Framework for a High Performance Health System for the United States

2006 ◽  
Keyword(s):  
United States ◽  
Health System ◽  
High Performance ◽  
The United States

Aiming High for the U.S. Health System: A Context for Health Reform

2008 ◽  
Vol 36 (4) ◽  
pp. 629-643
Author(s):  
Karen Davis ◽  
Cathy Schoen ◽  
Katherine Shea ◽  
Christine Haran
Keyword(s):  
United States ◽  
Health Care ◽  
Health System ◽  
High Performance ◽  
Insurance Coverage ◽  
Geographic Location ◽  
The United States ◽  
High Performing ◽  
Equity And Efficiency ◽  
The U.S

On the eve of the presidential inauguration, the U.S. health system faces rising costs of care, growing numbers of uninsured, wide variations in quality of care, and mounting public dissatisfaction. Despite spending more on health care than any other country, a recent Commonwealth Fund Commission on a High Performance Health Care System National Scorecard reports that the United States is lagging far behind other major industrialized countries — all of which provide universal health insurance — in five key domains: healthy lives, access, quality, equity, and efficiency. U.S. national performance is well below benchmarks of top performance set by other countries or high performing states, hospitals, or health plans within the United States, with broad disparities in experience depending on geographic location, income, race/ethnicity, and insurance coverage. National leadership is required to manage the growing health care crisis in the United States and improve care for all Americans.

Valuing Diversity and Inclusion in Healthcare: Pathways to Equip Workforces in the Post-COVID-19 New Normal (Preprint)

2021 ◽  
Author(s):  
Jiban Khuntia ◽  
Xue Ning ◽  
Wayne Cascio ◽  
Rulon Stacey
Keyword(s):  
United States ◽  
Health System ◽  
Health Systems ◽  
The United States ◽  
Mediating Effect ◽  
New Normal ◽  
Diversity And Inclusion ◽  
Healthcare Workforce ◽  
The Us ◽  
Service Oriented

BACKGROUND The COVID-19 pandemic, with all its virus variants, remains a serious situation. Health systems across the United States are trying their best to respond. The healthcare workforce remains relatively homogenous, even though they are caring for a highly diverse array of patients (6-12). It is a perennial problem in the US healthcare workforce that has only been accentuated during the COVID-19 pandemic. Medical workers should reflect the variety of patients they care for and strive to understand their mindsets within the larger contexts of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities. Along with talent and skills, diversity and inclusion (D&I) are essential for maintaining a workforce that can treat the myriad needs and populations that health systems serve. Developing hiring strategies in a post-COVID-19 “new normal” that will help achieve greater workforce diversity remains a challenge for health system leaders. OBJECTIVE Our primary objectives are (1) to explore the characteristics and perceived benefits of US health systems that value D&I; (2) to examine the influence of a workforce strategy designed to balance talent and D&I; and (3) to explore three pathways to better equip workforces and their relative influences on business- and service-oriented benefits: (a) improving D&I among existing employees (IMPROVE), (b) using multiple channels to find and recruit a workforce (RECRUIT), and (c) collaborating with universities to find new talent and establish plans to train students (COLLABORATE). METHODS During February–March 2021, we surveyed 625 health system chief executive officers, in the United States, 135 (22%) of whom responded. We assessed workforce talent and diversity-relevant factors. We collected secondary data from the Agency for Healthcare Research and Quality’s (AHRQ) Compendium of the US. Health Systems, leading to a matched data set of 124 health systems for analysis. We first explored differences in talent and diversity benefits across the health systems. Then, we examined the relationship between IMPROVE, RECRUIT, and COLLABORATE pathways to equip the workforce. RESULTS Health system characteristics, such as size, location, ownership, teaching, and revenue, have varying influences on D&I and business and service outcomes. RECRUIT has the most substantial mediating effect on diversity-enabled business- and service-oriented outcomes of the three pathways. This is also true of talent-based workforce acquisitions. CONCLUSIONS Diversity and talent plans can be aligned to realize multiple desired benefits for health systems. However, a one-size-fits-all approach is not a viable strategy for improving D&I. Health systems need to follow a multipronged approach based on their characteristics. To get D&I right, proactive plans and genuine efforts are essential.

Cuba and the Covid-19 pandemic

2021 ◽  
Vol 122 (1) ◽  
pp. 118-131
Author(s):  
Bob Oram
Keyword(s):  
Public Health ◽  
United States ◽  
Health System ◽  
Health Professionals ◽  
The United States ◽  
The Past ◽  
The Uk ◽  
Universal Health

For the UK struggling to deal with the Covid-19 pandemic, the experience of Cuba’s Ministry of Public Health over the past six decades provides the clearest case for a single, universal health system constituting an underlying national grid dedicated to prevention and care; an abundance of health professionals, accessible everywhere; a world-renowned science and biotech capability; and an educated public schooled in public health. All this was achieved despite being under a vicious blockade by the United States for all of that time.

scholarly journals Nursing care in the anesthetic procedure: an integrative review

2016 ◽  
Vol 50 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Cassiane de Santana Lemos ◽  
Aparecida de Cassia Giani Peniche
Keyword(s):  
United States ◽  
Health System ◽  
Patient Care ◽  
Nursing Care ◽  
Scientific Evidence ◽  
The United States ◽  
Nurse Anesthetists ◽  
Integrative Review ◽  
Nursing Professional

Abstract OBJECTIVE To search for the scientific evidence available on nursing professional actions during the anesthetic procedure. METHOD An integrative review of articles in Portuguese, English and Spanish, indexed in MEDLINE/PubMed, CINAHL, LILACS, National Cochrane, SciELO databases and the VHL portal. RESULTS Seven studies were analyzed, showing nurse anesthetists' work in countries such as the United States and parts of Europe, with the formulation of a plan for anesthesia and patient care regarding the verification of materials and intraoperative controls. The barriers to their performance involved working in conjunction with or supervised by anesthesiologists, the lack of government guidelines and policies for the legal exercise of the profession, and the conflict between nursing and the health system for maintenance of the performance in places with legislation and defined protocols for the specialty. Conclusion Despite the methodological weaknesses found, the studies indicated a wide diversity of nursing work. Furthermore, in countries absent of the specialty, like Brazil, the need to develop guidelines for care during the anesthetic procedure was observed.

MSV(L): Continuing the Legacy of Army Waterborne Capability

2021 ◽  
Author(s):  
David Richard Toepler ◽  
Nathan Leightner
Keyword(s):  
United States ◽  
United States Army ◽  
High Performance ◽  
The United States ◽  
Engineering Management ◽  
Fourth Quarter ◽  
Detailed Design ◽  
New Class ◽  
Source Selection ◽  
Primary Mission

The United States Army operates several classes of landing craft, which provide combatant commanders with waterborne maneuver capabilities essential for accomplishing a range of critical missions unique to the Army. These missions involve transport of personnel, cargo, and equipment from advanced bases and large sealift ships to ports, inland riverine regions, as well as remote undeveloped coastlines and beaches. Recognizing the significant roles these vessels play and will continue to play in achieving Army objectives, Army leadership allocated funding to design and build a new class of high performance landing craft: Maneuver Support Vessel (Light) (MSV(L)). The primary mission of MSV(L) is to conduct movement and maneuver of combat-configured Brigade Combat Team force elements such as one M1A2 main battle tank, or two Stryker vehicles, or four Joint Light Tactical Vehicles, each with its crew. MSV(L) will have beaching capability and be able to operate at speeds significantly in excess of any current Army landing craft. The Army Watercraft Systems organization was tasked with overseeing development of requirements and specifications, source selection and acquisition, along with contract, finance, and engineering management of the MSV(L) Program. A contract to develop the detailed design and build a series of vessels was awarded in September 2017. Launch of the initial vessel is planned during the fourth quarter of 2021.

High-Performance Steels in the United States

2005 ◽  
pp. 11-44
Author(s):  
M. Myint Lwin ◽  
Alexander D. Wilson ◽  
Vasant C. Mistry
Keyword(s):  
United States ◽  
Driving Force ◽  
High Performance ◽  
The United States ◽  
Atmospheric Conditions ◽  
Iron And Steel ◽  
Federal Highway ◽  
The U.S ◽  
Steel Institute

<p>In 1992, the U.S. Federal Highway Administration (FHWA) initiated an effort with the American Iron and Steel Institute (AISI) and the U. S. Navy (Navy) to develop new high-performance steels (HPS) for bridges. The driving force for this project was the need to develop improved higher strength, improved weldability, higher toughness steels to improve the overall quality and fabricability of steels used in bridges in the United States. It was furthermore established that such steels should be "weathering". By this is meant the ability to perform without painting under normal atmospheric conditions.</p>

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