Donald M Berwick
Datos Biográficos
| ID | 5533872 |
|---|---|
| NOMBRE | Donald M Berwick |
| NOMBRES | Donald M |
| APELLIDO | Berwick |
| FIRMA | BERWICK D M |
| AFILIACIONES | Institute for Healthcare Improvement |
| ORCID | 0000-0001-9507-4157 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 20 |
| TOTAL DE CITAS | 0 |
| TOTAL COMO AUTOR | 20 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1975 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2022 |
| ÍNDICE H | 0 |
Strengthening national capacities for pandemic preparedness
The International Health Regulations—State Party Annual Reporting (IHR-SPAR) index and the Global Health Security Index (GHSI) have been developed to aid in strengthening national capacities for pandemic preparedness. We examined the relationship between country-level rankings on these two indices, along with two additional indices (the Universal Health Coverage Service Coverage Index and World Bank Worldwide Governance Indicator (n = 195)) and c…
What ‘Patient-Centered’ Should Mean: Confessions Of An Extremist
"Patient-centeredness" is a dimension of health care quality in its own right, not just because of its connection with other desired aims, like safety and effectiveness. Its proper incorporation into new health care designs will involve some radical, unfamiliar, and disruptive shifts in control and power, out of the hands of those who give care and into the hands of those who receive it. Such a consumerist view of the quality of care, itself, has…
The Science of Improvement
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolary…
The Triple Aim
Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health care. Preconditions for this include the enrollment of an identified population, a commitment to universality for its members, and the existence of an organization (an "integrator") that accepts responsibility for all three aims for that population. The in…
The Stories Beneath
From the Institute for Healthcare Improvement, Cambridge, Massachusetts. Reprints: Donald M. Berwick, MD, MPP, President and CEO, Institute for Healthcare Improvement, 20 University Road, 7th Floor, Cambridge, MA 02138. E-mail: [email protected]
Disseminating Innovations in Health Care
Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly—if at all. Diffusion of innovations is a major challenge in all industries including health care. This article examines the theory and research on the dissemination of innovations and suggests applications of that theory to health care. It explores in detail 3 clusters of influence on the ra…
Connections Between Quality Measurement and Improvement
BACKGROUND: Measurement is necessary but not sufficient for quality improvement. Because the purpose of the national quality measurement and reporting system (NQMRS) is to improve quality, a discussion of the link between measurement and improvement is critical for ensuring an appropriate system design. OBJECTIVES: To classify approaches to the use of measurement in improvement into two different--although linked and potentially synergistic--agen…
Healthcare in a land called PeoplePower
In a 5‐day retreat at a Salzburg Seminar attended by 64 individuals from 29 countries, teams of health professionals, patient advocates, artists, reporters and social scientists adopted the guiding principle of ‘nothing about me without me’ and created the country of PeoplePower. Designed to shift health care from ‘biomedicine’ to ‘infomedicine’, patients and health workers throughout PeoplePower join in informed, shared decision‐making and gover…
The Support Project
One of greatest living scholars of quality, Professor Noriaki Kano of Tokyo University, and his American colleague, Tom Nolan, suggest that system improvements can come in three categories: 1. Reductions of defects experienced by customers; 2. Reductions of cost, while maintaining or improving experiences of customers; and 3. Creating and satisfying a new need, or satisfying an old need to an unprecedented degree.[1] Kano and Nolan suggest furthe…
Measuring Public Priorities for Insurable Health Care
The goal of this research was to develop and evaluate a way to measure the value people place on various medical services in their decisions about what health insurance should cover. A vignette approach to measuring consumer values was developed. People were asked to assign priority and desire to have insurance cover 64 different services. A national probability sample of 206 adults was interviewed by telephone. Their ratings were compared with t…
Performance of a Five-Item Mental Health Screening Test
We compared the screening accuracy of a short, five-item version of the Mental Health Inventory (MHI-5) with that of the 18-item MHI, the 30-item version of the General Health Questionnaire (GHQ-30), and a 28-item Somatic Symptom Inventory (SSI-28). Subjects were newly enrolled members of a health maintenance organization (HMO), and the criterion diagnoses were those found through use of the Diagnostic Interview Schedule (DIS) in a stratified sam…
Controlling Variation in Health Care
The control of unintended variation is an objective central to modern industrial quality management methods, based largely on the theoretical work of Walter A. Shewhart. As industrial quality management techniques find their place in health care, professionals may feel threatened by the effort to reduce variation. Understanding may reduce this fear. Variation of the types addressed in quality control efforts erodes quality and reliability, and ad…
Conclusions and Recommendations
Health Services Research and Quality of Care
The unabated rise in health care costs is bringing health services research into center stage as an applied science to help guide health care managers, purchasers, and regulators. To be equal to the task, health services research must pursue at least four intellectual agendas: the study of efficacy (knowing what works), the study of appropriateness (using what works), the study of the execution of care (doing well what works), and the study of th…
A Comparison of Three Psychiatric Screening Tests Using Receiver Operating Characteristic (ROC) Analysis
Self-administered screening questionnaires are available to assist primary care physicians in detecting undiagnosed depression and anxiety disorders. This study used receiver operating characteristic (ROC) analysis to evaluate three such tests: the General Health Questionnaire (GHQ), the Mental Health Inventory (MHI), and the Somatic Symptom Inventory (SSI). Stratified by the results of a preliminary GHQ, 364 health maintenance organization (HMO)…
The Measurement of Health Status in Clinical Practice
Functional status measurement and the assessment of health status are reaching their maturity as technical disciplines. Good tools exist that meet requirements such as brevity, validity, reliability, ease of administration, and ease of scoring, which make them potentially suitable for use in clinical practice. Despite this progress, widespread adoption of measurement tools has not occurred in the clinical world. The authors analyze both the poten…
Efficacy of a Brief Psychosocial Intervention for Symptoms of Stress and Distress Among Patients in Primary Care
Psychosocial problems and symptoms of emotional distress play a prominent role in patients reporting to primary care settings. Interpersonal counseling (IPC) was developed as a brief psychosocial intervention for patients with stress and distress to be administered by nurse practitioners in a primary care setting. The results of a pilot study indicate more rapid reduction of symptoms and improvement in emotional symptoms and psychosocial function…
What Do Patients Value
Evaluations of diagnostic tests have focused primarily on their value in clinical decisions. Patients may attach value to 1) information that has little or no medical significance, and 2) information (medical or nonmedical) that has no bearing on decisions to be made by the doctor or the patient. Ultrasound in pregnancy, which provides a great deal of information to both doctor and patient, was chosen as the example with which to explore these hy…
Receiver Operating Characteristic Analysis of Diagnostic Skill
In an effort to assess diagnostic skill, the authors collected estimates of the probability of positive results for 392 chest x-rays and 595 throat cultures from 56 pediatricians at different stages in training. Positivity rates were 28.6% for x-rays and 32.9% for throat cultures. The ability to predict the outcome of chest x-rays (pneumonia or not) improved with training on two measures: 1) "calibration," the accuracy of the guessed probability …
The politics of medicare
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The politics of medicare
Receiver Operating Characteristic Analysis of Diagnostic Skill
In an effort to assess diagnostic skill, the authors collected estimates of the probability of positive results for 392 chest x-rays and 595 throat cultures from 56 pediatricians at different stages in training. Positivity rates were 28.6% for x-rays and 32.9% for throat cultures. The ability to predict the outcome of chest x-rays (pneumonia or not) improved with training on two measures: 1) "calibration," the accuracy of the guessed probability …
What Do Patients Value
Evaluations of diagnostic tests have focused primarily on their value in clinical decisions. Patients may attach value to 1) information that has little or no medical significance, and 2) information (medical or nonmedical) that has no bearing on decisions to be made by the doctor or the patient. Ultrasound in pregnancy, which provides a great deal of information to both doctor and patient, was chosen as the example with which to explore these hy…
Efficacy of a Brief Psychosocial Intervention for Symptoms of Stress and Distress Among Patients in Primary Care
Psychosocial problems and symptoms of emotional distress play a prominent role in patients reporting to primary care settings. Interpersonal counseling (IPC) was developed as a brief psychosocial intervention for patients with stress and distress to be administered by nurse practitioners in a primary care setting. The results of a pilot study indicate more rapid reduction of symptoms and improvement in emotional symptoms and psychosocial function…
Health Services Research and Quality of Care
The unabated rise in health care costs is bringing health services research into center stage as an applied science to help guide health care managers, purchasers, and regulators. To be equal to the task, health services research must pursue at least four intellectual agendas: the study of efficacy (knowing what works), the study of appropriateness (using what works), the study of the execution of care (doing well what works), and the study of th…
A Comparison of Three Psychiatric Screening Tests Using Receiver Operating Characteristic (ROC) Analysis
Self-administered screening questionnaires are available to assist primary care physicians in detecting undiagnosed depression and anxiety disorders. This study used receiver operating characteristic (ROC) analysis to evaluate three such tests: the General Health Questionnaire (GHQ), the Mental Health Inventory (MHI), and the Somatic Symptom Inventory (SSI). Stratified by the results of a preliminary GHQ, 364 health maintenance organization (HMO)…
The Measurement of Health Status in Clinical Practice
Functional status measurement and the assessment of health status are reaching their maturity as technical disciplines. Good tools exist that meet requirements such as brevity, validity, reliability, ease of administration, and ease of scoring, which make them potentially suitable for use in clinical practice. Despite this progress, widespread adoption of measurement tools has not occurred in the clinical world. The authors analyze both the poten…
Conclusions and Recommendations
Performance of a Five-Item Mental Health Screening Test
We compared the screening accuracy of a short, five-item version of the Mental Health Inventory (MHI-5) with that of the 18-item MHI, the 30-item version of the General Health Questionnaire (GHQ-30), and a 28-item Somatic Symptom Inventory (SSI-28). Subjects were newly enrolled members of a health maintenance organization (HMO), and the criterion diagnoses were those found through use of the Diagnostic Interview Schedule (DIS) in a stratified sam…
Controlling Variation in Health Care
The control of unintended variation is an objective central to modern industrial quality management methods, based largely on the theoretical work of Walter A. Shewhart. As industrial quality management techniques find their place in health care, professionals may feel threatened by the effort to reduce variation. Understanding may reduce this fear. Variation of the types addressed in quality control efforts erodes quality and reliability, and ad…
Measuring Public Priorities for Insurable Health Care
The goal of this research was to develop and evaluate a way to measure the value people place on various medical services in their decisions about what health insurance should cover. A vignette approach to measuring consumer values was developed. People were asked to assign priority and desire to have insurance cover 64 different services. A national probability sample of 206 adults was interviewed by telephone. Their ratings were compared with t…
The Support Project
One of greatest living scholars of quality, Professor Noriaki Kano of Tokyo University, and his American colleague, Tom Nolan, suggest that system improvements can come in three categories: 1. Reductions of defects experienced by customers; 2. Reductions of cost, while maintaining or improving experiences of customers; and 3. Creating and satisfying a new need, or satisfying an old need to an unprecedented degree.[1] Kano and Nolan suggest furthe…
Healthcare in a land called PeoplePower
In a 5‐day retreat at a Salzburg Seminar attended by 64 individuals from 29 countries, teams of health professionals, patient advocates, artists, reporters and social scientists adopted the guiding principle of ‘nothing about me without me’ and created the country of PeoplePower. Designed to shift health care from ‘biomedicine’ to ‘infomedicine’, patients and health workers throughout PeoplePower join in informed, shared decision‐making and gover…
Disseminating Innovations in Health Care
Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly—if at all. Diffusion of innovations is a major challenge in all industries including health care. This article examines the theory and research on the dissemination of innovations and suggests applications of that theory to health care. It explores in detail 3 clusters of influence on the ra…
Connections Between Quality Measurement and Improvement
BACKGROUND: Measurement is necessary but not sufficient for quality improvement. Because the purpose of the national quality measurement and reporting system (NQMRS) is to improve quality, a discussion of the link between measurement and improvement is critical for ensuring an appropriate system design. OBJECTIVES: To classify approaches to the use of measurement in improvement into two different--although linked and potentially synergistic--agen…
The Stories Beneath
From the Institute for Healthcare Improvement, Cambridge, Massachusetts. Reprints: Donald M. Berwick, MD, MPP, President and CEO, Institute for Healthcare Improvement, 20 University Road, 7th Floor, Cambridge, MA 02138. E-mail: [email protected]
The Science of Improvement
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolary…
The Triple Aim
Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health care. Preconditions for this include the enrollment of an identified population, a commitment to universality for its members, and the existence of an organization (an "integrator") that accepts responsibility for all three aims for that population. The in…
What ‘Patient-Centered’ Should Mean: Confessions Of An Extremist
"Patient-centeredness" is a dimension of health care quality in its own right, not just because of its connection with other desired aims, like safety and effectiveness. Its proper incorporation into new health care designs will involve some radical, unfamiliar, and disruptive shifts in control and power, out of the hands of those who give care and into the hands of those who receive it. Such a consumerist view of the quality of care, itself, has…
Strengthening national capacities for pandemic preparedness
The International Health Regulations—State Party Annual Reporting (IHR-SPAR) index and the Global Health Security Index (GHSI) have been developed to aid in strengthening national capacities for pandemic preparedness. We examined the relationship between country-level rankings on these two indices, along with two additional indices (the Universal Health Coverage Service Coverage Index and World Bank Worldwide Governance Indicator (n = 195)) and c…
Medicine (16 obras) · Psychology (13 obras) · Political science (10 obras) · Health care (9 obras) · Business (8 obras) · Computer Science (8 obras) · Economics (6 obras) · Healthcare Policy and Management (6 obras) · Nursing (6 obras) · Family medicine (5 obras)