Health systems science

Title page
Table of Contents
Copyright
Contributors
Foreword
Preface
1.  What is health systems science? Building an integrated vision
	I. The need for curricula in health systems science
	II. The rapidly changing health care environment
	III. Clinician readiness to practice in the evolving health care system
	IV. The third medical science: Health systems science
	V. Health systems science curricular domains
	VI. Case studies: Renal disease and treatment—where basic, clinical, and health systems science merge
	VII. Professional identity formation
	VIII. Challenges for learners to engage health systems science
	IX. Chapter summary
	X. Overview of book chapters
	XI. Chapter template
	Questions for further thought
	References
	Annotated bibliography
	References
2.  Systems thinking in health care: Addressing the complex dynamics of patients and health systems
	I. Burning platform for change in health care delivery and the need for systems thinking
	II. Systems thinking in health care
	III. Health care delivery as complex adaptive challenges
	IV. The habits of a systems thinker
	V. Application of systems thinking to health care
	VI. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
3.  The health care delivery system
	I. Desired outcomes of health care delivery
	II. Catalysts for change in US health care delivery
	III. New models of health care delivery
	IV. Congruence of current delivery systems with accountable care and population health
	V. Closing gaps in the health care delivery system
	VI. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
4.  Health care structures and processes
	I. Introduction to the donabedian model
	II. Structures across the continuum of care
	III. Processes within the health care system
	IV. Clinical microsystems
	V. Future directions
	VI. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
5.  Value in health care
	I. Introduction to value in health care
	II. Knowledge and education gaps in high-value care
	III. Defining value
	IV. Value from stakeholders’ perspectives
	V. Assessing the current value of US health care
	VI. Key attributes of a high-value health care system
	VII. Barriers to high-value care
	VIII. What can health care professionals do to promote high-value care?
	IX. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
6.  Patient safety
	I. Introduction
	II. Basic principles of patient safety
	III. Specific types of medical errors
	IV. Factors contributing to error
	V. Communicating with patients after adverse events due to medical errors
	VI. Second victims
	VII. Reporting systems—mandatory versus voluntary
	VIII. Assessment of risk and mitigation of medical errors
	IX. Evaluation of near misses and errors
	X. Patient safety improvement strategies
	XI. Changing the future of patient safety
	XII. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
7.  Quality improvement
	I. Quality improvement in health care
	II. Quality measurement
	III. Quality reporting
	IV. Quality improvement methods
	V. Common quality issues and successful interventions
	VI. Quality improvement scholarship
	VII. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
8.  Principles of teamwork and team science
	I. Introduction—teams as a critical aspect of health systems science
	II. The promise of interprofessional practice
	III. Teams and collaboration
	IV. Evaluating teams and teamwork
	V. Understanding health systems, systems thinking, and teams
	VI. Team training
	VII. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
9.  Leadership in health care
	I. Introduction
	II. The health care leadership imperative
	III. Who are health care leaders?
	IV. The importance of clinician leadership
	V. Influential leadership theories
	VI. Guiding principles of health care leadership
	VII. Health care leadership competencies
	VIII. Specific attributes for health care leaders in different settings
	IX. Pathways to leadership
	X. New leadership roles
	XI. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
10.  Clinical informatics
	I. Rationale and terminology of clinical informatics
	II. Use of clinical informatics in health care delivery
	III. Secondary use of clinical data
	IV. Outcomes and implications of clinical informatics
	V. Competencies of clinical informatics
	VI. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
11.  Population health
	I. Introduction
	II. What is population health?
	III. Why a focus on population health?
	IV. Solutions to improve population health
	V. Future of population health
	VI. Education initiatives in population health
	VII. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
12.  Structural and social determinants of health
	I. Introduction
	II. Case studies and exercise
	III. How structural and social determinants lead to adverse health outcomes
	IV. Structural determinants of health inequities
	V. Social determinants of health
	VI. Interventions focusing on root causes
	VII. Case study conclusions
	VIII. Chapter summary
	Questions for further thought
	Acknowledgments
	Annotated bibliography
	References
13.  Health law and ethics
	I. Introduction: Law and ethics in health systems change
	II. Fiduciary duty and conflict of interest
	III. Professional self-regulation and market competition
	IV. Fraud and abuse
	V. Privacy and confidentiality
	VI. Health insurance
	VII. Informed consent to treatment
	VIII. Medical malpractice and redressing error
	IX. Withholding and withdrawing care
	X. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
14.  Health care policy and economics
	I. Introduction
	II. Core principles of health policy
	III. Core principles of health care economics
	IV. Theories and history of health care reform
	V. The path to the Affordable Care Act
	VI. The major components of the ACA
	VII. The effect of the ACA on patients, health care professionals, and institutions
	VIII. Policy controversies and challenges
	IX. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
15.  Application of health systems science competencies in patient care
	I. Introduction: Foundational skills for health care delivery
	II. Evidence-based medicine
	III. Communication skills via new technology
	IV. Teamwork
	V. Professionalism
	VI. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
16.  The use of assessment to support students’ learning and improvement in health systems science
	I. Introduction
	II. Current attention to health systems science in major assessment frameworks in US medical education
	III. Assessment of knowledge, skills, and practice performance in health systems science
	IV. Student-directed assessment strategies for the clinical workplace
	V. Assessment of team performance
	VI. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
17.  Looking ahead: The dynamic nature of health systems science, future trends, and the role of learners as change agents
	I. Health systems science—a dynamic, rapidly developing domain and field of inquiry
	II. Future trends and their implications for health systems science
	III. Health professions students and trainees as master adaptive learners and change agents
	IV. Future directions for health systems science
	V. Chapter summary
	Questions for further thought
	Annotated bibliography
	References
Glossary
Index