse and Mental 0ealth ervices /dministration.
<etrieved from http://ihcrp.georgeto#n.e'u/p'fs/prittse3consent.p'f
2(. <odwin, M. #244C%. The case for public ownership of patient data. /ournal of the
"merican :edical "ssociation, 6%#, >D)>>.
24. <ojas)Furke, H. #244D, Hanuar- 2=, 244D%. "rovidence critics push for
safer records, The Oregonian. <etrieved from
http://###.oregonli"e.com/ne#s/oregonian/in'e7.ssf9/$ase/ne#s/113B3341
21232<80.7mlHcoll:5
29. <othstein, M., P Talbott, M. #244D%. 1ompelled disclosure of health information:
protecting against the greatest potential threat to privac-. /ournal of the
"merican :edical "ssociation, #>', 2>>2)2>>9.
2D. weene-, L. #5CC=%. :uaranteeing anon-mit- when sharing medical data, the
7atafl- -stem. "roceedings of the 5CC= /MI/ /nnual $all -mposium,
6ashville, T6, 95)99.
2=. 'right, /., P ittig, 7. #244=a%. Encr-ption characteristics of two +F)based
personal health record devices. /ournal of the "merican :edical !nformatics
"ssociation, &$, (C=)(CC.
2>. 'right, /., P ittig, 7. #244=b%. ecurit- threat posed b- +F)based personal
health records. "nnals of !nternal :edicine, &$?, (58)(59.El Emam, 244=
(ecture <a Charts/ Ta$les an' 0igures
C.5 $igure 5 /dapted from weene-, L. #5CC=%. :uaranteeing anon-mit- when
sharing medical data, the 7atafl- -stem. "roceedings of the 5CC= /MI/ /nnual $all
-mposium, 6ashville, T6, 95)99.
(ecture <$
5. /llan, /. #2449%. "assword /ging 1an Furden an /lread-)'eak /uthentication
Method. tamford, 1T: :artner.
2. /non-mous. #5CC=%. $or the <ecord: "rotecting Electronic 0ealth Information.
'ashington, 71: 6ational /cademies "ress.
3. /non-mous. #2442%. ecure 0ash ignature tandard. :aithersburg, M7:
6ational Institute for tandards and Technolog-. <etrieved Han 2452 from
http://csrc.nist.go"/pu$lications/fips/fips1B032/fips1B03
2#ithchangenotice.p'f
4. /non-mous. #244>b%. Mitigating medical identit- theft. /ournal of "H!:", @>#=%,
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare ==
D()DC. <etrieved Han 2452 from
http://li$rar*.ahima.org/7pe'io/groups/pu$lic/'ocuments/ahima/$oD1603<0
8B.hcsp9',ocame:$oD1603<08B
9. 7aemen, H., P <ijmen, 3. #2442%. The Design of ,i=ndael8 "AS 9 The "dvanced
Ancryption Standard. Ferlin, :erman-: pringer)3erlag.
D. 0erLig, T. #Ed.%. #2454%. Information ecurit- in 0ealthcare ) Managing <isk.
1hicago, IL: 0ealthcare Information Management -stems ociet-.
5. "abrai, /. #244>, Hanuar- 2(, 244>%. The ingle ign),n olution. H&HNFs :ost
2ired :aga4ine. <etrieved Han 2452 from
http://###.hhnmost#ire'.com/hhnmost#ire'6app/%sp/article'ispla*.%sp9
'crpath:HHM!ST2I.+,/&rticle/'ata/0all2005/0B0123M26!nline6)a$raiH
'omain:HHM!ST2I.+,
>. <indfleisch, T. #5CC=%. "rivac-, information technolog-, and healthcare.
1ommunications of the /1M, 84#>%, C()544.
C. <othfeder, H. #5CC2%. 5rivacy for Sale8 How omputeri4ation Has :ade
AveryoneFs 5rivate -ife "n Open Secret. 6ew Aork: imon P chuster.
54. 'agner, <., /llan, /., P 0eiser, H. #2449%. Eight ecurit- "ractices ,ffer More
3alue Than "assword /ging. tamford, 1T: :artner.
(ecture <$ Charts/ Ta$les/ 0igures
C.2 1hart. $low of information in healthcare #<indfleisch, 5CC=%.
C.( 1hart. 0ealth information securit- is a trade)off #11 FA)61)/ (.4, 2452%.
(ecture <c
1. /non-mous. #244=b%. ecurit- 545 for 1overed Entities. Faltimore, M7: 1enters
for Medicare and Medicaid ervices. <etrieved from
http://###.hhs.go"/ocr/pri"ac*/hipaa/a'ministrati"e/securit*rule/securit*10
1.p'f
2. /non-mous. #244Ca%. 244C 0IM /nal-tics <eport: Evaluating 0ITE10Ks
Impact on 0ealthcare "rivac- and ecurit-. 1hicago, IL: 0IM /nal-tics.
<etrieved from
http://hapro'.himssanal*tics.org/'ocs/I,6+7perts611180<.p'f
3. /non-mous. #244Cb%. Impact of the /merican <ecover- P <einvestment /ct of
244C on 0I"// "rivac- P ecurit-. Feaverton, ,<: Fridgefront. <etrieved from
http://###.hipaar7.net/'o#nloa's/&..&6HI)&&62hite6)aper.p'f
8. /rmstrong, 7., Bline)<ogers, E., Hani, ., :oldman, E., $ang, H., Mukherjee, 7., .
. . Eagle, B. #2449%. "otential impact of the 0I"// privac- rule on data collection
in a registr- of patients with acute coronar- s-ndrome. "rchives of !nternal
:edicine, &?', 5529)552C.
8. /ssociation of /merican "h-sicians and urgeons, Inc. #nd.%. ,ath of
0ippocrates& 7eclaration of :eneva of the 'M/. <etrieved Han 2452 from:
http://###.aapsonline.org/ethics/oaths.htm .
D. Freese, "., P Furman, '. #2449%. <eadabilit- of notice of privac- forms used b-
major health care institutions. /ournal of the "merican :edical "ssociation, #>6,
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare =>
59C()59C8.
5. 0ouser, ., 0ouser, 0., P hewchuk, <. #244=%. /ssessing the effects of the
0I"// privac- rule on release of patient information b- healthcare facilities.
5erspectives in Health !nformation :anagement, #6#8%, 5. <etrieved from
http://###.pu$me'central.nih.go"/articleren'er.fcgi9pu$me'i':1B0;;381
>. Bamoie, F., P 0odge, H. #2448%. 0I"//Os implications for public health polic- and
practice: guidance from the 171. 5ublic Health ,eports, &&>, 25D)25C.
C. Le-va, 1., P Le-va, 7. #2455%. 0I"// urvival :uide for "roviders: "rivac- P
ecurit- <ules, Third Edition. Largo, $L: 0ITE10 urvival :uide.
10. Mc:raw, 7. #244C%. <ethinking the <ole of 1onsent in "rotecting 0ealth
Information "rivac-. 'ashington, 71: 1enter for 7emocrac- P Technolog-.
<etrieved from http://###.c't.org/healthpri"ac*/200<012;Consent.p'f
55. Mc:raw, 7., 7empse-, H., 0arris, L., P :oldman, H. #244C%. "rivac- as an
enabler, not an impediment: building trust into health information e!change.
Health "ffairs, #;, 85D)82=.
52. 6ass, ., Levit, L., P :ostin, L. #Eds.%. #244C%. Fe-ond the 0I"// "rivac- <ule:
Enhancing "rivac-, Improving 0ealth Through <esearch. 'ashington, 71:
6ational /cademies "ress.
5(. 6ess, <. #244=%. Influence of the 0I"// "rivac- <ule on health research.
/ournal of the "merican :edical "ssociation, #>;, 25D8)25=4.
(ecture <'
1. /non-mous. #244=%. ecurit- 545 for 1overed Entities. Faltimore, M7: 1enters
for Medicare and Medicaid ervices. <etrieved Han 2452 from
http://###.hhs.go"/ocr/pri"ac*/hipaa/a'ministrati"e/securit*rule/securit*10
1.p'f.
2. /non-mous. #2454%. :uidance on <isk /nal-sis <e*uirements under the 0I"//
ecurit- <ule. 'ashington, 71: 7epartment of 0ealth and 0uman ervices.
<etrieved Han 2452 from
http://###.hhs.go"/ocr/pri"ac*/hipaa/a'ministrati"e/securit*rule/rafinalgui
'ancep'f.p'f.
comp2@unitC@discuss.doc
comp2@unitC@discuss@ke-.doc
comp2@unitC@self@assess.doc
comp2@unitC@self@assess@ke-.doc
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare =C
Component 2/-nit 10
-nit Title
Sociotechnical &spects: Clinicians an' Technolog*
-nit ,escription
This unit looks at the challenges of adapting work processes to new technolog-, and the
resulting impact on *ualit-, efficienc-, and safet-. This unit also e!amines the
phenomena of social and technical resistance to change, especiall- among clinicians.
-nit !$%ecti"es
5. 7escribe the concepts of medical error and patient safet- #Lecture a, b%
2. 7iscuss error as an individual and as a s-stem problem #Lecture a%
(. 1ompare and contrast the interaction and interdependence of social and
technical Jresistance to changeM #Lecture c%
8. 7iscuss the challenges inherent with adapting work processes to new
technolog- #Lecture c%
9. 7iscuss the downside of adapting technolog- to work practices and wh-
this is not desirable #Lecture c%
D. 7iscuss the impact of changing sociotechnical processes on *ualit-,
efficienc-, and safet- #Lecture a, b%
5. Medical errors
2. "atient safet-
(. ociotechnical aspects of healthcare
-nit .eferences
(ecture 10a
5. /uerbach, /., Landefeld, 1., et al. #244=%. The tension between needing to
improve care and knowing how to do it. 6ew England Hournal of Medicine, (9=:
D4>)D5(.
2. 7onabedian, /. #5C>>%. The *ualit- of care: how can it be assessed? Hournal of
the /merican Medical /ssociation, 2D4: 5=8()5=8>.
(. Bohn, L., 1orrigan, H., et al., eds. #2444%. To Err Is 0uman: Fuilding a afer
0ealth -stem. 'ashington, 71. 6ational /cademies "ress.
8. BrumholL, 0. and Lee, T. #244>%. <edefining *ualit- )) implications of recent
clinical trials. 6ew England Hournal of Medicine, (9>: 29(=)29(C.
9. Leape, L. #2444%. Institute of Medicine medical error figures are not e!aggerated.
Hournal of the /merican Medical /ssociation, 2>8: C9)C=.
D. Mc:l-nn, E., /sch, ., et al. #244(%. The *ualit- of 0ealthcare delivered to adults
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare >4
in the +nited tates. 6ew England Hournal of Medicine, (8>: 2D(9)2D89.
=. 6olte, E. and McBee, 1. #244>%. Measuring the health of nations: updating an
earlier anal-sis. 0ealth /ffairs, 2=: 9>)=5.
>. chimmel EM. The 0aLards of 0ospitaliLation. /nn Intern Med Hanuar- 5, 5CD8
D4:544)554
C. o!, 0. and 'oloshin, . #2444%. 0ow man- deaths are due to medical error?
:etting the number right. Effective 1linical "ractice, D: 2==)2>(.
10. The tate of 0ealthcare Gualit-: 244C. 'ashington, 71, 6ational 1ommittee for
Gualit- /ssurance. http://###.ncFa.org/ta$i'/B3;/,efault.asp7.
(ecture 10$
5. $onarow, :., /braham, '., et al. #244=%. /ssociation between performance
measures and clinical outcomes for patients hospitaliLed with heart failure.
Hournal of the /merican Medical /ssociation, 2C=: D5)=4.
2. $owles, H., Bind, E., et al. #244>%. "erformance Measures +sing Electronic
0ealth <ecords: $ive 1ase tudies. 'ashington, 71, 1ommonwealth $und.
'oc6i':;B8103
3. Institute of Medicine #2444%. VTo Err Is 0uman: Fuilding a afer 0ealth -stem
#2444%V. The 6ational /cademies "ress. http://$ooDs.nap.e'u/open$ooD.php9
is$n:030<0;B351
4. Hoint 1ommission 7o 6ot +se List at
http://###.%ointcommission.org/assets/1/1B/!fficial6,o>20ot
>20-se6(ist6>20;610.p'f
9. Landon, F., 6ormand, ., et al. #244(%. "h-sician clinical performance
assessment: prospects and barriers. Hournal of the /merican Medical
/ssociation, 2C4: 55>()55>C.
D. Leape LL. Error in Medicine. H/M/. 5CC8&2=2#2(%:5>95)5>9=.
=. Lindenauer, "., <emus, 7., et al. #244=%. "ublic reporting and pa- for
performance in hospital *ualit- improvement. 6ew England Hournal of Medicine,
(9D: 8>D)8CD.
>. L-nn, H., Fail-, M., et al. #244=%. The ethics of using *ualit- improvement
methods in healthcare. /nnals of Internal Medicine, 58D: DDD)D=(.
<. Measuring hand h-giene monograph from the Hoint 1ommission at
http://###.%ointcommission.org/assets/1/1B/hh6monograph.p'f #would
assign onl- portion of this document for reading%
10. +niversal protocol at
http://###.%ointcommission.org/assets/1/1B/-)6)oster.p'f
(ecture 10c
5. 7ohert- 6$, Bing M. #2449%. $rom technical to socio)technical change:
tackling the human and organiLational aspects of s-stems development
projects. European Hournal of Information -stems .58, 5;9
2. Mc:l-nn, E., /sch, ., et al. #244(%. The *ualit- of healthcare delivered to
adults in the +nited tates. 6ew England Hournal of Medicine, (8>: 2D(9)
2D89.
(. Miller, T., Frennan, T., et al. #244C%. 0ow can we make more progress in
measuring ph-siciansO performance to improve the value of care? 0ealth
/ffairs, 2>: 582C)58(=.
4. ociotechnical s-stems at
http://en.#iDipe'ia.org/#iDi/Sociotechnical6s*stems
9. Tang, "., <alston, M., et al. #244=%. 1omparison of methodologies for
calculating *ualit- measures based on administrative data versus clinical data
from an electronic health record s-stem: implications for performance
measures. Hournal of the /merican Medical Informatics /ssociation, 58: 54)
59.
;. Timeline of medicine and medical technolog- at
http://en.#iDipe'ia.org/#iDi/Timeline6of6me'icine6an'6me'ical6technol
og*
=. 3onnegut, M. #244=%. Is *ualit- improvement improving *ualit-? / view from
the doctorOs office. 6ew England Hournal of Medicine, (9=: 2D92)2D9(.
B. 'orld 0ealth organiLation 99
th
'orld 0ealth /ssembl-. Gualit- of care:
patient safet-. <eport b- the ecretariat, 2442
http://apps.#ho.int/g$/archi"e/p'f6files/2H&88/ea8813.p'f
Component &cron*m ?lossar*
/1$ ; /dministration for 1hildren and $amilies
/7/ ; /merican 7ental /ssociation
/7L ; activit- of dail- living
/0<G ; /genc- for 0ealthcare <esearch and Gualit-
/I7 ) /c*uired immune deficienc- s-ndrome
/M/ ; The /merican Medical /ssociation
/o/ ; /dministration on /ging
/T7< ; /genc- for To!ic ubstances and 7isease <egistr-
11+ ; critical care unit
17)54)"1 ) The International 1lassification of 7iseases, 54th <evision, "rocedure
1oding
171 ; 1enters for 7isease 1ontrol and "revention
1701 ) 1onsumer 7riven 0ealth 1are "lans
17 ; 1linical 7ecision upport
17T ) 1ode on 7ental "rocedures and 6omenclature
1M ; 1enters for Medicare and Medicaid ervices
1"I ; 1onsumer "rice Inde!
1"T ) 1urrent "rocedure Terminolog-
1T ; 1omputeriLed Tomograph-
76< ; do)not)resuscitate order
7<: ) 7iagnosis <elated :roups
EFM ; Evidence Fased Medicine
E7 ) Emergenc- 7epartment
E7I ) Electronic data interchange
EMT ; emergenc- medical technician
EMT/L/ ; Emergenc- Medical Treatment and /ctive Labor /ct
E", ) E!clusive "rovider ,rganiLation
E< ; emergenc- room
$7/ ; $ood and 7rug /dministration
$$ ) $ee)for)service
:7" ; gross domestic product
01, ; 0ealth 1are ,rganiLation
01"1 ) 0ealth 1are 1ommon "rocedure 1oding -stem
00 ; 7epartment of 0ealth and 0uman ervices
0I"// ; 0ealth Insurance "ortabilit- and /ccountabilit- /ct
0IT ; 0ealth Information Technolog-
0ITE10 /ct ) The 0ealth Information Technolog- for Economic and 1linical 0ealth /ct
0I3 ) 0uman immunodeficienc- virus
0M, ) 0ealth Maintenance ,rganiLation
0</ ; 0ealth <esources and ervices /dministration
I17)54)1M ) The International 1lassification of 7iseases, 54th <evision, 1linical
Modification,
0ealth IT 'orkforce 1urriculum The 1ulture of 0ealthcare >(
I17)C)1M ) The International 1lassification of 7iseases, 6inth <evision, 1linical
Modification
I1+ ; intensive care unit
I0 ; Indian 0ealth ervice
I"/ ; independent practice association
H1 ; Hoint 1ommission
HTT ; Hoint Theater Trauma -stem
L"6 ; licensed practical nurse
L<6 ) Lab <esponse 6etwork
M1, ) Managed care organiLation
M0 ; Militar- 0ealth -stem
M<I ; Magnetic <esonance Imaging
M</ ) methicillin)resistant taph-lococcus aureus
6ational 7rug 1odes #671
6/T, ; 6orth /tlantic Treat- ,rganiLation
6I0 ; 6ational Institutes of 0ealth
6, ; 6ot ,therwise pecified
,I: ; ,ffice of Inspector :eneral
,< ; operating room
"/ ; ph-sician assistant
"M"M ) per member per month
", ) "oint of ervice "lan
"", ) "referred "rovider ,rganiLation
"T7 ; post)traumatic stress disorder
<F<3 ) <esource Fased <elative 3alue cale
<6 ; registered nurse
/M0/ ; ubstance /buse and Mental 0ealth ervices /dministration
TFI ; traumatic brain injur-
3/ ; 7epartment of 3eterans /ffairs
Creati"e Commons &ttri$ution3onCommercial3Share&liDe 3.0
-nporte'
CC EG3C3S&
This #orD is license' un'er the Creati"e Commons &ttri$ution3onCommercial3
Share&liDe 3.0 -nporte' (icense. To "ie# a cop* of this license/ "isit
http://creati"ecommons.org/licenses/$*3nc3sa/3.0/ or sen' a letter to Creati"e
Commons/ 151 Secon' Street/ Suite 300/ San 0rancisco/ California/ <4108/ -S&.
,+T&I(S of the onCommercial3Share&liDe 3.0 -nporte' license:
Gou are free:
to Share X to cop-, distribute and transmit the work
to .emi7 X to adapt the work
-n'er the follo#ing con'itions:
&ttri$ution X Aou must attribute the work in the manner specified b- the author or
licensor #but not in an- wa- that suggests that the- endorse -ou or -our use of the
work%: 1ourtes- of #name of universit- that created the work% and the ,61 0ealth IT
'orkforce 1urriculum program.
oncommercial X Aou ma- not use this work for commercial purposes.
Note8 Use of these materials is considered Gnon9commercialH for all educational
institutions, for educational purposes, including tuition9based courses, continuing
educations courses, and fee9based courses( The selling of these materials is not
permitted( harging tuition for a course shall not be considered commercial use(
Share &liDe X If -ou alter, transform, or build upon this work, -ou ma- distribute the
resulting work onl- under the same or similar license to this one with the understanding
that:
2ai"er X /n- of the above conditions can be waived if -ou get permission from the
cop-right holder #the universit- that created the work%.
)u$lic ,omain X 'here the work or an- of its elements is in the public domain under
applicable law, that status is in no wa- affected b- the license.
!ther .ights X In no wa- are an- of the following rights affected b- the license:
Aour fair dealing or fair use rights, or other applicable cop-right e!ceptions and
limitations&
The authorOs moral rights&
<ights other persons ma- have either in the work itself or in how the work is used, such
as publicit- or privac- rights.
otice X $or an- reuse or distribution, -ou must make clear to others the license terms
of this work. The best wa- to do this is with a link to this web page
#http:..creativecommons.org.licenses.b-)nc)sa.(.4.%.
To view the Legal 1ode of the full license, follow this link:
http:..creativecommons.org.licenses.b-)nc)sa.(.4.legalcode

02-Manual - The Culture of Healthcare

Diunggah oleh

Informasi Dokumen

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

02-Manual - The Culture of Healthcare

Diunggah oleh

Hak Cipta:

Format Tersedia

Component 2:

Anda mungkin juga menyukai