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To Err Is Human
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book se...
A Framework for Educating Health Professionals to Address the Social Determinants of Health
The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies, and political systems. In an era of pronounced human migration, changing demographics, and growing financial gaps between rich and poor, a fundamental understanding of how the conditions and circumstances in which individuals and populations exist affect mental and physical health is imperative. Educating health professionals about the social determinants of...
Promising Practices for Addressing the Underrepresentation of Women in Science, Engineering, and Medicine
Careers in science, engineering, and medicine offer opportunities to advance knowledge, contribute to the well-being of communities, and support the security, prosperity, and health of the United States. But many women do not pursue or persist in these careers, or advance to leadership positions - not because they lack the talent or aspirations, but because they face barriers, including: implicit and explicit bias; sexual harassment; unequal access to funding and resources; pay inequity; higher teaching and advising loads; and fewer speaking invitations, among others. There are consequences from this underrepresentation of women for the nation as well: a labor shortage in many science, engin...
Technically Speaking
Cell phones . . . airbags . . . genetically modified food . . . the Internet. These are all emblems of modern life. You might ask what we would do without them. But an even more interesting question might be what would we do if we had to actually explain how they worked? The United States is riding a whirlwind of technological change. To be sure, there have been periods, such as the late 1800s, when new inventions appeared in society at a comparable rate. But the pace of change today, and its social, economic, and other impacts, are as significant and far reaching as at any other time in history. And it seems that the faster we embrace new technologies, the less we're able to understand them...
Optimizing the Nation's Investment in Academic Research
Research universities are critical contributors to our national research enterprise. They are the principal source of a world-class labor force and fundamental discoveries that enhance our lives and the lives of others around the world. These institutions help to create an educated citizenry capable of making informed and crucial choices as participants in a democratic society. However many are concerned that the unintended cumulative effect of federal regulations undercuts the productivity of the research enterprise and diminishes the return on the federal investment in research. Optimizing the Nation's Investment in Academic Research reviews the regulatory framework as it currently exists,...
Clinical Practice Guidelines We Can Trust
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiqu...
Improving Diagnosis in Health Care
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients...
Reproducibility and Replicability in Science
One of the pathways by which the scientific community confirms the validity of a new scientific discovery is by repeating the research that produced it. When a scientific effort fails to independently confirm the computations or results of a previous study, some fear that it may be a symptom of a lack of rigor in science, while others argue that such an observed inconsistency can be an important precursor to new discovery. Concerns about reproducibility and replicability have been expressed in both scientific and popular media. As these concerns came to light, Congress requested that the National Academies of Sciences, Engineering, and Medicine conduct a study to assess the extent of issues ...
Sexual Harassment of Women
Over the last few decades, research, activity, and funding has been devoted to improving the recruitment, retention, and advancement of women in the fields of science, engineering, and medicine. In recent years the diversity of those participating in these fields, particularly the participation of women, has improved and there are significantly more women entering careers and studying science, engineering, and medicine than ever before. However, as women increasingly enter these fields they face biases and barriers and it is not surprising that sexual harassment is one of these barriers. Over thirty years the incidence of sexual harassment in different industries has held steady, yet now mor...
Organ Donation
Rates of organ donation lag far behind the increasing need. At the start of 2006, more than 90,000 people were waiting to receive a solid organ (kidney, liver, lung, pancreas, heart, or intestine). Organ Donation examines a wide range of proposals to increase organ donation, including policies that presume consent for donation as well as the use of financial incentives such as direct payments, coverage of funeral expenses, and charitable contributions. This book urges federal agencies, nonprofit groups, and others to boost opportunities for people to record their decisions to donate, strengthen efforts to educate the public about the benefits of organ donation, and continue to improve donation systems. Organ Donation also supports initiatives to increase donations from people whose deaths are the result of irreversible cardiac failure. This book emphasizes that all members of society have a stake in an adequate supply of organs for patients in need, because each individual is a potential recipient as well as a potential donor.
