This book's focus is on the decisions taken in consultations between health care patients and professionals. Clinician- patient partnerships in health care decisions are increasingly advocated. Evidence- based patient choice describes a model of health care in which the evidence-based approach can integrate with the promotion of consumer choice. The book examines the traditional approach and the changing experience and expectations of consumers. It describes with many clinical examples and patient narratives how to practice evidence-based patient choice, and explores the ethical, sociological and economic issues raised. It also addresses the future modifications to professional training and organisational change which are required if evidence-based patient choice is to become the norm and speculates about what is likely to be achieved in the next few years. The book provides a summary of current perspectives in this area, which will be of interest to consumers, their representative groups, and to professionals in practice and training alike. From the foreword by Richard Grol: 'An enormous challenge lies before us. In this new and challenging field Evidence-based patient choice is manna from heaven. It summarises the current state of knowledge about these new patient involvement approaches. It is by far the most comprehensive account of scientific and ethical thinking about patient choice at this moment. And, it manages to show us the way to a potential future: health care provision where patients and professionals operate as real partners with shared goals...'

Over the past decade health care systems around the world have placed increasing importance on the relationship between patient choice and clinical decision-making. In the years since the publication of the second edition of Shared Decision Making in Health Care, there have been significant new developments in the field, most notably in the US where 'Obamacare' puts shared decision making (SDM) at the centre of the 2009 Affordable Care Act. This new edition explores shared decision making by examining, from practical and theoretical perspectives, what should comprise an effective decision-making process. It also looks at the benefits and potential difficulties that arise when patients and clinicians share health care decisions. Written by leading experts from around the world and utilizing high quality evidence, the book provides an up-to-date reference with real-word context to the topics discussed, and in-depth coverage of the practicalities of implementing and teaching SDM. The breadth of information in Shared Decision Making in Health Care makes it the definitive source of expert knowledge for healthcare policy makers. As health care systems adapt to increasingly collaborative patient-clinician care frameworks, this will also prove a useful guide to SDM for clinicians of all disciplines.

What is ‘good care’ and does more choice lead to better care? This innovative and compelling work investigates good care and argues that the often touted ideal of ‘patient choice’ will not improve healthcare in the ways hoped for by its advocates.

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

The idea of person-centred health systems is widely advocated in political and policy declarations to better address health system challenges. A person-centred approach is advocated on political, ethical and instrumental grounds and believed to benefit service users, health professionals and the health system more broadly. However, there is continuing debate about the strategies that are available and effective to promote and implement 'person-centred' approaches. This book brings together the world's leading experts in the field to present the evidence base and analyse current challenges and issues. It examines 'person-centredness' from the different roles people take in health systems, as individual service users, care managers, taxpayers or active citizens. The evidence presented will not only provide invaluable policy advice to practitioners and policymakers working on the design and implementation of person-centred health systems but will also be an excellent resource for academics and graduate students researching health systems in Europe. This title is available as Open Access on Cambridge Core.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Practical guide for health practitioners and policy-makers, demystifying evidence-informed decision-making from the individual clinical level to global policy.