Adult education Students completing high school may choose to attend a college or university, which offer undergraduate degrees such as Associate's degrees or Bachelor's degrees baccalaureate. Community college or junior college typically offer two-year associate degrees, although some community colleges offer a limited number of bachelor's degrees. Some community college students choose to transfer to a four-year institution to pursue a bachelor's degree.
This chapter describes these challenges—incorporating related evidence and the views expressed by participants in the Health Professions Education Summit—and examines the resulting implications for the education of health professionals and its reform. Estimates of the number of Americans dying each year as a result of medical errors are as high as 98,—more than those who die from motor vehicle accidents, breast cancer, or AIDS Institute of Medicine, The American public is dissatisfied with chronic care; 72 percent of those surveyed believe it is difficult for people living with chronic conditions to obtain the necessary care from their health care providers Harris Interactive and ARiA Marketing, Health professionals are also concerned: The committee that authored the Quality Chasm report Institute of Medicine,speakers at the summit, health experts, employers, and health professionals and students have all identified reasons for this disconnect between an ideal system and what actually exists.
The health care system can hardly be called a system. Rather it is a dizzying array of highly decentralized sectors. Although the size of physician groups is growing, 37 percent of practicing physicians are still in solo or two-person practices Center for Studying Health System Change, The health plan sector is turning away from structures that can facilitate integration and coordination, with the market share of health maintenance organizations HMOs falling and preferred provider organizations PPOs becoming more popular Kaiser Family Foundation and Health Research and Educational Trust, And even though the hospital sector has been consolidating in many markets—of the 5, community hospitals, more than 3, belong to some network or system—most of these arrangements are focused on administrative rather than clinical integration American Hospital Association, ; Lesser and Ginsburg, The absence of systems, or poorly designed systems, and the resulting lack of integration are apparent across sectors, as well as within individual health care organizations.
Such systems can harm patients or fail to deliver what patients need. A previous IOM report makes abundantly clear that the inability to apply knowledge about human factors in systems design and the failure to incorporate well-acknowledged safety principles into health care such as standardizing and simplifying equipment, supplies, and processes are key contributors to the unpardonably high number of medical errors that occur Institute of Medicine, Mary Naylor, School of Nursing, University of Pennsylvania, a panelist at the summit, echoed this reality: We have both a culture and organization of care that separate our care into distinct systems—hospitals, home care, skilled nursing facilities—with little formal communication, relationships, or collaboration between and among those settings….
The Quality Chasm report also stresses that a redesigned system is predicated on interdisciplinary teams. In the current system, however, health professionals work together, but display little of the coordination and collaboration that would characterize an interdisciplinary team.
The hierarchy in which physicians dominate and the emphasis on assuming individual responsibility for decision making result in a reliance on personal accountability and a failure to solicit the contributions of others who could bring added insight and relevant information, whatever their formal credentials Helmreich, ; Institute of Medicine, a.
The resulting lack of continuity and coordination of care, miscommunication, redundant and wasteful processes, and excess costs have resulted in patient suffering Institute of Medicine, a; Larson, Patients and families commonly report that caregivers appear not to coordinate their work or even to know what each other are doing.
Patients spend a great deal of time consulting with an endless stream of physicians, nurses, therapists, social workers, home care workers, nutritionists, pharmacists, and other specialists, who too often are ignorant of past medical histories, medications, or treatment plans and therefore work at cross purposes.
When patients are moved from one setting to another—for example, from hospital to rehabilitation center to home—fragmentation of care results in overlapping or conflicting treatment that is costly and confusing and, worst of all, detrimental to the patient. In a recent survey, 85 percent of physicians surveyed stated that one or more adverse outcomes result from uncoordinated care, and more than half suggested that a lack of coordination is usually the cause of patients receiving contradictory health information from providers Partnership for Solutions, b.
As the population ages, there will be more patients with chronic conditions. Inabout 13 percent of the population 35 million Americans were over age 65; this proportion is expected to rise to 20 percent 70 million by National Center for Health Statistics, An estimated million Americans already have one or more chronic conditions, and more than half of these people have multiple such conditions Wu and Green, Studies show that effective treatment of chronic conditions needs to be continuous across settings and types of providers.
Clinicians need to collaborate with each other and with patients to develop joint care plans with agreed-upon goals, targets, and implementation steps. Such care should support patient self-management and encompass regular clinician follow-up, both face-to-face and through electronic means DeBusk et al.
Clinicians practicing in such an environment need to be effective members of an interdisciplinary team, provide care that is patient-centered, and be proficient in informatics applications.
A recent survey underscored issues faced by the chronically ill, with about three of every four respondents reporting difficulty in obtaining medical care. Specifically, 72 percent had experienced difficulty in obtaining care from a primary care physician, 79 percent from a medical specialist, and 74 percent from providers of drug therapy Partnership for Solutions, b.
This same survey indicated that, as a result of the lack of coordination, the chronically ill were receiving spotty or contradictory information and facing avoidable complications. At the summit, Mary Naylor described a typical real-life example of the lack of coordination for the chronically ill: A year old woman…had a number of chronic conditions: That does not include the numbers of ancillary personnel and other support people involved in her care.
While hospitalized, she interacted with an orthopedic surgeon and his team, a cardiologist, an endocrinologist, a primary care nurse, a physical therapist based in the hospital, and a social worker who helped facilitate her discharge to a skilled nursing facility. At that point, the hand-off was to a physician in the skilled nursing facility, a physical therapist, an occupational therapist, and a variety of other providers.
Her care was characterized by poor communication…. Very little attention [was paid] to her preferences or the preferences of her family members in decision making about what care [she should receive] and what site she should go to, and what the plan of care should be at each of those sites.
There was very poor transfer of information from one site to the other; in fact, critical pieces of her care plan were not communicated from the hospital to the nursing home, resulting in an emergency room visit within a couple of days of discharge to the skilled nursing facility.
And there was no point person, no broker of care, no one there advocating for her, for her family, and coordinating this entire experience, all of which took place in a very short period of time Naylor, Feb 15, · Rahila Simzar: Reform movements in education tend to focus on a “one size fits all” approach in attempting to solve educational inequity issues.
While universalizing core standards and. The Education Trust has been on the forefront of improving educational standards and focuses specifically on the partnership between K education and colleges.
Also part of our education system is our armed forces, read The United States Military and Higher Education . This study was enthused by the premise that no nation grows further than the quality of its educational leaders and or educational managers. In this theoretical debate, the authors presented a moderately detail analysis of a theoretical research conducted on the need for African countries especially Nigeria to reform.
Because education in Germany costs little compared with that in the United States, for example, and because educational support of various kinds is widely available, Germans are likely to receive education and training suited to their abilities and desires.
President Calvin Coolidge signs the Probation Act of , establishing probation as a sentence in the federal courts. The first federal probation officer, Richard McSweeney, is appointed in the District of Massachusetts. Higher education in the United States is an optional final stage of formal learning following secondary education, often at one of the 4, colleges or universities and junior colleges in the attheheels.comy languages: English.