up-front investments required by provider groups, 197–199

“Batch size of one,” 125

Behavioral change, patients’ need for, 28

Benefits of information technology, 166–170

Bill of Rights, 64

Biological approach, 314–315

Biomedical research, increasing investments in, 25

Blended payment methods

adapting, 200–201

incentives of current, 188–189

British Medical Journal, 150

Bronchitis, inappropriate acute care of, 296

Budget approaches, incentives of current, 186– 187

Building organizational supports for change, 11–12

Bureau of Health Professionals, 214

Bureau of Primary Health Care, Quality Center, 91

Buyers Health Care Action Group, 200

C

Cancer, 91, 103

chronic care, 274–279

screening, 251–253

Cancerfacts.com, 55

Capitation payment, adapting, 200

Cardiac care problems, findings about, 227

Cardiac rehabilitation, 170

Cardiac risk factors, 254–257

Cardiovascular disease

chronic care of, 279–291

inappropriate acute care of, 298–301

Care processes

establishing new environment for, 13–20

redesigning, 11, 117–127

Carotid arteries, inappropriate acute care of, 302

Case histories

chronic care (using partnership to improve), 107

Henry L. (HIV positive), 69

hospital emergency department (improving timeliness of services), 107

Mary Chao (diabetes educator), 75

Maureen Waters (care as it could be), 54–56

Ms. Martinez (failed care), 41–44, 49, 51

patient-centered primary care (reorganizing staff), 107–108

Pearl Clayton (mental health), 81

Cataracts, inappropriate acute care of, 302

Center for Organization and Delivery Studies, 105

Centers for Disease Control and Prevention, 156

Centers of Excellence, 100, 106

Change

building organizational supports for, 11–12

in the health care environment, responding to, 138

leadership for managing, 137–140

providing assets and encouragement for positive, 13

providing the resources needed to initiate, 103–108

Changes in Health Care Financing and Organization Program, 105

CHESS database, 55

Chronic care

asthma, 264–265

cancer, 274–279

cardiovascular disease, 279–291

diabetes mellitus, 265–268

hypertension, 269–270

mental/addictive disorder, 272–274

mental health, 270–272

peptic ulcer disease, 269

underuse of, 264–291

Chronic conditions, 3–4.

See also Priority conditions

health care for, 9

increase in, 26–27

Chronic heart failure, 97

Clinical care, potential benefits of information technology for, 167–168

Clinical decision support system (CDSS), 151– 155

Clinical education and training

changes in health professional education required, 210

curricular changes required, 209–210

new or enhanced skills required by health professionals, 209

opportunities for multidisciplinary training, 210–211

reasons for little change in traditional clinical education, 213–214

retooling practicing clinicians, 211–212

retraining nonclinical administrative management personnel, 212



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