List of Articles
- Patient Safety
Patient safety is a fundamental principle of health care. Understanding the causes of medical error and strategies to reduce harm is simple compared with the complexity of clinical practice. Communication breakdown remains a leading contributor to adverse events in the United States. Every point in the process of care-giving contains a certain degree of inherent unsafety. A number of countries have published studies showing that significant numbers of patients are harmed during health care, either resulting in permanent injury, increased length of stay in health care facilities, or even death. Clear policies, organizational leadership capacity, data to drive safety improvements, skilled health care professionals and effective involvement of patients in their care, are all needed to ensure sustainable and significant improvements in the safety of health care. The purpose of this document is to discuss strategic pathways to accelerate future improvement in patient safety. It includes fundamental changes in health care education, patient engagement, transparency, care coordination, and improving health care providers' morale. Transforming groups of individual experts into expert teams is central to this cultural transformation. This document aims to address the weakness in health systems that lead to medication errors and severe harm that results. It lays out ways to improve the way medicines are prescribed, distributed, and increase awareness among patients about the risks associated with the improper use of medications. Both health workers and patients can make mistakes that result in severe harm, such as prescribing, ordering, dispensing, preparing, administrating or consuming the wrong medication or the wrong dose at the wrong time. But all medication errors are potentially avoidable. Preventing errors and the harm that results requires putting systems and procedures in place to ensure the right patient receives the right medication at the right dose at the right time. Although much progress has been made, there is still much work to be done to reduce iatrogenic harm. Key to future improvement is engaged clinical and organizational leadership that must drive a shift in culture and help transform individual experts into expert teams.
- Medical Liability: Coping With Litigation Stress
The stress resulting from a medical liability case can have a negative effect on physician’s personal and professional life, and their ability to defend themselves against the charge. The purpose of this document is to promote mental wellbeing of healthcare providers by the provision of productive and healthy workplaces. Wellness goes beyond merely the absence of distress and includes being challenged, thriving, and achieving success in various aspects of personal and professional life. When physicians are unwell, the performance of healthcare systems can be suboptimum. Physician wellness might not only benefit the individual physician, it could also be vital to the delivery of high-quality health care. This review discusses the work stresses faced by physicians, the barriers to attending to wellness, and the consequences of unwell physicians to the individual and to healthcare systems. There are many programs in the USA, Canada and UK that are designed to improve physician’s wellness by recognition of potential health problems and by the provision of education and support (e.g. from basics such as getting enough food at work, sleeping properly, and to how to deal with adverse events, complaints, and litigation). The endpoint is better care for patients and improved system outcomes. Individual physician wellness is a valid indicator for organizational health. Healthy physicians mean healthier patients, safer care, and a more sustainable workforce.
- Medical Liability: Tort Reform
The greatest ongoing challenge for health care reform in the United States is to provide better health care for less money. Both aspirations are possible, but only if the nation is willing to overhaul the unreliable system of medical justice. Containing costs requires changing the rules for all participants. A range of malpractice reform proposals have been suggested as part of the national debate, and it is useful to examine them and identify the advantages of each. All of these reforms have significant merit, but special health courts are by far the most important in reducing defensive medicine. Perhaps the most important reason for adopting administrative compensation models for adverse medical outcomes is the effect on patient safety and quality of care. Adverse outcomes, preventable or otherwise, are an uncomfortable reality of medical care. Disclosure and discussion of adverse events in health care is desired by patients and championed by safety experts and policy makers.
- Medical Liability: Risk Management
Risk management in the healthcare profession refers to strategies designed to enhance patient safety, decrease the risk of malpractice claims, and minimize loss. The goal of this program is to improve patient safety, decrease patient injury, and decrease liability losses through an educational program that identifies and initiates specific risk-reduction clinical practices and creates a comprehensive culture of safety. This effective risk management program includes both proactive and reactive components. The proactive component consists of strategies to prevent adverse occurrences, and the reactive component includes strategies for responding to such occurrences (i.e. minimizing loss). Given that obstetrics is the number one cause of admission to hospitals and that the professional liability system, as it now exists, threatens both the ability of obstetric providers to continue care and women to access care, it is imperative to take a leading role in patient safety and work towards optimizing outcome for our patients. One of the major results of health reform is the development of health-insurance exchanges, which will expand quality measurement. Enhancing safety of women in the hospitals and minimizing errors is not only an ethical and moral obligation, but also an essential component of liability reform.
- Medical Liability: Current Status and Patient Safety
Accusations of negligence and the harm they do can be greatly reduced by a no-fault compensation, more realistic expectations, and an appropriate continuing education system for health professionals. In recent years, a science of patient safety has developed. Harm to patients is not inevitable and can be avoided. To achieve this, clinicians and institutions must learn from past errors, and learn how to prevent future errors. We need to adapt our ways of working to make safe health care a robust and achievable goal. Clinicians, managers, healthcare organizations, governments (worldwide) and consumers must become familiar with patient safety concepts and principles. Though medical curricula are continually changing to accommodate the latest discoveries and new knowledge, patient safety knowledge is different from other because it applies to all areas of practice. It is therefore fitting that the Women's Health and Education Center (WHEC) with its partners in health, has developed this curriculum which will enable and encourage medical schools and healthcare facilities to include patient safety in their courses. Reducing harm caused by health care is a global priority. These skills are fundamental to patient safety.
- Health Literacy, e-Health and Sustainable Development
Literacy is a human right and can be considered a tool of personal empowerment: a means for social and human development. Health literacy and e-Health are valuable tools in empowering women and communities to improve their health status and achieve sustainable development by reaching the indicators of the Millennium Development Goals (MDGs). In today's world, the local and global are inextricably linked. Action on one cannot ignore the influence of or impact on the other. e-Health is a global phenomenon. The Women's Health and Education Center's (WHEC's) strategy on e-Health focuses on strengthening health systems in countries; fostering public-private partnerships in information and communication technologies (ICT) research and development for health; supporting capacity building for e-Health application worldwide; and the development and use of norms and standards. Long-term government commitment, based on a strategic plan, is a prerequisite for the successful implementation of e-Health activities. Health is both a fundamental human right and a sound social investment.
- Women's Health and Human Rights
Human rights are used by international organizations, governments, non-governmental organizations (NGOs), civil society groups and individuals in their work with respect to health in many different ways. The right to life is a fundamental human right, implying not only the right to protection against arbitrary execution by the state but also the obligations of governments to foster the conditions essential for life and survival. Human rights are universal and must be applied without discrimination on any grounds whatsoever, including sex. For women, human rights include access to services that will ensure safe pregnancy and childbirth. The right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant is essential. This has been the focus of an initiative developed by the Women's Health and Education Center (WHEC) with various partners, to provide all those working for Safe Motherhood, with a way of analyzing the impact in an understanding of both health and human rights.
- Health Care: Who Should Pay For What?
Today, maternal, newborn and child health are no longer discussed in purely technical terms, but as part of a broader agenda of universal access. We must spare no effort to find financing solutions which work for rich and poor countries alike because a population's good health is one of a country's most precious assets. As the reform of health care systems progresses, countries are searching for a balance between the financial benefits of a competitive health care market, and the need for fairness in sharing the burden of treatment costs. Differences between countries mean that no single model of health care financing will apply everywhere; principles must be adapted to the specific local context. The key to moving towards universal access and financial protection is the organization of financing. Current government expenditure and international flows cannot guarantee universal access and financial protection, because they are insufficient and because they are too unpredictable. Better health through better use of resources.
- Improving Maternal Health through Education
Education improves health, while health improves learning potential. Education and health complement, enhance and support each other; together, they serve as the foundation for a better world. Gender equality, including in education, is a condition for development. In so doing, we can make healthier choices and lay the foundations for true social and economic development. If we consider what it takes to create health, the school becomes an ideal setting for action. Schools can help young people acquire the basic skills needed to create health. Adolescents find themselves under strong peer pressure to engage in highly risky behavior, which can have serious implications on theirlives. Lack of access to and use of essential obstetric services is a crucial factor that contributes to high maternal mortality. Continuing medical education in women's health and health care is beneficial to both donor and recipient countries and can engage public and private stakeholders towards common goals.
- Poverty and Maternal Mortality
The wide acceptance of the Millennium Development Goals (MDGs) by the international community confirms the central role of human development, including health and nutrition, in combating poverty. As countries develop and implement their Poverty Reduction Strategies (PRS), one of the key challenges is to identify actions that will have the greatest impact on poverty and improve the lives of poor. The challenge is compounded by the fact that poverty has many dimensions, cuts across many sectors, and is experienced differently by women and by men. In no region of the developing world are women equal to men in legal, social and economic rights. Gender gaps are widespread in access to and control of resources, in economic opportunities, in power and political voice. Gender equality is a development objective on its own -- it also makes good business sense as it is central to economic growth and sustainable development. Safe Motherhood is back at the top of the global health agenda. Today the interventions already exist to transform the lives of millions of mothers and children and to prevent millions of tragically premature deaths and disabilities.
- Health Care Patents and The Interests of Patients
Discussions of intellectual property are very complex and involve knowledge of convoluted laws, legal decisions, economic and business analyses. This forum attempts to present and evaluate the arguments on all sides and suggests a possible way out of the current impasse. It attempts to determine the ethical responsibility of the drug industry in making drugs available to the needy, while at the same time developing the parallel responsibilities of individuals, governments, and NGOs. It concludes with the suggestions and areas for future development of mutual interests (continuing medical education initiatives).
- Improving Maternal and Child Health: Towards Universal Access
Universal access for mothers and children requires health systems to be able to respond to the needs and demands of the population, and to offer them protection against the financial hardship that results from ill-health. Children are the future of society and their mothers are guardians of that future. To make this possible; investments in health systems and in the human resources for health need to be stepped up. Women's Health and Education Center (WHEC) addresses through its publications the most pressing public health concerns of populations around the world. To ensure the widest possible availability of authoritative information and guidance on public health matters, WHEC encourages its translation and adaptation.
- Ethical Issues in Reproductive Health: That Delicate Balance
Although the deliberate creation of human embryos for scientific research is complicated by ethical and practical issues, a detailed understanding of the cellular and molecular events occurring during human fertilization is essential, particularly for understanding infertility. When research is carefully targeted to identify and solve reproductive health problems, it can potentially serve as a powerful tool for health and social development. Scientific information alone cannot resolve questions about the moral status of the pre-embryos (stem cells). At the dawn of the genomic era, with its unprecedented research, there is an opportunity to ask the right questions.
- Challenges of Cultural Diversity and Practice of Medicine
Culture is a lens through which people see their world. Every professional encounter with a patient involves three cultures: that of patient, that of healthcare provider and that of environment. The answer to the situation is as simple as the issue is complex. If there were any religion that could cope with modern scientific needs, it would be - an open mind.
- Safe Motherhood: A Matter of Human Rights & Social Justice
Maternal health is a multifaceted problem with social, psychological and cultural roots. There is no simple or single solution to the problem; rather women's healthcare must be addressed at multiple levels and in multiple sectors of society to develop effective projects and programs. Aim to ensure equal access to affordable and quality healthcare.
- Migration of Physicians and Nurses: Trends & Policies
Migrant health workers are faced with a set of options that are a combination of economic, social and psychological factors and family choices. They trade decisions related to their career opportunities and to financial security for their families against the psychological and social costs of leaving their country, family and friends. In both the countries of origin and the receiving countries, consumers of health services have similar concerns. Continuing Medical Education (CME) Initiatives can be of benefit to donor, and recipient countries both.
- World Health Organization's Commission On Macroeconomics And Health: A Short Critique
When donors earmark funds for a developing country, it does not necessarily follow that the amount of money allocated to programs that yield the best health benefits will increase in the country concerned. Does donor pledge inspire domestic investment in health? Earmarking can distort resource allocation in unintended ways.
- Culture and Health
As the health system changes and increasingly focuses on primary care and prevention, it is critical that health care providers develop ongoing and trusting relationships with their patients. Cultural sensitivity and awareness is particularly relevant to maternity care. The birth of a child initiates another generation into a family and affords a new opportunity for cultural traditions to be solidified, thus strengthening the bond between parents and child and serving to unify family members. Communication is at the heart of who we are as human beings. It is our way of exchanging information; it also signifies our symbolic capability. Medicine has a culture of its own, with traditional codes of conduct that have been passed on from generation to generation. From that point of view, Women's Health and Education Center (WHEC)'s community and family health approaches are particularly important for achieving social and cultural relevance in health work.
- Medical Negligence: A Return to Trust
Science and law must coexist. It would be for the good of all if this relationship were a mutually helpful one; at the very least neither one should exploit the other.
- The Business of Health -- Can we afford to ignore reality?
In USA there is no medical care crisis. It is a medical cost crisis. The health care delivery system needs a major reform. A plan for quality medical care for everyone that preserves our choices is needed.
Please send your thoughts and opinion for publication.
- Adapting to Change Learning Program
In December 2000, 149 heads of state and or government and 189 Member States jointly endorsed the Millennium Declaration, thereby committing themselves to achieving, by 2015, ambitious goals including reducing poverty, hunger and disease. These goals are known collectively as the Millennium Development Goals (MDGs) and they will serve as a basis for recording progress in development for the next 15 years.
- Health Care Crisis in the USA
Discusses the rising cost of health care due to social and medico-legal pressures which are responsible for the over-utilization of diagnostic techniques and various treatments.
- Dying With Dignity
Every one of us will be confronted by our own death and that of the people we care about, yet it is difficult to name any other fact of life that is so fiercely resisted. In our culture denial of death is pervasive. In the past, death at home surrounded by relatives was perhaps easier to accept as a natural event. Now that more people die in hospitals, set apart from the living, death seems all the more mysterious, frightening and remote from our existence.
- End-of-Life Decision Making
The population of the earth is aging, and as medical techniques, pharmaceuticals, and devices push the boundaries of human physiological capabilities, more humans will go on to live longer. However, this prolonged existence may involve incapacities, particularly at the end-of-life, and especially in the intensive care unit. This arena involves not only patients and families, but also care-givers. It involves topics from economics to existentialism and from surgery to spiritualism. It requires education, communication, acceptance of diversity, and an ultimate acquiescence to the inevitable. Advance directives can be a difficult topic because they deal with end-of-life and other serious medical situations. However, advance directives are valuable to patients and health care providers alike because they minimize conflict between family and health care providers by clarifying and respecting patients’ wishes. In a perfect world, every patient would have clear, concise documents that designate a proxy who communicates his or her end-of-life wishes. In the real world, however, this doesn't always happen. This series on End-of-Life Care explores answers to some key questions to help physicians avoid legal liability in situations when the path is not entirely clear.
Women's Health & Education Center
Dedicated to Women's and Children's Well-being and Health Care Worldwide
Dedicated to Women's and Children's Well-being and Health Care Worldwide