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May 24, 2024

US Acute Care Solutions Names Dr. Shea Combs Regional Vice President of South Division

CANTON, Ohio, May 24, 2024 – US Acute Care Solutions (USACS), the nation’s largest physician-owned provider of hospital-based emergency and inpatient medicine, announced today that it has named Shea Combs, MD, FACEP, a Regional Vice President of its South Division. Most recently, Dr. Combs served as the Regional Integrated Acute Care (IAC) Medical Director of the USACS South Division and System Medical Director of Hospital Medicine. In this role she was responsible for the management of several service lines at both Cedar Park Regional Medical Center in Cedar Park, TX, and Peterson Regional Medical Center in Kerrville, TX. Dr. Combs is also an active member of the USACS South Clinical Governance Board which aims to ensure consistency and quality patient care throughout all USACS locations. “Our team is looking forward to welcoming Dr. Combs as she steps into her new leadership role within our division,” said Brandon Lewis, DO, MBA, FACOEP, FACEP, President of the USACS South Division. “Dr. Combs has proven to be an outstanding leader and we are fully confident she will continue to excel as a regional vice president.” Dr. Combs said, “Being selected to fill this role for our group is an honor and a privilege. I am ready to embrace new responsibilities with the goal of leading our division to continued success. I am grateful to our existing leadership team for their confidence and look forward to making an impact both regionally and company-wide.” A board-certified emergency physician, Dr. Combs completed her bachelor’s and master’s degrees at the University of Texas at Austin then went on to earn her medical degree at the University of Texas Health Science Center at San Antonio. She completed her emergency medicine residency at Allegheny General Hospital in Pittsburgh, PA. About USACS Founded by emergency medicine and inpatient physicians across the country, USACS is solely owned by its physicians and hospital system partners. The group is a national leader in integrated acute care, including emergency medicine, hospitalist, and critical care services. USACS provides high-quality care to approximately ten million patients annually across more than 400 programs and is aligned with many of the leading health systems in the country. Visit usacs.com for more. ### Media Contact Marty Richmond Corporate Communications Department US Acute Care Solutions 330.493.4443 x1406 [email protected]

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Research Topics & Ideas: Healthcare

100+ Healthcare Research Topic Ideas To Fast-Track Your Project

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

• Allopathic medicine
• Alternative /complementary medicine
• Veterinary medicine
• Physical therapy/ rehab
• Optometry and ophthalmology
• Pharmacy and pharmacology
• Public health
• Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

• The effectiveness of telemedicine in remote elderly patient care
• The impact of stress on the immune system of cancer patients
• The effects of a plant-based diet on chronic diseases such as diabetes
• The use of AI in early cancer diagnosis and treatment
• The role of the gut microbiome in mental health conditions such as depression and anxiety
• The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
• The benefits and drawbacks of electronic health records in a developing country
• The effects of environmental pollution on breast milk quality
• The use of personalized medicine in treating genetic disorders
• The impact of social determinants of health on chronic diseases in Asia
• The role of high-intensity interval training in improving cardiovascular health
• The efficacy of using probiotics for gut health in pregnant women
• The impact of poor sleep on the treatment of chronic illnesses
• The role of inflammation in the development of chronic diseases such as lupus
• The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

• The benefits of herbal medicine in treating young asthma patients
• The use of acupuncture in treating infertility in women over 40 years of age
• The effectiveness of homoeopathy in treating mental health disorders: A systematic review
• The role of aromatherapy in reducing stress and anxiety post-surgery
• The impact of mindfulness meditation on reducing high blood pressure
• The use of chiropractic therapy in treating back pain of pregnant women
• The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
• The impact of yoga on physical and mental health in adolescents
• The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
• The role of Reiki in promoting healing and relaxation post birth
• The effectiveness of naturopathy in treating skin conditions such as eczema
• The use of deep tissue massage therapy in reducing chronic pain in amputees
• The impact of tai chi on the treatment of anxiety and depression
• The benefits of reflexology in treating stress, anxiety and chronic fatigue
• The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

• The impact of sugar consumption on the oral health of infants
• The use of digital dentistry in improving patient care: A systematic review
• The efficacy of orthodontic treatments in correcting bite problems in adults
• The role of dental hygiene in preventing gum disease in patients with dental bridges
• The impact of smoking on oral health and tobacco cessation support from UK dentists
• The benefits of dental implants in restoring missing teeth in adolescents
• The use of lasers in dental procedures such as root canals
• The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
• The role of fluoride in promoting remineralization and slowing down demineralization
• The impact of stress-induced reflux on oral health
• The benefits of dental crowns in restoring damaged teeth in elderly patients
• The use of sedation dentistry in managing dental anxiety in children
• The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
• The role of orthodontic appliances in improving well-being
• The impact of periodontal disease on overall health and chronic illnesses

Tops & Ideas: Veterinary Medicine

• The impact of nutrition on broiler chicken production
• The role of vaccines in disease prevention in horses
• The importance of parasite control in animal health in piggeries
• The impact of animal behaviour on welfare in the dairy industry
• The effects of environmental pollution on the health of cattle
• The role of veterinary technology such as MRI in animal care
• The importance of pain management in post-surgery health outcomes
• The impact of genetics on animal health and disease in layer chickens
• The effectiveness of alternative therapies in veterinary medicine: A systematic review
• The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
• The impact of climate change on animal health and infectious diseases in animals
• The importance of animal welfare in veterinary medicine and sustainable agriculture
• The effects of the human-animal bond on canine health
• The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
• The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

• The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
• The impact of telerehabilitation on patient outcomes in Germany
• The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
• A comparison of manual therapy and yoga exercise therapy in the management of low back pain
• The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
• The impact of mindfulness-based interventions in physical therapy in adolescents
• The effects of resistance training on individuals with Parkinson’s disease
• The role of hydrotherapy in the management of fibromyalgia
• The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
• The use of virtual reality in physical rehabilitation of sports injuries
• The effects of electrical stimulation on muscle function and strength in athletes
• The role of physical therapy in the management of stroke recovery: A systematic review
• The impact of pilates on mental health in individuals with depression
• The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
• The effect of strength training on balance and gait in elderly patients

Topics & Ideas: Optometry & Opthalmology

• The impact of screen time on the vision and ocular health of children under the age of 5
• The effects of blue light exposure from digital devices on ocular health
• The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
• The use of telemedicine in optometry and ophthalmology in the UK
• The impact of myopia control interventions on African American children’s vision
• The use of contact lenses in the management of dry eye syndrome: different treatment options
• The effects of visual rehabilitation in individuals with traumatic brain injury
• The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
• The impact of environmental air pollution on ocular health
• The effectiveness of orthokeratology in myopia control compared to contact lenses
• The role of dietary supplements, such as omega-3 fatty acids, in ocular health
• The effects of ultraviolet radiation exposure from tanning beds on ocular health
• The impact of computer vision syndrome on long-term visual function
• The use of novel diagnostic tools in optometry and ophthalmology in developing countries
• The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

• The impact of medication adherence on patient outcomes in cystic fibrosis
• The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
• The effects of pharmacogenomics on drug response and toxicity in cancer patients
• The role of pharmacists in the management of chronic pain in primary care
• The impact of drug-drug interactions on patient mental health outcomes
• The use of telepharmacy in healthcare: Present status and future potential
• The effects of herbal and dietary supplements on drug efficacy and toxicity
• The role of pharmacists in the management of type 1 diabetes
• The impact of medication errors on patient outcomes and satisfaction
• The use of technology in medication management in the USA
• The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
• Leveraging the role of pharmacists in preventing and managing opioid use disorder
• The impact of the opioid epidemic on public health in a developing country
• The use of biosimilars in the management of the skin condition psoriasis
• The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

• The impact of the built environment and urbanisation on physical activity and obesity
• The effects of food insecurity on health outcomes in Zimbabwe
• The role of community-based participatory research in addressing health disparities
• The impact of social determinants of health, such as racism, on population health
• The effects of heat waves on public health
• The role of telehealth in addressing healthcare access and equity in South America
• The impact of gun violence on public health in South Africa
• The effects of chlorofluorocarbons air pollution on respiratory health
• The role of public health interventions in reducing health disparities in the USA
• The impact of the United States Affordable Care Act on access to healthcare and health outcomes
• The effects of water insecurity on health outcomes in the Middle East
• The role of community health workers in addressing healthcare access and equity in low-income countries
• The impact of mass incarceration on public health and behavioural health of a community
• The effects of floods on public health and healthcare systems
• The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
• On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
• Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
• Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
• Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
• When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
• Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
• Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
• Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
• Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
• Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
• The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
• Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
• Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

Need more help?

If you’re still feeling a bit unsure about how to find a research topic for your healthcare dissertation or thesis, check out Topic Kickstarter service below.

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15 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

Thank you to create new knowledge on research problem verse research topic

Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

Hello I have requirement of Health related latest research issue/topics for my social media speeches. If possible pls share health issues , diagnosis, treatment.

I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

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A Case Study of a Whole System Approach to Improvement in an Acute Hospital Setting

Marie e. ward.

1 Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D02 PN40 Dublin, Ireland; [email protected]

Ailish Daly

2 Beacon Hospital, Sandyford, D18 AK68 Dublin, Ireland; [email protected]

Martin McNamara

3 UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, UCD Health Sciences Centre, University College Dublin, D04 V1W8 Dublin, Ireland; [email protected] (M.M.); [email protected] (S.P.T.)

Suzanne Garvey

Sean paul teeling.

4 Centre for Person-Centred Practice Research Division of Nursing, School of Health Sciences, Queen Margaret University, Queen Margaret University Drive, Musselburgh EH21 6UU, UK

Associated Data

Not applicable.

Changes in healthcare tend to be project-based with whole system change, which acknowledges the interconnectedness of socio-technical factors, not the norm. This paper attempts to address the question of whole system change posed by the special issue and brings together other research presented in this special issue. A case study approach was adopted to understand the deployment of a whole system change in the acute hospital setting along four dimensions of a socio-technical systems framework: culture, system functioning, action, and sense-making. The case study demonstrates evidence of whole system improvement. The approach to change was co-designed by staff and management, projects involving staff from all specialities and levels of seniority were linked to each other and to the strategic objectives of the organisation, and learnings from first-generation projects have been passed to second and third-generation process improvements. The socio-technical systems framework was used retrospectively to assess the system change but could also be used prospectively to help healthcare organisations develop approaches to whole system improvement.

1. Introduction

The Patient Safety and Quality Improvement (QI) movements in healthcare have been slow to achieve momentum in improving outcomes [ 1 ]. Braithwaite et al. (2018) estimate that in healthcare organisations, nearly two-thirds of initiatives experience implementation failure [ 2 ]. Changes in healthcare tend to be project-based with whole system change, which acknowledges the interconnectedness of socio-technical factors, not the norm. In addition, it can be difficult both to sustain change beyond the project lifecycle as well as to generalise change to a broader level [ 3 ].

Lean Six Sigma is a powerful methodology that reduces waste and variation in an organisation and ultimately minimises operating costs, optimises productivity, and maximises customer satisfaction [ 4 ]. LSS is the merger of two methods used in process improvements. Lean originated in Toyota car production factories and focuses on refining and improving processes as well as eliminating non-value-added (NVA) activities [ 5 ]. Six Sigma was introduced by Motorola to optimise its manufacturing processes by reducing their variability through the rigorous application of process metrics collection and statistical analysis [ 6 , 7 ]. Since the early 2000s, LSS thinking has been adapted into healthcare with the goal of improving patient safety, quality of care, efficiency, patient satisfaction, and performance [ 8 ].

Healthcare providers worldwide, both publicly and privately funded, are faced with similar challenges of caring for an ageing population with a limited pool of financial and personnel resources. Consequently, the need to seek improved efficiencies while continuing to provide safe and high-quality services has become more and more acute [ 9 ]. LSS has been implemented in many healthcare organisations, with impacts achieved across many clinical and administrative pathways and processes [ 10 , 11 ]. While there are positive associations between LSS adoption and performance indicators in individual case studies [ 12 , 13 , 14 , 15 ], overall evidence on the success of LSS is mixed. Considerable time and effort need to be spent on implementation for LSS to be associated with gains in hospital performance. The degree to which this investment is made depends on the system maturity, leadership commitment, daily management system use, and training [ 16 , 17 ]. There is also increasing recognition of the importance of improving both patient and staff experience of healthcare [ 18 , 19 ] and moving to person-centred approaches in healthcare [ 20 ]. Political and policy stakeholders have widely advocated that person-centred care should be at the heart of the health system [ 21 , 22 , 23 , 24 ]. Person-centredness refers to embedded practices within a specific type of culture that enable and facilitate the delivery of person-centred care [ 25 , 26 ]. Person-centred cultures are deemed necessary for the delivery of person-centred care [ 26 ]. Person-centred care has an explicit focus on ensuring that the client or patient is at the centre of care delivery [ 25 , 27 ] and is concerned with every person involved in the patient’s care, including staff members and patients and their families/carers [ 20 , 27 ].

Implementation science as a field aims to help understand the factors surrounding the uptake of evidence-based practice into healthcare [ 28 ]. A central tenet of implementation science is that implementation strategies will be most successful when they align with healthcare systems’ existing culture, infrastructure, and practices [ 29 ]. Context has thus emerged as a key construct in understanding challenges to healthcare improvement [ 30 ]. Inconsistencies exist, however, in defining context [ 31 ] and in understanding the complexity of context in healthcare [ 32 ].

When talking about the healthcare system as a whole system, it is important to refer to a method for describing such a system that addresses its complexity and provides an analysis that gives leverage over the mechanisms of system change. McDonald et al.’s 2021 [ 33 ] work presented in this special issue makes a cogent argument for the importance of taking a socio-technical systems (STS) approach to whole system understanding and change. STS analysis involves studying the dynamic interconnectedness of elements of the system at different levels, such as team, processes, and information and knowledge. They propose a model called the CUBE for STS analysis that focuses on four domains:

1.1. Culture

Culture represents the pattern of shared basic assumptions and (what is often) a partial shared understanding of the STS and incorporates Schein’s [ 34 , 35 ] and Pigeon and O’Leary’s [ 36 , 37 ] work on culture.

1.2. System Functioning

System functioning represents how the system actually works and incorporates both formal elements (work-as-imagined), i.e., Policies, Procedures, Protocols, and Guidelines (PPPGs) as well as informal elements (work-as-done or the sequence of activities that normally takes place) [ 38 ] and incorporates Perrow’s functional focus on complexity and coupling [ 34 ].

1.3. Action

Action represents how we act within the system, incorporates Turner and Pidgeon’s work on the flows of information, knowledge and understanding, and anything that happens in the system that is recordable or measurable [ 37 ]; this can be analysed at different levels, such as individual actions, team performance against a standard, activity sequences, or key outcome, process, and balancing measures in relation to system performance [ 35 ].

1.4. Sense-Making

Sense-making represents how we understand and make sense of our world and incorporates Weick’s work on how individuals operating within the system make sense of it, often through practical action [ 39 ].

These dimensions of the CUBE are further broken down in terms of four types of relation: Goals (linked to objectives and outcomes), Process (sequential relations), Social Relations (reciprocal relations of working with and reporting to), and Information and Knowledge (exchanges of meaning that link people and processes). Figure 1 represents the CUBE.

Pictorial representation of the CUBE.

This case study reports on the system-wide implementation of LSS in conjunction with person-centred care principles in a large acute private hospital setting. The organisation’s mission is to provide exceptional patient care in an environment where quality, respect, caring, and compassion are central. This mission is based on organisational values of dignity, excellence, collegiality, and communication. In 2014, the organisation set out on a journey of expansion and growth. It was recognised that if this was to be achieved while holding the highest standards in quality and safety of patient care all staff would need to be involved and play a role. At that time, the organisation had achieved accreditation by the Joint Commission International and to maintain this was a key organisational goal [ 40 ].

This case study sets out to address the question ‘Was the deployment of LSS and person-centred care in this hospital a change on a whole system level?’. The CUBE will be employed as a descriptive and analytic framework to help answer this question.

The CUBE framework is firstly used here to outline some of the important considerations prior to the commencement of the change programme.

1.5. Culture

There was a recognition of the importance of culture from the outset. Retention and development of a highly-skilled staff body with significant organisational knowledge would be crucial to the journey of expansion. A key organisational priority became adopting a person-centred approach with the principles of collaboration, inclusiveness, and participation (CIP) underpinning process improvement in the hospital [ 20 ].

1.6. System

The following strategic objectives were set in 2014: to ensure excellence in quality and safety of patient care through compliance with the six International Patient Safety Goals as outlined by Joint Commission International [ 35 ]; to use Information Technology to enhance Safer Patient Care; to improve Patient Flow, and to improve Care of the High-Risk Patient. With the setting of these strategic objectives, it was recognised that all improvement work needed to come under one approach and be aligned to these strategic objectives as set out in the Hospital Leadership Goals 2014 [ 41 ]. This has been a criticism of QI in healthcare with the term ‘projectitis’ referring to an excessive focus on small projects that are not aligned to the strategic goals of the organisation or each other [ 42 ].

1.7. Action

Not all action in healthcare is suitable for easy measurement. A key focus of the hospital’s efforts, however, would be the ability to measure current performance and to know when a change is an improvement [ 43 , 44 ]. Another priority would be to give healthcare teams information and knowledge on how they were performing so that they would make sense of their own processes and improvement [ 38 , 45 ].

1.8. Sense-Making

Providing staff with excellent educational and developmental opportunities would be essential to support sense-making. The desired “future state” was a better patient and staff experience supported by a culture where all staff members, from Board and Executive Management Team (EMT) to frontline staff, had a shared vision of the goals and adopted a system-wide approach to process improvement, avoiding working in silos [ 46 ]. The organisation had a strong history of supporting staff in the completion of post-graduate education and training; however, before this project, education and training opportunities had been considered based on the individual’s or possibly the department’s needs. Outputs were delivered at the individual or departmental level. A system-wide consideration of education and training needs and outputs had not previously been attempted. It would be essential that staff were educated together to achieve a system-wide approach to change and improvement.

2. Materials and Methods

2.1. case study.

A case study approach [ 47 , 48 ] was adopted here to understand the deployment of a whole system change in the acute hospital along the four dimensions of STS outlined above. A case study is an approach that is used to generate an in-depth, multi-faceted understanding of a complex issue in its real-life context [ 49 ]. This case study sets out to address the question ‘Was the deployment of LSS and person-centred care in this hospital a change on a whole system level?’. The case study analysis was informed by a number of different sources of evidence [ 47 ].

2.2. Evidence

2.2.1. internal hospital documentation.

Hospital Leadership Goals (2014)

Education and Training Working Group; agendas and minutes (2015–2021)

Education and Training Working Group; gap analysis (2015)

Lean Academy presentation to the Hospital Board of Directors (2016)

LSS projects; meeting notes, project progress tracking (2017–2021)

2.2.2. Seven Research Studies Presented in This Special Issue

Operation Note Transformation: The Application of Lean Six Sigma to Improve the Process of Documenting the Operation Note in a Private Hospital Setting [ 50 ].

Releasing Operating Room Nursing Time to Care through the Reduction of Surgical Case Preparation Time: A Lean Six Sigma Pilot Study [ 51 ].

Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach [ 52 ].

Lean Six Sigma Redesign of a Process for Healthcare Mandatory Education in Basic Life Support—A Pilot Study [ 53 ].

The Use of Lean Six Sigma for Improving Availability of and Access to Emergency Department Data to Facilitate Patient Flow [ 54 ].

Using Lean Six Sigma to Redesign the Supply Chain to the Operating Room Department of a Private Hospital to Reduce Associated Costs and Release Nursing Time to Care [ 55 ].

The Use of Lean Six Sigma Methodology in Reducing Length of Stay and Improving Patient Pathway in Anterior Cruciate Ligament Reconstruction Surgery (submitted) [ 56 ].

2.2.3. Participant Observation

One of the authors (AD) is the Director of Education, Innovation, and Rehabilitation at the hospital and has been on this whole system change journey since 2014. She has observed most of the processes concerning the deployment of LSS and person-centred care across the hospital. Another author participated in the Education and Training Working Group (SG). Another author (SPT) is one of the staff members from the Lean Academy who has also been involved since the beginning of the deployment from an academic provision perspective and has observed the system change unfold through this lens since 2017.

2.3. Synthesis

The synthesis of the evidence was facilitated by two authors (MEW and MMcN). MEW was involved in the development of the STS CUBE framework [ 33 , 57 ] and MMcN developed the university-accredited LSS curriculum to overcome system blindness [ 58 ], which was used within the hospital. MEW and MMcN supported the synthesis of the evidence by using questions from the CUBE framework combined with reflective questions from Oshry’s Organic Systems Framework (OSF) [ 59 , 60 ]. Because of the participatory nature of the involvement, it was felt important to add this reflective dimension. Oshry’s OSF provides a framework and vocabulary for describing human systems as organic wholes and allows us to understand and, potentially, influence a range of system phenomena. Oshry’s concepts enable us to see the whole as a pattern of systemic relationships (what the whole is) and as a pattern of systemic processes (what the whole does). He addresses how, as system members, we experience ourselves, our relationships with others, the systems we are a part of, other systems, and the relationships among systems, and it allows us to make more informed decisions and to take more informed actions based on these experiences. A set of questions based on the CUBE and Oshry’s OSF can be found in Table 1 and Table 2 . These questions were posed by MEW and MMcN to the other authors and answered through a process of iteratively writing up this case study. The synthesis set out to generate an answer to the question of whether or not this change could be described as being at a whole system level.

High-level questions are derived from the STSA CUBE [ 46 ].

Reflective questions derived from Oshry’s Organic Systems Framework [ 48 , 49 ].

2.4. Approach to Change

The approach to change at the time of commencement is now outlined under the domains of the CUBE.

2.4.1. Culture

Simpson et al. (2019) describe the importance of healthcare organisational culture when considering quality and patient safety in healthcare [ 49 ]. In 2014, the organisation culture was evolving from a “Power Culture” where the key to the organisation sits in the centre surrounded by widening circles of intimates and influence [ 61 ] (Handy 1999 p. 86). While such a command-and-control culture supported the successful initial drive to build and open the hospital, there was an acknowledgement that a challenge to sustaining and developing an organisation based on a “Power Culture” can be high staff turnover and staff dissatisfaction. There was a need to evolve to a culture of collaboration, inclusion, and participation, allowing the right staff power and influence to contribute to service progression and ultimately organisational development and expansion [ 20 ].

2.4.2. System

The strategic goals that the change was to support are outlined in Table 3 . These are aligned to the JCI accreditation program chapters. JCI accreditation had been achieved by the organisation and a key strategic goal was to maintain this accreditation.

The organisation’s strategic goals.

2.4.3. Action

Each part of the change process would address a strategic goal and would need to achieve certain pre-defined outcomes as outlined in Table 4 below.

System and action table.

2.4.4. Sense-Making

With support from the Board of Directors and the EMT, an Education and Training Working Group (ETWG) was created to identify the needs of the organisation and recommend relevant education and training programmes for implementation. The ETWG comprised a diverse set of stakeholders, all with a crucial role in developing a strategic direction for the organisation. The ETWG agreed on the importance of including all staff in opportunities to input into the design of the education programme; however, they also identified the challenge in accessing and meeting with a wide number of staff productively and effectively. Therefore, an open platform for suggestions was created through town hall meetings, departmental meetings, and performance reviews, including training needs analysis. Each ETWG member took responsibility for a staff/departmental grouping to gain their thoughts on education and training requirements as outlined in Table 5 .

Education and Training Working Group.

Engagement sessions were structured as focus groups with one-to-one sessions also facilitated when requested. The results of the stakeholder engagement sessions helped to inform the desired outcome of education and training solutions as outlined in Table 6 .

Outputs from stakeholder engagement sessions.

Participants were asked to consider focus group themes in the context of the wider organisation rather than discipline or department-specific and the context of the deliverables outlined by the hospital Board of Directors and EMT. To ensure inclusion, a representative from all departments was invited to contribute. When choosing a representative, departments were encouraged to consider staff from all grades/groupings—not specifically managers.

Based on feedback from stakeholders, the ETWG proceeded to scope potential education and training solutions with some key outcomes required in the following areas:

• the culture of quality and patient safety as a priority goal for the organisation would need to be endorsed in any education and training programme;
• to continue to deliver the best patient care, the organisation would need to constantly evolve and improve, working to best international evidence-based practice; and
• the programme would need to take account of the strategic direction of the organisation, including the use of technology to enhance patient care, optimise patient flow, and optimise care of the high-risk patient.

The ETWG identified that the gap in organisational knowledge lay not in the theory of what care to provide but the project management and process improvement skills to bring those theories to fruition. Rather than middle management/senior clinicians passing an idea to EMT to realise, the goal was to achieve a system-wide change in how projects are delivered—co-creating and realising strategies with senior and middle management and frontline staff working together [ 62 ]. Thus, education and training would need to be accessible to team members from all disciplines and all levels of seniority. To support future goals of improved inter-professional collaborative and shared decision-making, education and training that was accessible to the wider healthcare team across levels of seniority, from EMT to department managers as well as staff directly involved in the patients’ journey through the organisation, was deemed a priority [ 62 ].

To add accountability to students and the organisation, a formal academic qualification was deemed a requirement. This was to ensure that students would receive official recognition of knowledge gained and the organisation would be able to formally identify deliverables from investment in training that could be expected.

With education requirements defined ( Table 6 ), the ETWG completed a scoping review of literature of Cinahl and PUBMED databases using keywords including Process Improvement, Healthcare, and Person-Centredness. Emerging evidence of the role of LSS in wider healthcare settings was identified. Of particular note was the variation in LSS work completed in healthcare settings, including administration/patient scheduling, Emergency Department patient flow, Theatre flow, and laboratory turnaround times [ 11 , 63 , 64 , 65 , 66 ], as well as the impact of LSS in improving quality, patient safety, and employee engagement in healthcare [ 27 ]. The ETWG identified LSS as an evidence-based approach to process improvement. Its background in business and then healthcare aligned with the logistics of merging clinical and business process improvements in a private healthcare setting. The principles of LSS include recognising the complexity of healthcare, avoiding silo working, always being open to change and improvement, gathering data to create knowledge, cutting waste not care and focusing on improving the process rather than seeking person-specific improvements that matched the ethos of the organisation.

The ETWG took the evidence from the literature and sought further information regarding the impact of LSS in healthcare through visiting sites that had successfully implemented LSS to examine the “lived experience” of the organisation and their team. This took the form of a site visit to an acute hospital as well as attendance at a White Belt: “Fundamentals of Process Improvement for Healthcare” provided by the Mater Lean Academy. On assessing the literature and reflecting on the site visit, the ETWG reflected on the potential for LSS in healthcare as an education and training resource for process improvement in the organisation. The specific advantages related to accessibility. The structured delivery of LSS from White Belt: “Fundamentals of Process Improvement for Healthcare” to Green Belt: “Professional Certificate Process Improvement in Health Systems” to Black Belt: “Graduate Diploma Process Improvement in Health Systems” would enable staff at all levels to access LSS training—from a 1-day training course to a 1-year diploma.

The ETWG agreed to recommend LSS as an education programme to support process improvement in the organisation. The hospital Board of Directors supported the recommendation and an implementation plan was agreed upon. The support of the Board and EMT was a key requirement before the implementation plan and was based on the following principles:

• LSS training would be made available to all staff. Training would not be discipline or grade-specific. This was important in developing staff who ‘can’, contextualising the change across the organisation, and recognising the role of all employees [ 62 ].
• The method of delivery would be the same for all staff—thus, there was no specific delivery methodology for the EMT.
• The organisation would fully support participation in LSS education events. This included the provision of study leave and financial support for attendance at LSS training events. Thus, the improvement approach was resourced from the outset.
• Members of the EMT were committed to attending training events and acting as executive sponsors as projects emerged. This confirmed leadership commitment through walking the walk, getting involved, and supporting the project [ 50 , 51 , 52 , 53 , 54 , 55 , 56 ].

3.1. How Change Was Achieved in the Organisation

The details for how each individual project achieved its goals are written up in the accompanying papers to this case study [ 50 , 51 , 52 , 53 , 54 , 55 , 56 ]. Some examples of quality and patient safety improvement include: a reduction in the length of stay for surgeries, leading to less likelihood of acquiring a healthcare-associated infection; an increase in capacity to deliver Basic Life Support across the organisation; surgical notes transferred to electronic platforms to improve legibility and accessibility; and releasing nursing and healthcare assistants time to care for patients. Please see Table 7 for a full list of outcomes.

LSS projects delivered through collaborative, inclusive, and participative working.

The mechanisms for change at a system level are presented here using the four domains of the CUBE.

3.1.1. Culture

As can be seen in Table 7 , it is evident that the teams involved in the process improvement projects were from a wide range of backgrounds and seniority, some directly involved in the process, some giving an external perspective. Working from a common framework of the LSS methodology underpinned by a person-centred approach has allowed voices across disciplines and seniority to take an active role in project delivery. It has allowed for devolved responsibility for project delivery from the EMT level. The organisational culture shifted from a power-based culture to a task-based culture [ 61 ].

3.1.2. System

All projects supported organisational strategic goals as well as quality and patient safety priorities. Table 7 demonstrates the system-wide impact of process improvement projects delivered to date. Learnings from first-generation projects have been passed to second and third-generation process improvements ( Figure 2 ). Rather than being completed in isolation, projects are linked and outcomes are used to inform further process improvement.

Interconnection of projects supporting multiple strategic targets.

3.1.3. Action

Each of the projects described in Table 7 has resulted in concrete tangible outcomes for the organisation. For example, the Emergency Department data are circulated daily to the Emergency Department and EMT [ 54 ]. The use of LSS to redesign the delivery of Basic Life Support (BLS) training has resulted in a 50% increase in the capacity to deliver BLS [ 53 ]. Key to this was the academic qualification attached to the LSS training. The requirement to present a completed project that was nominated and supported by the hospital Board of Directors and EMT gave influence and a voice to the project groups.

3.1.4. Sense-Making

The deployment of LSS in conjunction with person-centred care commenced in the hospital in 2017. The following practical aspects of deployment were also put in place to support the above principles. All staff members were included in invites to attend training events. LSS training events were advertised through hospital-wide newsletters, email groups, team meetings, etc. Every staff member was invited to attend White Belt training. Staff from all disciplines and grades attended White Belt training together; there was no specific training for members of the EMT. This supported the hospital’s values of removing barriers between senior managers and staff directly involved in patient care as well as encouraging collaboration across teams/moving from a siloed approach to process improvement. White Belt training had to be completed before moving on to Green Belt training. Academic institution requirements were also noted. Once a staff member was assigned a place at a training event, they agreed to participate actively in the training event. To encourage collaboration, training events were arranged with team members from different departments and at different levels of seniority.

To ensure a whole system approach to improvement, each staff member applying for Green or Black Belt training was asked to submit a project charter as part of their application. Members of the EMT and quality and patient safety staff committed time to potential students to co-design project suggestions and project charters. This ensured that projects were aligned to the strategic goals and direction of the organisation. From a staff perspective, this also demonstrated the EMT and senior management commitment to their improvement project. This commitment was also demonstrated in practice. To assist with staff being released for improvement work, each application required approval from the staff member’s line manager—to ensure cover was in place for the staff member’s improvement leave as required. The first White Belt course was delivered in May 2017. Attendees included the CEO, a nurse specialist, a procurement operative, a physiotherapist, a healthcare assistant, and a patient services administrator. The ETWG had achieved a very important goal—the training event was accessible to all and had served to show that hierarchy was not going to be a barrier to improvement [ 67 ].

Following the implementation of White Belt training events, the organisation was ready to submit applications for Green Belt training commencing September 2017. For the candidates proceeding to Green Belt training, the organisation and candidates hoped that this would empower “middles” to lead process improvement by giving them the skills to integrate the needs and requirements of management with the potential and skills of the frontline staff [ 60 ]. The first Black Belt training programme was completed in November 2020, delivering advanced knowledge on LSS in healthcare. This also delivered the very significant milestone of the hospital being able to deliver White Belt training internally.

Each LSS training event resulted in specific deliverables. At the Black Belt/Green Belt level, this was the completion of process improvement projects with a tangible impact on the strategic goals of the organisation. At the White Belt level, a network of staff familiar with LSS tools was developed who could assist Black and Green Belts to achieve project goals. Every staff member in the hospital has a role to play in quality and patient safety. The accessibility of LSS to all staff created an avenue for all staff to learn and become actively involved in patient safety activities. Combining a person-centred approach and stakeholder engagement methodology, a shared purpose approach has emerged in the LSS projects to date. The project teams formed and refined the project goals and took a shared responsibility with key stakeholders to see projects through to completion.

3.2. Case Study Synthesis

The importance of taking a socio-technical systems approach to whole system change that focuses on the four domains of culture, system, action, and sense-making was stressed in the Introduction [ 33 ] as an important approach to move forward the lack of traction on quality and patient safety improvement that has afflicted healthcare over the last 20 years [ 1 , 2 ].

The results of this case study are now discussed with these four domains in mind. At the outset, the organisation required increased knowledge and skills in person-centred process improvement to help staff provide a sustainable workforce that could engage with and support organisation expansion and development. The person-centred implementation of LSS in the organisation has resulted in the emergence of a task-based culture that focuses on involving the right people with the right resources to complete improvements [ 61 ]. The unifying power of the group is in their approach to the project—a commonality in structuring the project utilising LSS tools based on the principles of collaboration, inclusion, and participation [ 27 ]. These principles allow staff who have completed Green and Black Belt training to support process improvement outside of their usual areas of work—moving away from silo-based improvement or ‘projectitis’ and to more of a system-wide approach to change. LSS graduates from one area are supporting improvement in another. This enables sharing of knowledge and skills, the building up of organisational trust, systemic learning at both a tacit [ 63 ] and explicit level, and the provision of support to system-wide improvement. Interdependencies between projects and areas are noted and a systems view emerges. Staff from patient services supported improvement projects in theatre procurement and graduates from physiotherapy supported projects in information technology/education planning. Investing time and energy to allow staff to do this can be a challenge in a busy acute hospital. By employing the principles of stakeholder engagement promoted by LSS—seeking to understand and giving voice, but also ensuring improvement sessions were well structured with identifiable deliverables, staff were happy to dedicate time to achieve the desired outcome and the organisation supported this.

Study leave was approved before Green Belt and Black Belt training and education commenced. A support network for covering staff was agreed upon. The clear message of support from the Board and EMT removed concerns regarding financial and study leave support. More challenging was facilitating stakeholder engagement/data collection sessions. Teams had to be mindful to meet their stakeholders at times and venues that suited. Additionally, hugely important was the need to reassure stakeholders that the teams sought to understand processes and challenges and seek solutions. The purpose of a LSS project was never to examine or find fault with the person—94% of the problems are caused by the system and 6% by the individual [ 68 ].

In terms of the development of a long-term sustainable team that can support hospital development and expansion, the hospital has moved through forming, storming, and norming and is currently progressing to performing [ 69 ]. D’Andrematteo (2015) [ 70 ] called for further investigation into the organisation-wide success and weakness of LSS. In this system-wide implementation of LSS underpinned by a person-centred approach, the hospital has achieved an organisation-wide approach to improvement involving staff from all specialities and levels of seniority.

Benefits and challenges involving roles within the improvement team were noted. The involvement of clinicians in healthcare improvement is central to system change [ 71 ]. There was great support from clinicians throughout—from practical support given by the Orthopaedic Consultants and Anaesthetist in implementing Day Case Anterior Cruciate Ligament surgery to the “external” process view offered by the Speech and Language Therapist to theatre procurement and stock management [ 55 ]. Each LSS project is based on the collaboration of team members from a combination of medical, nursing, HSCP, and management/administrative backgrounds [ 72 ].

Clinicians are trained to make quick decisions to address an evolving presentation in a patient. The temptation to start a process improvement with “I know the solution—we just have to …..” was something that a lot of staff had to learn to avoid. Process owners within teams also had to learn to allow others the authority to examine processes and facilitate stakeholder engagement and data collection—in some cases acknowledging that team members from outside the process were better placed to complete these activities—as they approached them with “fresh eyes”. This supports a culture where all staff members have psychological safety [ 67 ] and feel able to speak up for important issues such as quality and safety of patient care [ 68 ]. Psychological safety is an essential component of achieving JCI accreditation [ 40 ]. It helps healthcare move on a journey towards high reliability [ 1 ] and to building organisational resilience [ 73 ]. The management is also learning to distribute power and knowledge and acknowledge the expertise and insights of others. There is less emphasis on the positional role and traditional authority [ 74 , 75 ].

LSS is now the method of choice used for improving processes. LSS is also used to present improvements as part of JCI accreditation. The organisation completes JCI accreditation every three years. As part of this accreditation, the hospital reports on key performance indicators, including length of stay and readmission rates, and quality improvement projects around these indicators. Please see Table 8 .

Hospital leadership goals and key performance indicators.

From 2019, these projects have been completed using the LSS methodology. The hospital first achieved JCI accreditation in 2007 and has been re-accredited every three years since then—most recently in 2019. Continuing to achieve re-accreditation requires continuing improvement as well as a commitment to quality and safety of care, including the International Patient Safety Goals.

In addition to the projects described above and as a reflection of the maturing of a LSS culture in the organisation, the LSS methodology has now been adopted as the process improvement method of choice in the organisation. Green and Black Belt projects, as mentioned above, have led to legacy projects outside of the academic structure.

As the number of staff familiar with the LSS approach increases in the organisation, the use of various methods, tools, and strategies has become commonplace. For example, when planning a new or changed service, first thoughts are always to align with the strategic objectives of the organisation, followed by using LSS tools such as process mapping to understand how the service currently runs (AS IS mapping) and to identify how the service will run (TO BE mapping). When analysing potential risks associated with changing a process, a Failure Modes Effect Analysis (FMEA) is completed as standard—this is of particular benefit when preparing for JCI accreditation as it is a tool that JCI commonly requests as part of their accreditation of quality and safety improvement in the hospital.

The CUBE STS analysis framework as further developed in the Access Risk Knowledge (ARK) Platform addresses questions of value in terms of the projected gain and the actual gain of the change achieved [ 28 , 66 ]. In Table 7 the expected outcome and the actual outcome achieved are presented for each individual project. Improvements also occurred outside of these projected outcomes, for example, improvements related to operation notes also improved patient safety and created a template for the transference of further documents to the patient electronic record—without having to seek external consultancy advice. Value can also be seen by stakeholder satisfaction and improved patient care. Examples of stakeholder satisfaction include:

“The novelty, of actually being able to read the handwriting and understand the detail of the surgery, is brilliant!”

“It’s so easy to use”,

“With the help of the templates, I can complete my Op note in minutes”

“It’s saving me so much time!”

“Love the layout, it’s so easy to read”

Harder to estimate is overall Return on Investment (ROI). Four years into the deployment, ROI can be estimated by savings made related to improvement projects. Each of the seven studies reported on here achieved outcomes that can be quantified separately, e.g., projects involving theatre stock have led to a 91% reduction or EUR 24,769 in the value of out-of-date stock and a 45% reduction in nursing stock preparation time (releasing that nursing time to caring for patients) [ 51 , 55 ]. Projects involving patient flow, such as improving the pathway for patients attending Anterior Cruciate Ligament reconstruction, have resulted in an additional 24.6 bed days annually in the organisation [ 56 ]. This implementation was funded within the existing postgraduate education and training budget. Analysis of staff retention and progression is complicated due to many changing circumstances resulting from the COVID-19 pandemic. Of the 32 staff who have completed Lean Six Sigma practitioner training, 25 (78%) remain and are progressing to new roles in the organisation. Further analysis of the 21% of staff trained who have left the organisation is required to identify motivating factors behind the staff member’s decision to change.

Another ROI was the ability to continue White Belt training with in-house resources, meaning the cost of continuing LSS training in the organisation reduced significantly in 2020. Perhaps a mark of leadership satisfaction with the LSS programme was that rather than allocating those savings to another area, the savings were ploughed back into LSS training and education—supporting further Green Belt and Black Belt training.

4. Discussion

The case study synthesis, using the CUBE domains of culture, action, system functioning, and sense-making combined with Oshry’s OSF, has enabled us to answer the question of whether or not these elements combined to create agency for change at the organisational level of the hospital. The case study demonstrates evidence of whole system improvement; projects involving staff from all specialities and levels of seniority are linked to each other and to the strategic objectives of the organisation, and learnings from first-generation projects have been passed to second and third-generation process improvements.

The question of whole system change is difficult, however. There is little agreement in the literature on what constitutes ‘whole system’ change, which speaks to the origins of this special issue. This case study has taken the approach that the design of an effective agency of complex and socio-technical system change requires both an understanding of socio-technical systems and the engineering of their development [ 28 ] and takes some reflection on our role as actors within the system [ 47 , 48 ].

Flynn et al. (2019) [ 77 ] completed a realist evaluation to identify contexts and mechanisms that enabled and hindered implementation and had an effect on the outcome of sustainability of what was meant to be a whole system Lean intervention in a pediatric healthcare setting (CMOs). This intervention was noted as being the ‘largest Lean transformation in the world’ [ 78 ]. While Flynn et al.’s evaluation focused on the outcome of sustainability, the framework could still be used to assess whether the hospital intervention reported here did have an impact at a systems level. The CMOs from Flynn et al.’s work are thus presented here along with a response from the synthesis of evidence in this case study.

CMO1: The early stages of Lean’s implementation were funded, mandated, and top-down in nature (C), driven by an external consultancy firm that initially focused on training senior leadership (C). Frontline staff did not feel involved in Lean changes, and they felt pressured to adopt Lean (M). The Lean language used did not make sense to staff (M). Training failed to demonstrate a connection between Lean and healthcare.

In this case study, it can be seen that an approach to whole system improvement was co-designed from within the system by a team of staff (ETWG) in conjunction with the Board of Directors and EMT. A partnership approach was developed with the UCD Lean Academy who are a team of former and current healthcare workers who have adopted LSS for healthcare staff. The training used and examples given were based in the Irish healthcare settings. The UCD Lean Academy has committed to supporting healthcare teams publish their research to add to the international evidence base [ 12 , 13 , 14 , 15 , 79 ]. Materials from these cases studies were used to support the training.

CMO2: The complexity and dynamic nature of healthcare (C) were perceived as incongruent with the nature of Lean. The translation of Lean to patient care did not make sense for many staff and Lean efforts felt impersonal. Lean training failed to make the connection between Lean and healthcare clear for staff (M) and the early stages of implementation led by the consultancy company failed to customise Lean to the local context. This triggered pitfalls to the success of Lean, such as feelings of disconnection and negative perceptions of Lean (M), resulting in resistance to and a lack of support for Lean continuation (O).

In this case study, it was seen that LSS process improvements were designed and led by organisational staff from the outset with support from staff from the Lean Academy. Organisation stakeholders met with their colleagues rather than with an external consultant. This enabled a shared approach to understanding the challenges, the joint consideration of solutions, and an acknowledgement of previous efforts at improvement made in the past, rather than a suggestion of “just do it” solutions.

CMO3: Lean was implemented in areas that experience constant change (C), early stages of implementation involved multiple Lean events for training purposes (C), and frontline staff felt overwhelmed from the constant change, they were unsure what changes were due to Lean, and felt that Lean was the latest fad (M). This led to negative perceptions of Lean, resistance, and a lack of support by frontline staff (O).

As a relatively young organisation, staff are accustomed to change and progression with short lead-in times. In this case study, it was evident that rather than change being seen as a challenge, the use of LSS and data-driven solution design allowed team members to participate actively in change and take ownership and credit when solutions were found.

CMO4: The contract of the external consultancy leading Lean’s implementation ended (C), placing the continuation of Lean on internal senior leaders and unit managers (C). This led to a process of customisation of Lean to the local context through a variety of ways. This customisation of Lean and shift in implementation triggered positive and negative responses from frontline staff, unit managers, and senior leaders (M). As a result, only some Lean efforts became embedded. However, there was variation and a discrepancy between senior leaders and unit managers compared with frontline staff on perceptions of how embedded Lean efforts were (O).

In this case study, it was seen that the hospital system was committed to building up in-house expertise from the beginning via the training of White, Green, and Black Belts who would reinvest in the system and train further White Belts.

CMO5: The context of early stages of implementation (C) failed to trigger sense-making processes necessary for staff to understand Lean and potentially engage with and begin to embed Lean into their practices (O). Shared values were evident between Lean principles and staff professional values as healthcare providers. However, value congruency without clear sense-making processes resulted in a lack of adoption of Lean behaviours as part of normalised frontline practices. Sense-making processes were hindered by a failure of initial Lean training efforts to translate the principles of Lean into the context of healthcare that would resonate with staff (M). Lean language and the lack of staff involvement in Lean changes also hindered sense-making processes and feelings of engagement. This resulted in negative perceptions of Lean, a lack of buy-in, and a lack of support for the continuation of Lean from frontline staff (O).

In this case study, it can be seen that there was a focus on sense-making from the outset. One learning from the LSS deployment to date is the need to explore and understand the pain/challenge from all perspectives from the outset.

Strengths and Limitations

The strengths of taking a case study approach are that it allows us to attempt to answer complex questions by triangulating different data from different sources [ 43 ]. Internal consistency was increased by collecting data from multiple sources and by using different types and sources of data. Reliability was aided by transparency in terms of outlining the questions and processes of synthesis [ 80 ].

A criticism, however, of this study could be that only one author (MEW) was outside of the process as it was happening. However, there is also a strength in combining insider insights on change and using the rigour of a STS analytic framework such as the CUBE combined with Oshry’s Organic Systems Framework to approach the case study.

A further point to be acknowledged is that this case study reports on the system that was one hospital. This is the strength of the case study approach and helps us give importance to and answer questions on topics in their own right. However, as noted above, whole system change is complex and there may be other factors at play when we consider a ‘systems-of-systems’ approach and acknowledge the wider impact of societal, legislative, political, and other factors on that system. As Flynn et al. note in this special issue [ 81 ], there is growing traction for the need to look at what has been termed ‘learning health systems, which are dynamic ecosystems where scientific, social, technological, policy, legal, and ethical dimensions are aligned to enable continuous learning and improvement to be embedded across the system [ 82 ]. COVID-19 has also taught us a great deal about the importance of taking a ‘systems-of-systems’ approach in healthcare and there are further lessons to be learned from this [ 83 ].

5. Conclusions

There are strengths and limits to the case study approach; however, we hope here, guided by an STS approach, to add to the body of literature on what would constitute whole system improvement in healthcare. Recognising the organisation’s culture , aligning complex system functionality requirements and the ability to activate these requirements to deliver concrete outcomes, and developing a shared understanding or sense-making of future goals aligned with embedding a person-centred approach to whole system improvement have synergised in a way that credibly addresses what it takes to change a whole system. Through the growing organisation-wide knowledge of the LSS approach and methods underpinned by person-centredness [ 27 ], the hospital is creating an increasing network of those who, in Oshry’s terms, “can”, “know”, and “want” to continuously strive for improvement in the quality and safety of patient care in the organisation [ 60 ]. This case study highlights achievements to date. The organisation will continue to grow and develop process improvement with a growing network of staff to support this important work. The STSA CUBE framework and Oshry’s OS framework were used here retrospectively to assess an intervention but could also be used prospectively to help healthcare organisations develop approaches to whole system improvement. Future areas of development for this organisation and to promote the sustainability of LSS and person-centred care include: (1) assessing the impact of LSS/person-centred process improvement through a stakeholder survey as well as the recording of formal project outputs; (2) disseminating and celebrating achievements internally and externally; and (3) continuing to reinvest in training and education to ensure leaders and process improvers remain equipped with skills and knowledge in this constantly evolving field.

Acknowledgments

The authors acknowledge the support of the hospital’s Executive Management Team, Board of Directors, and Education and Training Working Group in the scoping and implementation of this project. We also thank the UCD Mater Lean Academy for the support provided during this project.

Author Contributions

Conceptualisation, M.E.W., M.M., A.D., and S.P.T. methodology, M.E.W., M.M., and A.D.; formal analysis, M.E.W., M.M., and A.D., writing—original draft preparation, A.D., M.E.W., and M.M. writing—review and editing, A.D., M.E.W., M.M., S.G., and S.P.T.; visualisation, A.D. and M.E.W.; funding acquisition, A.D. and S.G. All authors have read and agreed to the published version of the manuscript.

The research received no external funding.

Institutional Review Board Statement

This work took place as part of ongoing organisational quality improvement. Institutional Review Board approval was not required.

Informed Consent Statement

Data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Health Services Management: A Case Study Approach, Eleventh Edition

Ann scheck mcalearney, scd anthony r. kovner, phd.

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• Service Line Management

Book Description

Instructor Resources: Instructor’s Manual   NEW EDITION COMING AUGUST 2023!   Today’s healthcare managers face increasingly complex challenges and often must make decisions quickly. When a difficult situation arises, managers can no longer simply “look it up” online or in the management literature. Properly “looking it up” involves knowing where and how to look, appropriately framing a research question, weighing valid evidence, and understanding what is required to make proposed solutions work. Health Services Management: A Case Study Approach offers a diverse collection of case studies to help readers learn and apply key concepts of management, with an emphasis on the use of evidence in management practice. The case study authors, many of whom are practitioners or academics who work closely with practitioners, present realistic management challenges across a variety of settings. They examine potential responses to those challenges by health services managers and other stakeholders, and they provide a platform for meaningful discussion of opportunities and constraints for management decision makers attempting to implement change. This edition includes 60 case studies—32 of which are brand new—arranged thematically into six sections: The Role of the Manager, Control, Organizational Design, Professional Integration, Adaptation, and Accountability. The new cases include the following: • Better Metrics for Financial Management • What Makes a Patient-Centered Medical Home? • Doing the Right Thing When the Financials Do Not Support Palliative Care • Hearing the Patient Voice: Working with Patient and Family Advisers to Improve the Patient Experience • Managed Care Cautionary Tale: A Case Study in Risk Adjustment and Patient Dumping Learning by example is one of the oldest forms of learning, and the case study approach offers a time-tested way for students and healthcare professionals to develop practical skills that are not easily acquired through lectures. Health Services Management has been used in classrooms since 1978, and this eleventh edition offers a fresh take on a classic text.

• Table of Contents (PDF)
• Preface (PDF)
• Book Excerpt (PDF)
• Transition Guide
• Instructor Resource Sample
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Evidence-Based Management in Healthcare: Principles, Cases, and Perspectives, Second Edition

The United States Healthcare System: Overview, Driving Forces, and Outlook for the Future

The Middleboro Casebook: Healthcare Strategy and Operations, Second Edition

The Best Patient Experience: Helping Physicians Improve Care, Satisfaction, and Scores

Readmission Prevention: Solutions Across the Provider Continuum

The Core Elements of Value in Healthcare

Risk Management and the Emergency Department: Executive Leadership for Protecting Patients and Hospitals

Dimensions of Long-Term Care Management: An Introduction, Second Edition

Fundamentals of Medical Practice Management

A Physician Guidebook to The Best Patient Experience

World Health Systems: Challenges and Perspectives, Second Edition

The Middleboro Casebook: Healthcare Strategy and Operations, Third Edition

Evaluating the Healthcare System: Effectiveness, Efficiency, and Equity, Fourth Edition

Health Services Management: A Case Study Approach, Twelfth Edition

Dimensions of Long-Term Care Management: An Introduction, Third Edition

Fundamentals of Medical Practice Management, Second Edition

Healthcare in the United States: Clinical, Financial, and Operational Dimensions

Inspired to Change: Improving Patient Care One Story at a Time

Accountable Care Organizations: Your Guide to Strategy, Design, and Implementation

Healthcare in the United States: Clinical, Financial, and Operational Dimensions, Second Edition

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Healthcare Administration: Case Studies

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“Case Studies in Healthcare: Success Stories and Lessons Learned”

Table of Contents

The healthcare industry is an ever-evolving field with innovations and improvements happening daily. As healthcare providers strive to deliver the best care possible, case studies have become a valuable resource for learning and growth. In this article, we will explore various case studies in healthcare, highlighting both success stories and the lessons learned along the way. By analyzing what works and why, we can gain insight into the practices that lead to triumphs in healthcare and potentially replicate these successes in our own organizations.

Case Studies in Healthcare: A Closer Look at Triumphs and Takeaways

Healthcare case studies provide a unique opportunity to dissect real-world scenarios, understand the decisions made, and measure the outcomes of those choices. One notable success story is the implementation of telemedicine in rural areas. By leveraging technology, healthcare providers have successfully expanded access to care for patients who would otherwise have to travel long distances for treatment. Lessons learned include the importance of investing in reliable technology and training staff to effectively use telemedicine platforms.

Another critical case study involves the management of electronic health records (EHRs). When a large hospital system transitioned to a new EHR system, they faced significant resistance from physicians who were accustomed to the old way of doing things. However, by involving physicians in the planning and implementation process, the hospital successfully integrated the new system, leading to improved efficiency and patient care. This case study highlights the value of stakeholder engagement and effective change management.

In the fight against infectious diseases, case studies have shown the significance of swift and coordinated responses. An example of this is the containment of Ebola in West Africa. Through international collaboration and the rapid deployment of healthcare resources, the spread of the virus was effectively limited. This case study underscores the importance of preparedness, communication, and teamwork in tackling healthcare crises.

Success Stories in Healthcare: Analyzing What Works and Why

Understanding why certain strategies succeed is crucial for replicating positive results in the healthcare industry. For instance, one hospital’s initiative to reduce patient readmissions focused on comprehensive discharge planning and follow-up care. By ensuring patients had clear instructions and support after leaving the hospital, readmission rates dropped significantly. This case study emphasizes the role of thorough patient education and post-discharge care in improving outcomes.

In the realm of preventive care, a primary care clinic introduced a program to increase vaccination rates among its patient population. By actively reaching out to patients due for immunizations and offering flexible scheduling options, the clinic saw a dramatic increase in vaccination rates. The takeaway from this case study is the impact of proactive patient engagement and removing barriers to care.

Lastly, a healthcare organization’s embrace of continuous quality improvement (CQI) led to enhanced patient safety and satisfaction. By fostering a culture of open communication and ongoing learning, the organization identified areas for improvement and systematically implemented changes. This case study demonstrates the power of a commitment to CQI as a driver for excellence in healthcare.

The healthcare industry is rich with case studies that provide valuable insights and lessons learned. By analyzing and understanding these success stories, healthcare providers can apply similar strategies to achieve positive outcomes in their own organizations. Whether it’s through technology, stakeholder engagement, or quality improvement initiatives, these case studies offer a blueprint for triumph and provide a roadmap for future success in the ever-changing landscape of healthcare.

Why are case studies valuable in the healthcare industry, and how do they provide insights into successful decision-making and problem-solving within healthcare organizations?

Case studies are valuable as they offer real-world examples of challenges and solutions in healthcare. They provide insights into successful decision-making, problem-solving, and strategies that can be applied by healthcare professionals and organizations facing similar scenarios.

How does the article select and present case studies, and what criteria are considered to ensure the relevance and applicability of the showcased success stories to a diverse audience?

The article discusses the criteria for selecting case studies, such as their impact on healthcare outcomes, innovation, or overcoming significant challenges. It highlights the diversity of cases to ensure relevance to a broad audience, considering different healthcare settings, specialties, and contexts.

Can you provide examples of healthcare case studies featured in the article, and how do these stories illustrate successful decision-making or lessons learned that can benefit readers in the healthcare field?

Certainly! Examples may include cases where innovative technologies improved patient outcomes, or instances where strategic decisions enhanced operational efficiency. The article presents these stories to illustrate valuable lessons learned and best practices that readers can apply in their own healthcare settings.

In what ways do case studies contribute to professional development and learning opportunities for healthcare professionals, and how can organizations leverage these stories for continuous improvement and staff training?

The article explores how case studies offer learning opportunities, allowing healthcare professionals to gain insights from others’ experiences. Organizations can leverage these stories for staff training, fostering a culture of continuous improvement and encouraging employees to apply lessons learned to their daily practices.

For healthcare leaders seeking to implement successful strategies within their organizations, what recommendations and actionable insights does the article provide based on the analysis of the showcased case studies?

The article offers recommendations based on the case studies, such as the importance of collaboration, data-driven decision-making, and embracing innovation. It provides actionable insights that healthcare leaders can use to inform their decision-making processes and drive positive outcomes within their organizations.

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83 Healthcare Administration Essay Topic Ideas & Examples

🏆 best healthcare administration topic ideas & essay examples, ✍️ healthcare administration essay topics for college, 📌 good essay topics on healthcare administration, 💡 simple & easy healthcare administration titles.

• Emergency Action Plan: Occupational Safety and Health Administration Company Name: Company Name. Company Contact: Name: Your Name Title: Position Telephone/Cell: Email: In the event of an emergency, employees are alerted by:
• Job Demands in Canadian Health Services Office Administration Currently, relevant job demands in the modern field of Canadian office administration of health services pose considerable challenges for newcomers to the industry.
• Gender and Leadership in Healthcare Administration The authors were studying the challenges that the female gender face in healthcare leadership. The authors concluded that gender inequality in management could not be affected by the type and size of the hospital.
• Administration Errors in a Mental Health Hospital The selection of a representative group from the population of interest is among the prerequisites for the production of reliable and generalizable results.
• Silica Exposure and Occupational Safety and Health Administration In this research, the main focus is to investigate whether the exposure rate on a worker at the Iron Foundry is above the set standard by the OSHA.
• Healthcare Administration: The Role of Information Technologies Sometimes people can use the OR and AND tools to calculate the probability. In addition to probability, Excel allows people to calculate measures of the central tendency.
• The Job of Health Care Administration or Executive Assistance In terms of the contributions of the course to the development of the professional experience for the position, such areas as decision-making and problem-solving were especially relevant.
• Career Development in Healthcare Administration The institution provides regular training to the members and updates the current trends that are witnessed in the healthcare sector. Second, The American Society for Healthcare Human Resources Administration is a website that helps in […]
• ACOs in Healthcare Administration As part of the Medicare and Medicaid program, the main goal of coordinated care is to optimize services by reducing duplication of services and improving care timeliness.
• Amazon’s Occupational Safety and Health Administration The story of one of the Amazon workers presents the company as a firm that does not value ethics in its strategic scheme. It is a matter of ethics to prioritize the employee’s well-being and […]
• Healthcare Administration: The Legal Aspects The essence of this study is to evaluate and assert the usefulness and the advantage of using case studies in teaching legal aspects in healthcare administration.
• Health Administration: Ethical and Legal Perspectives The HIPAA’s primary role was established in order to give people the authority to share their personal medical information, and again gain more accessibility of information about their health status healthcare.
• Legal Aspects of the US Health Care Administration Limiting or revoking the privileges of a medical practitioner is the extreme disciplinary step taken by the medical staff leaders of hospitals in USA.
• Aspects of Health Care Administration In most cases, the role of the administrator in a medical facility is to oversee and ensure the smooth sailing of the medical institution.
• U. S Public Health Administration The public health budget process is an important tool for governments in mobilizing resources that are needed for health, in the implementation of health-based policies and in the provision of quality health services that is […]
• US Public Health Administration While aspects of identification and curing of various kinds of diseases are surely within the agenda of public health, this is not its main task, which, in its broadest scope would embrace, preventive and protective […]
• US Public Health Public Health Administration If a catastrophic disaster occurs, public health staff are needed in terms of quantity and quality therefore, the US government has come up with initiatives to deal with the above.
• The Substance Abuse and Mental Health Services Administration’s Center Substance abuse and mental health services administration has a well-established principle of collaborating with public and private partners so as to provide the most effective services to the needy people within the society.
• Applications for Health Care Administration Finally, there is a need to build a simple but robust network infrastructure within the hospital that will not only allow the above three systems to operate collectively, but also prepare the hospital for future […]
• Finding a Job in the Healthcare Administration Field Following the recommendations, looking for new openings, and continuously working on skills and knowledge improvement can lead one to a good position in healthcare administration.
• Veterans Health Administration Integrative Care Model The purpose of the following study is to provide a thorough research on the influence of the practices conducted on mental health and to examine the overall effectiveness of the integrative care system in delivering […]
• Healthcare Organization’s Strategic Administration To cater to the needs of the population and react to the external and internal fluctuations of the environment, the company has to enhance the quality of the provided services and create a favorable environment […]
• Health and Human Services Administration Master’s Program In this section, I will discuss some of the reasons why I think I am best-placed in my career and the areas I need to sharpen my metrics.
• Health Administration Instructor’s Teaching Philosophy The US labor statistics show that health care is one of the most rapidly developing fields that accounts for the fact that it provides a huge variety of opportunities and options to build a career.
• Business Administration in the Healthcare Field Precise and states the objectives of the hospital, the market segment that it intends to serve, and how it intends to serve it.
• Health Administration Course and Lessons Learnt In this paper, I will present my reflections on the module assignments to identify the areas that I excelled in and those that I need to improve on.
• “Legal Aspects of Healthcare Administration” by George Pozgar In the context of healthcare, information management can be described as the maintenance of records containing the confidential data of patients and medical workers.
• Veteran Health Administration Program The hospital seems to offer quality care to patients, and one of the studies done showed that patients with diabetes got more care than in other health care systems.
• Occupational Safety and Health Administration In population, the mental state of people that arises from the need of space in excess of the available supply is referred to as crowding.
• Legal Aspects of US Healthcare System Administration Professional conduct within a health care setting is grounded in values that reflect the nature and the dynamics of the relationships between a provider and a patient.
• Veterans Health Administration in Northern California The organization mentors and monitors its employees using the best Performance Management System. The healthcare facility has hired the right supervisors and managers to monitor the system.
• Veteran Health Administration: Electronic Systems It is from such sessions that the staff will get a chance to learn from individuals who have prior significant experiences as well as knowledge in their areas of specialization.
• Veterans Health Administration System Development Lifecycle Evidence in support of this is identified in the GAO report which highlights the fact that despite spending large sums on money and time on the VA project implementation is yet to be done on […]
• Mental Health Administration With the increased number of cases, the government opted to have a policy that would see the proper administration of the condition; this lead to the formation of the Substance Abuse and Mental Health Services […]
• Healthcare Administration: Foreign Trade Commission The role of FTC is to ensure effective law enforcement on consumer interests by provision and sharing of its expertise with the federal state, international agencies and the legislative body in the US.
• Effects of Globalization in Health Care Administration In this regard, it fronts considerable challenges to the healthcare sector in the realms of administration and service provision. It is crucial to understand the provisions of globalization and how they affect the healthcare administration.
• Legal Aspects of Healthcare Administration This essay looks at the case of Terri Schiavo and the ethical issues that arose from it, the definitions used to judge cases similar to it from a bioethics perspective and it will attempt to […]
• Ethics in Health Administration The first group focuses on the issues that revolve around making of ethical decisions as well as the universal issues that have a bearing on ethics.
• Ethics in Health Administration: Four Principles of Autonomy For this reason, the role of the healthcare administrator will be to ensure that all the physicians in the organizations respect the choices made by the patients regarding treatment and other important factors pertaining the […]
• Business Administration in Healthcare Field The difference in the human perception of 3D and 2D images that calls for 3D image processing is the major focus of development in the field of informatics.
• Ethical Dilemma in Healthcare Administration Ethical concerns root for the distinction and separation of clinical ethics and business ethics in order to avoid complications of the responsibilities in the health care system.
• The Evolution of Healthcare Administration
• The New Healthcare Administration: How They Drive Diversity?
• General Healthcare Administration Positions
• Global Human Resource Management in the Healthcare Administration
• Career Outlook of Health Administrators
• The Educational Requirements for Healthcare Administration
• International Finance for Healthcare Administration in the United States
• Analysis of the Professional Development Plan Healthcare Administration
• Ethical Diligence in Healthcare Administration
• Work Environment of Health Administrators
• Plans and Features of Healthcare Administration in the United State
• Useful Professional Associations in Healthcare Administration
• The Role of Stakeholders and Community Assessment in Health Nursing Collaboration between community health nurses and community stakeholders as well as community resource assessment can help nurses promote population health.
• Healthcare Management vs. Administration: Key Differences
• The Organizational Behavior of Healthcare Administration
• Changing From Legal Practice to Healthcare Administration
• Healthcare Administration for Patient Safety and Engagement
• System Planning and Control: Health Administration
• Dismissal of Healthcare Administration Employees
• How to Manage the Healthcare Administration in Real Life?
• Pros and Cons of the New Master’s Program in Healthcare Administration
• Queueing System Analysis of Healthcare Administration
• Marketing Strategies and Recommendations for Healthcare Administration
• Factors Affecting the Activities of Healthcare Administration
• Skills That Can Help Improve Work in Healthcare Administration
• The Current Corporate and Global Strategies of Healthcare Administration
• Past and Present in Healthcare Administration
• Law, Ethics, and Policy in Healthcare Administration
• Organizational Behavior and Culture Change at Healthcare Administration
• Sources of Income in the Healthcare Administration: How They Can Affect the Work of Employees
• Healthcare Administrators: Roles and Responsibilities
• Debunking Misconceptions About Healthcare Administration Roles
• The Future of Healthcare Administration
• The Realities of Healthcare Management: What Can Go Unnoticed?
• Healthcare Administration: A Combination of Theory and Practice
• What Is the Role of Information Technology in the Healthcare Administration?
• Stress and the Hospital Administrator: Sources and Solutions
• Technological Advancements in Healthcare Administration
• View of Hospital Administration as a Profession
• Success Factors and Leadership Strategies Healthcare Administration
• The Fundamentals of Healthcare Administration: Navigating Challenges and Coordinating Care
• Workplace Health Essay Topics
• Nursing Theory Questions
• Pharmacy Research Ideas
• The Help Paper Topics
• Genetics Research Ideas
• Heart Failure Titles
• Blood Pressure Ideas
• Career Ideas
• Chicago (A-D)
• Chicago (N-B)

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Health Case Studies

(29 reviews)

Glynda Rees, British Columbia Institute of Technology

Rob Kruger, British Columbia Institute of Technology

Janet Morrison, British Columbia Institute of Technology

Copyright Year: 2017

Publisher: BCcampus

Language: English

Formats Available

Conditions of use.

Learn more about reviews.

Reviewed by Jessica Sellars, Medical assistant office instructor, Blue Mountain Community College on 10/11/23

This is a book of compiled and very well organized patient case studies. The author has broken it up by disease patient was experiencing and even the healthcare roles that took place in this patients care. There is a well thought out direction and... read more

Comprehensiveness rating: 5 see less

This is a book of compiled and very well organized patient case studies. The author has broken it up by disease patient was experiencing and even the healthcare roles that took place in this patients care. There is a well thought out direction and plan. There is an appendix to refer to as well if you are needing to find something specific quickly. I have been looking for something like this to help my students have a base to do their project on. This is the most comprehensive version I have found on the subject.

Content Accuracy rating: 5

This is a book compiled of medical case studies. It is very accurate and can be used to learn from great care and mistakes.

Relevance/Longevity rating: 5

This material is very relevant in this context. It also has plenty of individual case studies to utilize in many ways in all sorts of medical courses. This is a very useful textbook and it will continue to be useful for a very long time as you can still learn from each study even if medicine changes through out the years.

Clarity rating: 5

The author put a lot of thought into the ease of accessibility and reading level of the target audience. There is even a "how to use this resource" section which could be extremely useful to students.

Consistency rating: 5

The text follows a very consistent format throughout the book.

Modularity rating: 5

Each case study is individual broken up and in a group of similar case studies. This makes it extremely easy to utilize.

Organization/Structure/Flow rating: 5

The book is very organized and the appendix is through. It flows seamlessly through each case study.

Interface rating: 5

I had no issues navigating this book, It was clearly labeled and very easy to move around in.

Grammatical Errors rating: 5

I did not catch any grammar errors as I was going through the book

Cultural Relevance rating: 5

This is a challenging question for any medical textbook. It is very culturally relevant to those in medical or medical office degrees.

I have been looking for something like this for years. I am so happy to have finally found it.

Reviewed by Cindy Sun, Assistant Professor, Marshall University on 1/7/23

Interestingly, this is not a case of ‘you get what you pay for’. Instead, not only are the case studies organized in a fashion for ease of use through a detailed table of contents, the authors have included more support for both faculty and... read more

Interestingly, this is not a case of ‘you get what you pay for’. Instead, not only are the case studies organized in a fashion for ease of use through a detailed table of contents, the authors have included more support for both faculty and students. For faculty, the introduction section titled ‘How to use this resource’ and individual notes to educators before each case study contain application tips. An appendix overview lists key elements as issues / concepts, scenario context, and healthcare roles for each case study. For students, learning objectives are presented at the beginning of each case study to provide a framework of expectations.

The content is presented accurately and realistic.

The case studies read similar to ‘A Day In the Life of…’ with detailed intraprofessional communications similar to what would be overheard in patient care areas. The authors present not only the view of the patient care nurse, but also weave interprofessional vantage points through each case study by including patient interaction with individual professionals such as radiology, physician, etc.

In addition to objective assessment findings, the authors integrate standard orders for each diagnosis including medications, treatments, and tests allowing the student to incorporate pathophysiology components to their assessments.

Each case study is arranged in the same framework for consistency and ease of use.

This compilation of eight healthcare case studies focusing on new onset and exacerbation of prevalent diagnoses, such as heart failure, deep vein thrombosis, cancer, and chronic obstructive pulmonary disease advancing to pneumonia.

Each case study has a photo of the ‘patient’. Simple as this may seem, it gives an immediate mental image for the student to focus.

Interface rating: 4

As noted by previous reviewers, most of the links do not connect active web pages. This may be due to the multiple options for accessing this resource (pdf download, pdf electronic, web view, etc.).

Grammatical Errors rating: 4

A minor weakness that faculty will probably need to address prior to use is regarding specific term usages differences between Commonwealth countries and United States, such as lung sound descriptors as ‘quiet’ in place of ‘diminished’ and ‘puffers’ in place of ‘inhalers’.

The authors have provided a multicultural, multigenerational approach in selection of patient characteristics representing a snapshot of today’s patient population. Additionally, one case study focusing on heart failure is about a middle-aged adult, contrasting to the average aged patient the students would normally see during clinical rotations. This option provides opportunities for students to expand their knowledge on risk factors extending beyond age.

This resource is applicable to nursing students learning to care for patients with the specific disease processes presented in each case study or for the leadership students focusing on intraprofessional communication. Educators can assign as a supplement to clinical experiences or as an in-class application of knowledge.

Reviewed by Stephanie Sideras, Assistant Professor, University of Portland on 8/15/22

The eight case studies included in this text addressed high frequency health alterations that all nurses need to be able to manage competently. While diabetes was not highlighted directly, it was included as a potential comorbidity. The five... read more

The eight case studies included in this text addressed high frequency health alterations that all nurses need to be able to manage competently. While diabetes was not highlighted directly, it was included as a potential comorbidity. The five overarching learning objectives pulled from the Institute of Medicine core competencies will clearly resonate with any faculty familiar with Quality and Safety Education for Nurses curriculum.

The presentation of symptoms, treatments and management of the health alterations was accurate. Dialogue between the the interprofessional team was realistic. At times the formatting of lab results was confusing as they reflected reference ranges specific to the Canadian healthcare system but these occurrences were minimal and could be easily adapted.

The focus for learning from these case studies was communication - patient centered communication and interprofessional team communication. Specific details, such as drug dosing, was minimized, which increases longevity and allows for easy individualization of the case data.

While some vocabulary was specific to the Canadian healthcare system, overall the narrative was extremely engaging and easy to follow. Subjective case data from patient or provider were formatted in italics and identified as 'thoughts'. Objective and behavioral case data were smoothly integrated into the narrative.

The consistency of formatting across the eight cases was remarkable. Specific learning objectives are identified for each case and these remain consistent across the range of cases, varying only in the focus for the goals for each different health alterations. Each case begins with presentation of essential patient background and the progress across the trajectory of illness as the patient moves from location to location encountering different healthcare professionals. Many of the characters (the triage nurse in the Emergency Department, the phlebotomist) are consistent across the case situations. These consistencies facilitate both application of a variety of teaching methods and student engagement with the situated learning approach.

Case data is presented by location and begins with the patient's first encounter with the healthcare system. This allows for an examination of how specific trajectories of illness are manifested and how care management needs to be prioritized at different stages. This approach supports discussions of care transitions and the complexity of the associated interprofessional communication.

The text is well organized. The case that has two levels of complexity is clearly identified

The internal links between the table of contents and case specific locations work consistently. In the EPUB and the Digital PDF the external hyperlinks are inconsistently valid.

The grammatical errors were minimal and did not detract from readability

Cultural diversity is present across the cases in factors including race, ethnicity, socioeconomic status, family dynamics and sexual orientation.

The level of detail included in these cases supports a teaching approach to address all three spectrums of learning - knowledge, skills and attitudes - necessary for the development of competent practice. I also appreciate the inclusion of specific assessment instruments that would facilitate a discussion of evidence based practice. I will enjoy using these case to promote clinical reasoning discussions of data that is noticed and interpreted with the resulting prioritizes that are set followed by reflections that result from learner choices.

Reviewed by Chris Roman, Associate Professor, Butler University on 5/19/22

It would be extremely difficult for a book of clinical cases to comprehensively cover all of medicine, and this text does not try. Rather, it provides cases related to common medical problems and introduces them in a way that allows for various... read more

Comprehensiveness rating: 4 see less

It would be extremely difficult for a book of clinical cases to comprehensively cover all of medicine, and this text does not try. Rather, it provides cases related to common medical problems and introduces them in a way that allows for various learning strategies to be employed to leverage the cases for deeper student learning and application.

The narrative form of the cases is less subject to issues of accuracy than a more content-based book would be. That said, the cases are realistic and reasonable, avoiding being too mundane or too extreme.

These cases are narrative and do not include many specific mentions of drugs, dosages, or other aspects of clinical care that may grow/evolve as guidelines change. For this reason, the cases should be “evergreen” and can be modified to suit different types of learners.

Clarity rating: 4

The text is written in very accessible language and avoids heavy use of technical language. Depending on the level of learner, this might even be too simplistic and omit some details that would be needed for physicians, pharmacists, and others to make nuanced care decisions.

The format is very consistent with clear labeling at transition points.

The authors point out in the introductory materials that this text is designed to be used in a modular fashion. Further, they have built in opportunities to customize each cases, such as giving dates of birth at “19xx” to allow for adjustments based on instructional objectives, etc.

The organization is very easy to follow.

I did not identify any issues in navigating the text.

The text contains no grammatical errors, though the language is a little stiff/unrealistic in some cases.

Cases involve patients and members of the care team that are of varying ages, genders, and racial/ethnic backgrounds

Reviewed by Trina Larery, Assistant Professor, Pittsburg State University on 4/5/22

The book covers common scenarios, providing allied health students insight into common health issues. The information in the book is thorough and easily modified if needed to include other scenarios not listed. The material was easy to understand... read more

The book covers common scenarios, providing allied health students insight into common health issues. The information in the book is thorough and easily modified if needed to include other scenarios not listed. The material was easy to understand and apply to the classroom. The E-reader format included hyperlinks that bring the students to subsequent clinical studies.

Content Accuracy rating: 4

The treatments were explained and rationales were given, which can be very helpful to facilitate effective learning for a nursing student or novice nurse. The case studies were accurate in explanation. The DVT case study incorrectly identifies the location of the clot in the popliteal artery instead of in the vein.

The content is relevant to a variety of different types of health care providers and due to the general nature of the cases, will remain relevant over time. Updates should be made annually to the hyperlinks and to assure current standard of practice is still being met.

Clear, simple and easy to read.

Consistent with healthcare terminology and framework throughout all eight case studies.

The text is modular. Cases can be used individually within a unit on the given disease process or relevant sections of a case could be used to illustrate a specific point providing great flexibility. The appendix is helpful in locating content specific to a certain diagnosis or a certain type of health care provider.

The book is well organized, presenting in a logical clear fashion. The appendix allows the student to move about the case study without difficulty.

The interface is easy and simple to navigate. Some links to external sources might need to be updated regularly since those links are subject to change based on current guidelines. A few hyperlinks had "page not found".

Few grammatical errors were noted in text.

The case studies include people of different ethnicities, socioeconomic status, ages, and genders to make this a very useful book.

I enjoyed reading the text. It was interesting and relevant to today's nursing student. There are roughly 25 broken online links or "pages not found", care needs to be taken to update at least annually and assure links are valid and utilizing the most up to date information.

Reviewed by Benjamin Silverberg, Associate Professor/Clinician, West Virginia University on 3/24/22

The appendix reviews the "key roles" and medical venues found in all 8 cases, but is fairly spartan on medical content. The table of contents at the beginning only lists the cases and locations of care. It can be a little tricky to figure out what... read more

Comprehensiveness rating: 3 see less

The appendix reviews the "key roles" and medical venues found in all 8 cases, but is fairly spartan on medical content. The table of contents at the beginning only lists the cases and locations of care. It can be a little tricky to figure out what is going on where, especially since each case is largely conversation-based. Since this presents 8 cases (really 7 with one being expanded upon), there are many medical topics (and venues) that are not included. It's impossible to include every kind of situation, but I'd love to see inclusion of sexual health, renal pathology, substance abuse, etc.

Though there are differences in how care can be delivered based on personal style, changing guidelines, available supplies, etc, the medical accuracy seems to be high. I did not detect bias or industry influence.

Relevance/Longevity rating: 4

Medications are generally listed as generics, with at least current dosing recommendations. The text gives a picture of what care looks like currently, but will be a little challenging to update based on new guidelines (ie, it can be hard to find the exact page in which a medication is dosed/prescribed). Even if the text were to be a little out of date, an instructor can use that to point out what has changed (and why).

Clear text, usually with definitions of medical slang or higher-tier vocabulary. Minimal jargon and there are instances where the "characters" are sorting out the meaning as well, making it accessible for new learners, too.

Overall, the style is consistent between cases - largely broken up into scenes and driven by conversation rather than descriptions of what is happening.

There are 8 (well, again, 7) cases which can be reviewed in any order. Case #2 builds upon #1, which is intentional and a good idea, though personally I would have preferred one case to have different possible outcomes or even a recurrence of illness. Each scene within a case is reasonably short.

Organization/Structure/Flow rating: 4

These cases are modular and don't really build on concepts throughout. As previously stated, case #2 builds upon #1, but beyond that, there is no progression. (To be sure, the authors suggest using case #1 for newer learners and #2 for more advanced ones.) The text would benefit from thematic grouping, a longer introduction and debriefing for each case (there are learning objectives but no real context in medical education nor questions to reflect on what was just read), and progressively-increasing difficulty in medical complexity, ethics, etc.

I used the PDF version and had no interface issues. There are minimal photographs and charts. Some words are marked in blue but those did not seem to be hyperlinked anywhere.

No noticeable errors in grammar, spelling, or formatting were noted.

I appreciate that some diversity of age and ethnicity were offered, but this could be improved. There were Canadian Indian and First Nations patients, for example, as well as other characters with implied diversity, but there didn't seem to be any mention of gender diverse or non-heterosexual people, or disabilities. The cases tried to paint family scenes (the first patient's dog was fairly prominently mentioned) to humanize them. Including more cases would allow for more opportunities to include sex/gender minorities, (hidden) disabilities, etc.

The text (originally from 2017) could use an update. It could be used in conjunction with other Open Texts, as a compliment to other coursework, or purely by itself. The focus is meant to be on improving communication, but there are only 3 short pages at the beginning of the text considering those issues (which are really just learning objectives). In addition to adding more cases and further diversity, I personally would love to see more discussion before and after the case to guide readers (and/or instructors). I also wonder if some of the ambiguity could be improved by suggesting possible health outcomes - this kind of counterfactual comparison isn't possible in real life and could be really interesting in a text. Addition of comprehension/discussion questions would also be worthwhile.

Reviewed by Danielle Peterson, Assistant Professor, University of Saint Francis on 12/31/21

This text provides readers with 8 case studies which include both chronic and acute healthcare issues. Although not comprehensive in regard to types of healthcare conditions, it provides a thorough look at the communication between healthcare... read more

This text provides readers with 8 case studies which include both chronic and acute healthcare issues. Although not comprehensive in regard to types of healthcare conditions, it provides a thorough look at the communication between healthcare workers in acute hospital settings. The cases are primarily set in the inpatient hospital setting, so the bulk of the clinical information is basic emergency care and inpatient protocol: vitals, breathing, medication management, etc. The text provides a table of contents at opening of the text and a handy appendix at the conclusion of the text that outlines each case’s issue(s), scenario, and healthcare roles. No index or glossary present.

Although easy to update, it should be noted that the cases are taking place in a Canadian healthcare system. Terms may be unfamiliar to some students including “province,” “operating theatre,” “physio/physiotherapy,” and “porter.” Units of measurement used include Celsius and meters. Also, the issue of managed care, health insurance coverage, and length of stay is missing for American students. These are primary issues that dictate much of the healthcare system in the US and a primary job function of social workers, nurse case managers, and medical professionals in general. However, instructors that wish to add this to the case studies could do so easily.

The focus of this text is on healthcare communication which makes it less likely to become obsolete. Much of the clinical information is stable healthcare practice that has been standard of care for quite some time. Nevertheless, given the nature of text, updates would be easy to make. Hyperlinks should be updated to the most relevant and trustworthy sources and checked frequently for effectiveness.

The spacing that was used to note change of speaker made for ease of reading. Although unembellished and plain, I expect students to find this format easy to digest and interesting, especially since the script is appropriately balanced with ‘human’ qualities like the current TV shows and songs, the use of humor, and nonverbal cues.

A welcome characteristic of this text is its consistency. Each case is presented in a similar fashion and the roles of the healthcare team are ‘played’ by the same character in each of the scenarios. This allows students to see how healthcare providers prioritize cases and juggle the needs of multiple patients at once. Across scenarios, there was inconsistency in when clinical terms were hyperlinked.

The text is easily divisible into smaller reading sections. However, since the nature of the text is script-narrative format, if significant reorganization occurs, one will need to make sure that the communication of the script still makes sense.

The text is straightforward and presented in a consistent fashion: learning objectives, case history, a script of what happened before the patient enters the healthcare setting, and a script of what happens once the patient arrives at the healthcare setting. The authors use the term, “ideal interactions,” and I would agree that these cases are in large part, ‘best case scenarios.’ Due to this, the case studies are well organized, clear, logical, and predictable. However, depending on the level of student, instructors may want to introduce complications that are typical in the hospital setting.

The interface is pleasing and straightforward. With exception to the case summary and learning objectives, the cases are in narrative, script format. Each case study supplies a photo of the ‘patient’ and one of the case studies includes a link to a 3-minute video that introduces the reader to the patient/case. One of the highlights of this text is the use of hyperlinks to various clinical practices (ABG, vital signs, transfer of patient). Unfortunately, a majority of the links are broken. However, since this is an open text, instructors can update the links to their preference.

Although not free from grammatical errors, those that were noticed were minimal and did not detract from reading.

Cultural Relevance rating: 4

Cultural diversity is visible throughout the patients used in the case studies and includes factors such as age, race, socioeconomic status, family dynamics, and sexual orientation. A moderate level of diversity is noted in the healthcare team with some stereotypes: social workers being female, doctors primarily male.

As a social work instructor, I was grateful to find a text that incorporates this important healthcare role. I would have liked to have seen more content related to advance directives, mediating decision making between the patient and care team, emotional and practical support related to initial diagnosis and discharge planning, and provision of support to colleagues, all typical roles of a medical social worker. I also found it interesting that even though social work was included in multiple scenarios, the role was only introduced on the learning objectives page for the oncology case.

Reviewed by Crystal Wynn, Associate Professor, Virginia State University on 7/21/21

The text covers a variety of chronic diseases within the cases; however, not all of the common disease states were included within the text. More chronic diseases need to be included such as diabetes, cancer, and renal failure. Not all allied... read more

The text covers a variety of chronic diseases within the cases; however, not all of the common disease states were included within the text. More chronic diseases need to be included such as diabetes, cancer, and renal failure. Not all allied health care team members are represented within the case study. Key terms appear throughout the case study textbook and readers are able to click on a hyperlink which directs them to the definition and an explanation of the key term.

Content is accurate, error-free and unbiased.

The content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement.

The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used

The text is internally consistent in terms of terminology and framework.

The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course. Each case can be divided into a chronic disease state unit, which will allow the reader to focus on one section at a time.

Organization/Structure/Flow rating: 3

The topics in the text are presented in a logical manner. Each case provides an excessive amount of language that provides a description of the case. The cases in this text reads more like a novel versus a clinical textbook. The learning objectives listed within each case should be in the form of questions or activities that could be provided as resources for instructors and teachers.

Interface rating: 3

There are several hyperlinks embedded within the textbook that are not functional.

The text contains no grammatical errors.

Cultural Relevance rating: 3

The text is not culturally insensitive or offensive in any way. More examples of cultural inclusiveness is needed throughout the textbook. The cases should be indicative of individuals from a variety of races and ethnicities.

Reviewed by Rebecca Hillary, Biology Instructor, Portland Community College on 6/15/21

This textbook consists of a collection of clinical case studies that can be applicable to a wide range of learning environments from supplementing an undergraduate Anatomy and Physiology Course, to including as part of a Medical or other health... read more

This textbook consists of a collection of clinical case studies that can be applicable to a wide range of learning environments from supplementing an undergraduate Anatomy and Physiology Course, to including as part of a Medical or other health care program. I read the textbook in E-reader format and this includes hyperlinks that bring the students to subsequent clinical study if the book is being used in a clinical classroom. This book is significantly more comprehensive in its approach from other case studies I have read because it provides a bird’s eye view of the many clinicians, technicians, and hospital staff working with one patient. The book also provides real time measurements for patients that change as they travel throughout the hospital until time of discharge.

Each case gave an accurate sense of the chaos that would be present in an emergency situation and show how the conditions affect the practitioners as well as the patients. The reader gets an accurate big picture--a feel for each practitioner’s point of view as well as the point of view of the patient and the patient’s family as the clock ticks down and the patients are subjected to a number of procedures. The clinical information contained in this textbook is all in hyperlinks containing references to clinical skills open text sources or medical websites. I did find one broken link on an external medical resource.

The diseases presented are relevant and will remain so. Some of the links are directly related to the Canadian Medical system so they may not be applicable to those living in other regions. Clinical links may change over time but the text itself will remain relevant.

Each case study clearly presents clinical data as is it recorded in real time.

Each case study provides the point of view of several practitioners and the patient over several days. While each of the case studies covers different pathology they all follow this same format, several points of view and data points, over a number of days.

The case studies are divided by days and this was easy to navigate as a reader. It would be easy to assign one case study per body system in an Anatomy and Physiology course, or to divide them up into small segments for small in class teaching moments.

The topics are presented in an organized way showing clinical data over time and each case presents a large number of view points. For example, in the first case study, the patient is experiencing difficulty breathing. We follow her through several days from her entrance to the emergency room. We meet her X Ray Technicians, Doctor, Nurses, Medical Assistant, Porter, Physiotherapist, Respiratory therapist, and the Lab Technicians running her tests during her stay. Each practitioner paints the overall clinical picture to the reader.

I found the text easy to navigate. There were not any figures included in the text, only clinical data organized in charts. The figures were all accessible via hyperlink. Some figures within the textbook illustrating patient scans could have been helpful but I did not have trouble navigating the links to visualize the scans.

I did not see any grammatical errors in the text.

The patients in the text are a variety of ages and have a variety of family arrangements but there is not much diversity among the patients. Our seven patients in the eight case studies are mostly white and all cis gendered.

Some of the case studies, for example the heart failure study, show clinical data before and after drug treatments so the students can get a feel for mechanism in physiological action. I also liked that the case studies included diet and lifestyle advice for the patients rather than solely emphasizing these pharmacological interventions. Overall, I enjoyed reading through these case studies and I plan to utilize them in my Anatomy and Physiology courses.

Reviewed by Richard Tarpey, Assistant Professor, Middle Tennessee State University on 5/11/21

As a case study book, there is no index or glossary. However, medical and technical terms provide a useful link to definitions and explanations that will prove useful to students unfamiliar with the terms. The information provided is appropriate... read more

As a case study book, there is no index or glossary. However, medical and technical terms provide a useful link to definitions and explanations that will prove useful to students unfamiliar with the terms. The information provided is appropriate for entry-level health care students. The book includes important health problems, but I would like to see coverage of at least one more chronic/lifestyle issue such as diabetes. The book covers adult issues only.

Content is accurate without bias

The content of the book is relevant and up-to-date. It addresses conditions that are prevalent in today's population among adults. There are no pediatric cases, but this does not significantly detract from the usefulness of the text. The format of the book lends to easy updating of data or information.

The book is written with clarity and is easy to read. The writing style is accessible and technical terminology is explained with links to more information.

Consistency is present. Lack of consistency is typically a problem with case study texts, but this book is consistent with presentation, format, and terminology throughout each of the eight cases.

The book has high modularity. Each of the case studies can be used independently from the others providing flexibility. Additionally, each case study can be partitioned for specific learning objectives based on the learning objectives of the course or module.

The book is well organized, presenting students conceptually with differing patient flow patterns through a hospital. The patient information provided at the beginning of each case is a wonderful mechanism for providing personal context for the students as they consider the issues. Many case studies focus on the problem and the organization without students getting a patient's perspective. The patient perspective is well represented in these cases.

The navigation through the cases is good. There are some terminology and procedure hyperlinks within the cases that do not work when accessed. This is troubling if you intend to use the text for entry-level health care students since many of these links are critical for a full understanding of the case.

There are some non-US variants of spelling and a few grammatical errors, but these do not detract from the content of the messages of each case.

The book is inclusive of differing backgrounds and perspectives. No insensitive or offensive references were found.

I like this text for its application flexibility. The book is useful for non-clinical healthcare management students to introduce various healthcare-related concepts and terminology. The content is also helpful for the identification of healthcare administration managerial issues for students to consider. The book has many applications.

Reviewed by Paula Baldwin, Associate Professor/Communication Studies, Western Oregon University on 5/10/21

The different case studies fall on a range, from crisis care to chronic illness care. read more

The different case studies fall on a range, from crisis care to chronic illness care.

The contents seems to be written as they occurred to represent the most complete picture of each medical event's occurence.

These case studies are from the Canadian medical system, but that does not interfere with it's applicability.

It is written for a medical audience, so the terminology is mostly formal and technical.

Some cases are shorter than others and some go in more depth, but it is not problematic.

The eight separate case studies is the perfect size for a class in the quarter system. You could combine this with other texts, videos or learning modalities, or use it alone.

As this is a case studies book, there is not a need for a logical progression in presentation of topics.

No problems in terms of interface.

I have not seen any grammatical errors.

I did not see anything that was culturally insensitive.

I used this in a Health Communication class and it has been extraordinarily successful. My studies are analyzing the messaging for the good, the bad, and the questionable. The case studies are widely varied and it gives the class insights into hospital experiences, both front and back stage, that they would not normally be able to examine. I believe that because it is based real-life medical incidents, my students are finding the material highly engaging.

Reviewed by Marlena Isaac, Instructor, Aiken Technical College on 4/23/21

This text is great to walk through patient care with entry level healthcare students. The students are able to take in the information, digest it, then provide suggestions to how they would facilitate patient healing. Then when they are faced with... read more

This text is great to walk through patient care with entry level healthcare students. The students are able to take in the information, digest it, then provide suggestions to how they would facilitate patient healing. Then when they are faced with a situation in clinical they are not surprised and now how to move through it effectively.

The case studies provided accurate information that relates to the named disease.

It is relevant to health care studies and the development of critical thinking.

Cases are straightforward with great clinical information.

Clinical information is provided concisely.

Appropriate for clinical case study.

Presented to facilitate information gathering.

Takes a while to navigate in the browser.

Cultural Relevance rating: 1

Text lacks adequate representation of minorities.

Reviewed by Kim Garcia, Lecturer III, University of Texas Rio Grande Valley on 11/16/20

The book has 8 case studies, so obviously does not cover the whole of medicine, but the cases provided are descriptive and well developed. Cases are presented at different levels of difficulty, making the cases appropriate for students at... read more

The book has 8 case studies, so obviously does not cover the whole of medicine, but the cases provided are descriptive and well developed. Cases are presented at different levels of difficulty, making the cases appropriate for students at different levels of clinical knowledge. The human element of both patient and health care provider is well captured. The cases are presented with a focus on interprofessional interaction and collaboration, more so than teaching medical content.

Content is accurate and un-biased. No errors noted. Most diagnostic and treatment information is general so it will remain relevant over time. The content of these cases is more appropriate for teaching interprofessional collaboration and less so for teaching the medical care for each diagnosis.

The content is relevant to a variety of different types of health care providers (nurses, radiologic technicians, medical laboratory personnel, etc) and due to the general nature of the cases, will remain relevant over time.

Easy to read. Clear headings are provided for sections of each case study and these section headings clearly tell when time has passed or setting has changed. Enough description is provided to help set the scene for each part of the case. Much of the text is written in the form of dialogue involving patient, family and health care providers, making it easy to adapt for role play. Medical jargon is limited and links for medical terms are provided to other resources that expound on medical terms used.

The text is consistent in structure of each case. Learning objectives are provided. Cases generally start with the patient at home and move with the patient through admission, testing and treatment, using a variety of healthcare services and encountering a variety of personnel.

The text is modular. Cases could be used individually within a unit on the given disease process or relevant sections of a case could be used to illustrate a specific point. The appendix is helpful in locating content specific to a certain diagnosis or a certain type of health care provider.

Each case follows a patient in a logical, chronologic fashion. A clear table of contents and appendix are provided which allows the user to quickly locate desired content. It would be helpful if the items in the table of contents and appendix were linked to the corresponding section of the text.

The hyperlinks to content outside this book work, however using the back arrow on your browser returns you to the front page of the book instead of to the point at which you left the text. I would prefer it if the hyperlinks opened in a new window or tab so closing that window or tab would leave you back where you left the text.

No grammatical errors were noted.

The text is culturally inclusive and appropriate. Characters, both patients and care givers are of a variety of races, ethnicities, ages and backgrounds.

I enjoyed reading the cases and reviewing this text. I can think of several ways in which I will use this content.

Reviewed by Raihan Khan, Instructor/Assistant Professor, James Madison University on 11/3/20

The book contains several important health issues, however still missing some chronic health issues that the students should learn before they join the workforce, such as diabetes-related health issues suffered by the patients. read more

The book contains several important health issues, however still missing some chronic health issues that the students should learn before they join the workforce, such as diabetes-related health issues suffered by the patients.

The health information contained in the textbook is mostly accurate.

I think the book is written focusing on the current culture and health issues faced by the patients. To keep the book relevant in the future, the contexts especially the culture/lifestyle/health care modalities, etc. would need to be updated regularly.

The language is pretty simple, clear, and easy to read.

There is no complaint about consistency. One of the main issues of writing a book, consistency was well managed by the authors.

The book is easy to explore based on how easy the setup is. Students can browse to the specific section that they want to read without much hassle of finding the correct information.

The organization is simple but effective. The authors organized the book based on what can happen in a patient's life and what possible scenarios students should learn about the disease. From that perspective, the book does a good job.

The interface is easy and simple to navigate. Some links to external sources might need to be updated regularly since those links are subject to change that is beyond the author's control. It's frustrating for the reader when the external link shows no information.

The book is free of any major language and grammatical errors.

The book might do a little better in cultural competency. e.g. Last name Singh is mainly for Sikh people. In the text Harj and Priya Singh are Muslim. the authors can consult colleagues who are more familiar with those cultures and revise some cultural aspects of the cases mentioned in the book.

The book is a nice addition to the open textbook world. Hope to see more health issues covered by the book.

Reviewed by Ryan Sheryl, Assistant Professor, California State University, Dominguez Hills on 7/16/20

This text contains 8 medical case studies that reflect best practices at the time of publication. The text identifies 5 overarching learning objectives: interprofessional collaboration, client centered care, evidence-based practice, quality... read more

This text contains 8 medical case studies that reflect best practices at the time of publication. The text identifies 5 overarching learning objectives: interprofessional collaboration, client centered care, evidence-based practice, quality improvement, and informatics. While the case studies do not cover all medical conditions or bodily systems, the book is thorough in conveying details of various patients and medical team members in a hospital environment. Rather than an index or glossary at the end of the text, it contains links to outside websites for more information on medical tests and terms referenced in the cases.

The content provided is reflective of best practices in patient care, interdisciplinary collaboration, and communication at the time of publication. It is specifically accurate for the context of hospitals in Canada. The links provided throughout the text have the potential to supplement with up-to-date descriptions and definitions, however, many of them are broken (see notes in Interface section).

The content of the case studies reflects the increasingly complex landscape of healthcare, including a variety of conditions, ages, and personal situations of the clients and care providers. The text will require frequent updating due to the rapidly changing landscape of society and best practices in client care. For example, a future version may include inclusive practices with transgender clients, or address ways medical racism implicitly impacts client care (see notes in Cultural Relevance section).

The text is written clearly and presents thorough, realistic details about working and being treated in an acute hospital context.

The text is very straightforward. It is consistent in its structure and flow. It uses consistent terminology and follows a structured framework throughout.

Being a series of 8 separate case studies, this text is easily and readily divisible into smaller sections. The text was designed to be taken apart and used piece by piece in order to serve various learning contexts. The parts of each case study can also be used independently of each other to facilitate problem solving.

The topics in the case studies are presented clearly. The structure of each of the case studies proceeds in a similar fashion. All of the cases are set within the same hospital so the hospital personnel and service providers reappear across the cases, giving a textured portrayal of the experiences of the various service providers. The cases can be used individually, or one service provider can be studied across the various studies.

The text is very straightforward, without complex charts or images that could become distorted. Many of the embedded links are broken and require updating. The links that do work are a very useful way to define and expand upon medical terms used in the case studies.

Grammatical errors are minimal and do not distract from the flow of the text. In one instance the last name Singh is spelled Sing, and one patient named Fred in the text is referred to as Frank in the appendix.

The cases all show examples of health care personnel providing compassionate, client-centered care, and there is no overt discrimination portrayed. Two of the clients are in same-sex marriages and these are shown positively. It is notable, however, that the two cases presenting people of color contain more negative characteristics than the other six cases portraying Caucasian people. The people of color are the only two examples of clients who smoke regularly. In addition, the Indian client drinks and is overweight, while the First Nations client is the only one in the text to have a terminal diagnosis. The Indian client is identified as being Punjabi and attending a mosque, although there are only 2% Muslims in the Punjab province of India. Also, the last name Singh generally indicates a person who is a Hindu or Sikh, not Muslim.

Reviewed by Monica LeJeune, RN Instructor, LSUE on 4/24/20

Has comprehensive unfolding case studies that guide the reader to recognize and manage the scenario presented. Assists in critical thinking process. read more

Has comprehensive unfolding case studies that guide the reader to recognize and manage the scenario presented. Assists in critical thinking process.

Accurately presents health scenarios with real life assessment techniques and patient outcomes.

Relevant to nursing practice.

Clearly written and easily understood.

Consistent with healthcare terminology and framework

Has a good reading flow.

Topics presented in logical fashion

Easy to read.

No grammatical errors noted.

Text is not culturally insensitive or offensive.

Good book to have to teach nursing students.

Reviewed by april jarrell, associate professor, J. Sargeant Reynolds Community College on 1/7/20

The text is a great case study tool that is appropriate for nursing school instructors to use in aiding students to learn the nursing process. read more

The text is a great case study tool that is appropriate for nursing school instructors to use in aiding students to learn the nursing process.

The content is accurate and evidence based. There is no bias noted

The content in the text is relevant, up to date for nursing students. It will be easy to update content as needed because the framework allows for addition to the content.

The text is clear and easy to understand.

Framework and terminology is consistent throughout the text; the case study is a continual and takes the student on a journey with the patient. Great for learning!

The case studies can be easily divided into smaller sections to allow for discussions, and weekly studies.

The text and content progress in a logical, clear fashion allowing for progression of learning.

No interface issues noted with this text.

No grammatical errors noted in the text.

No racial or culture insensitivity were noted in the text.

I would recommend this text be used in nursing schools. The use of case studies are helpful for students to learn and practice the nursing process.

Reviewed by Lisa Underwood, Practical Nursing Instructor, NTCC on 12/3/19

The text provides eight comprehensive case studies that showcase the different viewpoints of the many roles involved in patient care. It encompasses the most common seen diagnoses seen across healthcare today. Each case study comes with its own... read more

The text provides eight comprehensive case studies that showcase the different viewpoints of the many roles involved in patient care. It encompasses the most common seen diagnoses seen across healthcare today. Each case study comes with its own set of learning objectives that can be tweaked to fit several allied health courses. Although the case studies are designed around the Canadian Healthcare System, they are quite easily adaptable to fit most any modern, developed healthcare system.

Content Accuracy rating: 3

Overall, the text is quite accurate. There is one significant error that needs to be addressed. It is located in the DVT case study. In the study, a popliteal artery clot is mislabeled as a DVT. DVTs are located in veins, not in arteries. That said, the case study on the whole is quite good. This case study could be used as a learning tool in the classroom for discussion purposes or as a way to test student understanding of DVTs, on example might be, "Can they spot the error?"

At this time, all of the case studies within the text are current. Healthcare is an ever evolving field that rests on the best evidence based practice. Keeping that in mind, educators can easily adapt the studies as the newest evidence emerges and changes practice in healthcare.

All of the case studies are well written and easy to understand. The text includes several hyperlinks and it also highlights certain medical terminology to prompt readers as a way to enhance their learning experience.

Across the text, the language, style, and format of the case studies are completely consistent.

The text is divided into eight separate case studies. Each case study may be used independently of the others. All case studies are further broken down as the focus patient passes through each aspect of their healthcare system. The text's modularity makes it possible to use a case study as individual work, group projects, class discussions, homework or in a simulation lab.

The case studies and the diagnoses that they cover are presented in such a way that educators and allied health students can easily follow and comprehend.

The book in itself is free of any image distortion and it prints nicely. The text is offered in a variety of digital formats. As noted in the above reviews, some of the hyperlinks have navigational issues. When the reader attempts to access them, a "page not found" message is received.

There were minimal grammatical errors. Some of which may be traced back to the differences in our spelling.

The text is culturally relevant in that it includes patients from many different backgrounds and ethnicities. This allows educators and students to explore cultural relevance and sensitivity needs across all areas in healthcare. I do not believe that the text was in any way insensitive or offensive to the reader.

By using the case studies, it may be possible to have an open dialogue about the differences noted in healthcare systems. Students will have the ability to compare and contrast the Canadian healthcare system with their own. I also firmly believe that by using these case studies, students can improve their critical thinking skills. These case studies help them to "put it all together".

Reviewed by Melanie McGrath, Associate Professor, TRAILS on 11/29/19

The text covered some of the most common conditions seen by healthcare providers in a hospital setting, which forms a solid general base for the discussions based on each case. read more

The text covered some of the most common conditions seen by healthcare providers in a hospital setting, which forms a solid general base for the discussions based on each case.

I saw no areas of inaccuracy

As in all healthcare texts, treatments and/or tests will change frequently. However, everything is currently up-to-date thus it should be a good reference for several years.

Each case is written so that any level of healthcare student would understand. Hyperlinks in the text is also very helpful.

All of the cases are written in a similar fashion.

Although not structured as a typical text, each case is easily assigned as a stand-alone.

Each case is organized clearly in an appropriate manner.

I did not see any issues.

I did not see any grammatical errors

The text seemed appropriately inclusive. There are no pediatric cases and no cases of intellectually-impaired patients, but those types of cases introduce more advanced problem-solving which perhaps exceed the scope of the text. May be a good addition to the text.

I found this text to be an excellent resource for healthcare students in a variety of fields. It would be best utilized in inter professional courses to help guide discussion.

Reviewed by Lynne Umbarger, Clinical Assistant Professor, Occupational Therapy, Emory and Henry College on 11/26/19

While the book does not cover every scenario, the ones in the book are quite common and troublesome for inexperienced allied health students. The information in the book is thorough enough, and I have found the cases easy to modify for educational... read more

While the book does not cover every scenario, the ones in the book are quite common and troublesome for inexperienced allied health students. The information in the book is thorough enough, and I have found the cases easy to modify for educational purposes. The material was easily understood by the students but challenging enough for classroom discussion. There are no mentions in the book about occupational therapy, but it is easy enough to add a couple words and make inclusion simple.

Very nice lab values are provided in the case study, making it more realistic for students.

These case studies focus on commonly encountered diagnoses for allied health and nursing students. They are comprehensive, realistic, and easily understood. The only difference is that the hospital in one case allows the patient's dog to visit in the room (highly unusual in US hospitals).

The material is easily understood by allied health students. The cases have links to additional learning materials for concepts that may be less familiar or should be explored further in a particular health field.

The language used in the book is consistent between cases. The framework is the same with each case which makes it easier to locate areas that would be of interest to a particular allied health profession.

The case studies are comprehensive but well-organized. They are short enough to be useful for class discussion or a full-blown assignment. The students seem to understand the material and have not expressed that any concepts or details were missing.

Each case is set up like the other cases. There are learning objectives at the beginning of each case to facilitate using the case, and it is easy enough to pull out material to develop useful activities and assignments.

There is a quick chart in the Appendix to allow the reader to determine the professions involved in each case as well as the pertinent settings and diagnoses for each case study. The contents are easy to access even while reading the book.

As a person who attends carefully to grammar, I found no errors in all of the material I read in this book.

There are a greater number of people of different ethnicities, socioeconomic status, ages, and genders to make this a very useful book. With each case, I could easily picture the person in the case. This book appears to be Canadian and more inclusive than most American books.

I was able to use this book the first time I accessed it to develop a classroom activity for first-year occupational therapy students and a more comprehensive activity for second-year students. I really appreciate the links to a multitude of terminology and medical lab values/issues for each case. I will keep using this book.

Reviewed by Cindy Krentz, Assistant Professor, Metropolitan State University of Denver on 6/15/19

The book covers eight case studies of common inpatient or emergency department scenarios. I appreciated that they had written out the learning objectives. I liked that the patient was described before the case was started, giving some... read more

The book covers eight case studies of common inpatient or emergency department scenarios. I appreciated that they had written out the learning objectives. I liked that the patient was described before the case was started, giving some understanding of the patient's background. I think it could benefit from having a glossary. I liked how the authors included the vital signs in an easily readable bar. I would have liked to see the labs also highlighted like this. I also felt that it would have been good written in a 'what would you do next?' type of case study.

The book is very accurate in language, what tests would be prudent to run and in the day in the life of the hospital in all cases. One inaccuracy is that the authors called a popliteal artery clot a DVT. The rest of the DVT case study was great, though, but the one mistake should be changed.

The book is up to date for now, but as tests become obsolete and new equipment is routinely used, the book ( like any other health textbook) will need to be updated. It would be easy to change, however. All that would have to happen is that the authors go in and change out the test to whatever newer, evidence-based test is being utilized.

The text is written clearly and easy to understand from a student's perspective. There is not too much technical jargon, and it is pretty universal when used- for example DVT for Deep Vein Thrombosis.

The book is consistent in language and how it is broken down into case studies. The same format is used for highlighting vital signs throughout the different case studies. It's great that the reader does not have to read the book in a linear fashion. Each case study can be read without needing to read the others.

The text is broken down into eight case studies, and within the case studies is broken down into days. It is consistent and shows how the patient can pass through the different hospital departments (from the ER to the unit, to surgery, to home) in a realistic manner. The instructor could use one or more of the case studies as (s)he sees fit.

The topics are eight different case studies- and are presented very clearly and organized well. Each one is broken down into how the patient goes through the system. The text is easy to follow and logical.

The interface has some problems with the highlighted blue links. Some of them did not work and I got a 'page not found' message. That can be frustrating for the reader. I'm wondering if a glossary could be utilized (instead of the links) to explain what some of these links are supposed to explain.

I found two or three typos, I don't think they were grammatical errors. In one case I think the Canadian spelling and the United States spelling of the word are just different.

This is a very culturally competent book. In today's world, however, one more type of background that would merit delving into is the trans-gender, GLBTQI person. I was glad that there were no stereotypes.

I enjoyed reading the text. It was interesting and relevant to today's nursing student. Since we are becoming more interprofessional, I liked that we saw what the phlebotomist and other ancillary personnel (mostly different technicians) did. I think that it could become even more interdisciplinary so colleges and universities could have more interprofessional education- courses or simulations- with the addition of the nurse using social work, nutrition, or other professional health care majors.

Reviewed by Catherine J. Grott, Interim Director, Health Administration Program, TRAILS on 5/5/19

The book is comprehensive but is specifically written for healthcare workers practicing in Canada. The title of the book should reflect this. read more

The book is comprehensive but is specifically written for healthcare workers practicing in Canada. The title of the book should reflect this.

The book is accurate, however it has numerous broken online links.

Relevance/Longevity rating: 3

The content is very relevant, but some links are out-dated. For example, WHO Guidelines for Safe Surgery 2009 (p. 186) should be updated.

The book is written in clear and concise language. The side stories about the healthcare workers make the text interesting.

The book is consistent in terms of terminology and framework. Some terms that are emphasized in one case study are not emphasized (with online links) in the other case studies. All of the case studies should have the same words linked to online definitions.

Modularity rating: 3

The book can easily be parsed out if necessary. However, the way the case studies have been written, it's evident that different authors contributed singularly to each case study.

The organization and flow are good.

Interface rating: 1

There are numerous broken online links and "pages not found."

The grammar and punctuation are correct. There are two errors detected: p. 120 a space between the word "heart" and the comma; also a period is needed after Dr (p. 113).

I'm not quite sure that the social worker (p. 119) should comment that the patient and partner are "very normal people."

There are roughly 25 broken online links or "pages not found." The BC & Canadian Guidelines (p. 198) could also include a link to US guidelines to make the text more universal . The basilar crackles (p. 166) is very good. Text could be used compare US and Canadian healthcare. Text could be enhanced to teach "soft skills" and interdepartmental communication skills in healthcare.

Reviewed by Lindsey Henry, Practical Nursing Instructor, Fletcher on 5/1/19

I really appreciated how in the introduction, five learning objectives were identified for students. These objectives are paramount in nursing care and they are each spelled out for the learner. Each Case study also has its own learning... read more

I really appreciated how in the introduction, five learning objectives were identified for students. These objectives are paramount in nursing care and they are each spelled out for the learner. Each Case study also has its own learning objectives, which were effectively met in the readings.

As a seasoned nurse, I believe that the content regarding pathophysiology and treatments used in the case studies were accurate. I really appreciated how many of the treatments were also explained and rationales were given, which can be very helpful to facilitate effective learning for a nursing student or novice nurse.

The case studies are up to date and correlate with the current time period. They are easily understood.

I really loved how several important medical terms, including specific treatments were highlighted to alert the reader. Many interventions performed were also explained further, which is great to enhance learning for the nursing student or novice nurse. Also, with each scenario, a background and history of the patient is depicted, as well as the perspectives of the patient, patients family member, and the primary nurse. This really helps to give the reader a full picture of the day in the life of a nurse or a patient, and also better facilitates the learning process of the reader.

These case studies are consistent. They begin with report, the patient background or updates on subsequent days, and follow the patients all the way through discharge. Once again, I really appreciate how this book describes most if not all aspects of patient care on a day to day basis.

Each case study is separated into days. While they can be divided to be assigned at different points within the course, they also build on each other. They show trends in vital signs, what happens when a patient deteriorates, what happens when they get better and go home. Showing the entire process from ER admit to discharge is really helpful to enhance the students learning experience.

The topics are all presented very similarly and very clearly. The way that the scenarios are explained could even be understood by a non-nursing student as well. The case studies are very clear and very thorough.

The book is very easy to navigate, prints well on paper, and is not distorted or confusing.

I did not see any grammatical errors.

Each case study involves a different type of patient. These differences include race, gender, sexual orientation and medical backgrounds. I do not feel the text was offensive to the reader.

I teach practical nursing students and after reading this book, I am looking forward to implementing it in my classroom. Great read for nursing students!

Reviewed by Leah Jolly, Instructor, Clinical Coordinator, Oregon Institute of Technology on 4/10/19

Good variety of cases and pathologies covered. read more

Good variety of cases and pathologies covered.

Content Accuracy rating: 2

Some examples and scenarios are not completely accurate. For example in the DVT case, the sonographer found thrombus in the "popliteal artery", which according to the book indicated presence of DVT. However in DVT, thrombus is located in the vein, not the artery. The patient would also have much different symptoms if located in the artery. Perhaps some of these inaccuracies are just typos, but in real-life situations this simple mistake can make a world of difference in the patient's course of treatment and outcomes.

Good examples of interprofessional collaboration. If only it worked this way on an every day basis!

Clear and easy to read for those with knowledge of medical terminology.

Good consistency overall.

Broken up well.

Topics are clear and logical.

Would be nice to simply click through to the next page, rather than going through the table of contents each time.

Minor typos/grammatical errors.

No offensive or insensitive materials observed.

Reviewed by Alex Sargsyan, Doctor of Nursing Practice/Assistant Professor , East Tennessee State University on 10/8/18

Because of the case study character of the book it does not have index or glossary. However it has summary for each health case study outlining key elements discussed in each case study. read more

Because of the case study character of the book it does not have index or glossary. However it has summary for each health case study outlining key elements discussed in each case study.

Overall the book is accurately depicting the clinical environment. There are numerous references to external sites. While most of them are correct, some of them are not working. For example Homan’s test link is not working "404 error"

Book is relevant in its current version and can be used in undergraduate and graduate classes. That said, the longevity of the book may be limited because of the character of the clinical education. Clinical guidelines change constantly and it may require a major update of the content.

Cases are written very clearly and have realistic description of an inpatient setting.

The book is easy to read and consistent in the language in all eight cases.

The cases are very well written. Each case is subdivided into logical segments. The segments reflect different setting where the patient is being seen. There is a flow and transition between the settings.

Book has eight distinct cases. This is a great format for a book that presents distinct clinical issues. This will allow the students to have immersive experiences and gain better understanding of the healthcare environment.

Book is offered in many different formats. Besides the issues with the links mentioned above, overall navigation of the book content is very smooth.

Book is very well written and has no grammatical errors.

Book is culturally relevant. Patients in the case studies come different cultures and represent diverse ethnicities.

Reviewed by Justin Berry, Physical Therapist Assistant Program Director, Northland Community and Technical College, East Grand Forks, MN on 8/2/18

This text provides eight patient case studies from a variety of diagnoses, which can be utilized by healthcare students from multiple disciplines. The cases are comprehensive and can be helpful for students to determine professional roles,... read more

This text provides eight patient case studies from a variety of diagnoses, which can be utilized by healthcare students from multiple disciplines. The cases are comprehensive and can be helpful for students to determine professional roles, interprofessional roles, when to initiate communication with other healthcare practitioners due to a change in patient status, and treatment ideas. Some additional patient information, such as lab values, would have been beneficial to include.

Case study information is accurate and unbiased.

Content is up to date. The case studies are written in a way so that they will not be obsolete soon, even with changes in healthcare.

The case studies are well written, and can be utilized for a variety of classroom assignments, discussions, and projects. Some additional lab value information for each patient would have been a nice addition.

The case studies are consistently organized to make it easy for the reader to determine the framework.

The text is broken up into eight different case studies for various patient diagnoses. This design makes it highly modular, and would be easy to assign at different points of a course.

The flow of the topics are presented consistently in a logical manner. Each case study follows a patient chronologically, making it easy to determine changes in patient status and treatment options.

The text is free of interface issues, with no distortion of images or charts.

The text is not culturally insensitive or offensive in any way. Patients are represented from a variety of races, ethnicities, and backgrounds

This book would be a good addition for many different health programs.

Reviewed by Ann Bell-Pfeifer, Instructor/Program Director, Minnesota State Community and Technical College on 5/21/18

The book gives a comprehensive overview of many types of cases for patient conditions. Emergency Room patients may arrive with COPD, heart failure, sepsis, pneumonia, or as motor vehicle accident victims. It is directed towards nurses, medical... read more

The book gives a comprehensive overview of many types of cases for patient conditions. Emergency Room patients may arrive with COPD, heart failure, sepsis, pneumonia, or as motor vehicle accident victims. It is directed towards nurses, medical laboratory technologists, medical radiology technologists, and respiratory therapists and their roles in caring for patients. Most of the overview is accurate. One suggestion is to provide an embedded radiologist interpretation of the exams which are performed which lead to the patients diagnosis.

Overall the book is accurate. Would like to see updates related to the addition of direct radiography technology which is commonly used in the hospital setting.

Many aspects of medicine will remain constant. The case studies seem fairly accurate and may be relevant for up to 3 years. Since technology changes so quickly in medicine, the CT and x-ray components may need minor updates within a few years.

The book clarity is excellent.

The case stories are consistent with each scenario. It is easy to follow the structure and learn from the content.

The book is quite modular. It is easy to break it up into cases and utilize them individually and sequentially.

The cases are listed by disease process and follow a logical flow through each condition. They are easy to follow as they have the same format from the beginning to the end of each case.

The interface seems seamless. Hyperlinks are inserted which provide descriptions and references to medical procedures and in depth definitions.

The book is free of most grammatical errors. There is a place where a few words do not fit the sentence structure and could be a typo.

The book included all types of relationships and ethnic backgrounds. One type which could be added is a transgender patient.

I think the book was quite useful for a variety of health care professionals. The authors did an excellent job of integrating patient cases which could be applied to the health care setting. The stories seemed real and relevant. This book could be used to teach health care professionals about integrated care within the emergency department.

Reviewed by Shelley Wolfe, Assistant Professor, Winona State University on 5/21/18

This text is comprised of comprehensive, detailed case studies that provide the reader with multiple character views throughout a patient’s encounter with the health care system. The Table of Contents accurately reflected the content. It should... read more

This text is comprised of comprehensive, detailed case studies that provide the reader with multiple character views throughout a patient’s encounter with the health care system. The Table of Contents accurately reflected the content. It should be noted that the authors include a statement that conveys that this text is not like traditional textbooks and is not meant to be read in a linear fashion. This allows the educator more flexibility to use the text as a supplement to enhance learning opportunities.

The content of the text appears accurate and unbiased. The “five overarching learning objectives” provide a clear aim of the text and the educator is able to glean how these objectives are captured into each of the case studies. While written for the Canadian healthcare system, this text is easily adaptable to the American healthcare system.

Overall, the content is up-to-date and the case studies provide a variety of uses that promote longevity of the text. However, not all of the blue font links (if using the digital PDF version) were still in working order. I encountered links that led to error pages or outdated “page not found” websites. While the links can be helpful, continued maintenance of these links could prove time-consuming.

I found the text easy to read and understand. I enjoyed that the viewpoints of all the different roles (patient, nurse, lab personnel, etc.) were articulated well and allowed the reader to connect and gain appreciation of the entire healthcare team. Medical jargon was noted to be appropriate for the intended audience of this text.

The terminology and organization of this text is consistent.

The text is divided into 8 case studies that follow a similar organizational structure. The case studies can further be divided to focus on individual learning objectives. For example, the case studies could be looked at as a whole for discussing communication or could be broken down into segments to focus on disease risk factors.

The case studies in this text follow a similar organizational structure and are consistent in their presentation. The flow of individual case studies is excellent and sets the reader on a clear path. As noted previously, this text is not meant to be read in a linear fashion.

This text is available in many different forms. I chose to review the text in the digital PDF version in order to use the embedded links. I did not encounter significant interface issues and did not find any images or features that would distract or confuse a reader.

No significant grammatical errors were noted.

The case studies in this text included patients and healthcare workers from a variety of backgrounds. Educators and students will benefit from expanding the case studies to include discussions and other learning opportunities to help develop culturally-sensitive healthcare providers.

I found the case studies to be very detailed, yet written in a way in which they could be used in various manners. The authors note a variety of ways in which the case studies could be employed with students; however, I feel the authors could also include that the case studies could be used as a basis for simulated clinical experiences. The case studies in this text would be an excellent tool for developing interprofessional communication and collaboration skills in a variety healthcare students.

Reviewed by Darline Foltz, Assistant Professor, University of Cincinnati - Clermont College on 3/27/18

This book covers all areas listed in the Table of Contents. In addition to the detailed patient case studies, there is a helpful section of "How to Use this Resource". I would like to note that this resource "aligns with the open textbooks... read more

This book covers all areas listed in the Table of Contents. In addition to the detailed patient case studies, there is a helpful section of "How to Use this Resource". I would like to note that this resource "aligns with the open textbooks Clinical Procedures for Safer Patient Care and Anatomy and Physiology: OpenStax" as noted by the authors.

The book appears to be accurate. Although one of the learning outcomes is as follows: "Demonstrate an understanding of the Canadian healthcare delivery system.", I did not find anything that is ONLY specific to the Canadian healthcare delivery system other than some of the terminology, i.e. "porter" instead of "transporter" and a few french words. I found this to make the book more interesting for students rather than deter from it. These are patient case studies that are relevant in any country.

The content is up-to-date. Changes in medical science may occur, i.e. a different test, to treat a diagnosis that is included in one or more of the case studies, however, it would be easy and straightforward to implement these changes.

This book is written in lucid, accessible prose. The technical/medical terminology that is used is appropriate for medical and allied health professionals. Something that would improve this text would to provide a glossary of terms for the terms in blue font.

This book is consistent with current medical terminology

This text is easily divided into each of the 6 case studies. The case studies can be used singly according to the body system being addressed or studied.

Because this text is a collection of case studies, flow doesn't pertain, however the organization and structure of the case studies are excellent as they are clear and easy to read.

There are no distractions in this text that would distract or confuse the reader.

I did not identify any grammatical errors.

This text is not culturally insensitive or offensive in any way and uses patients and healthcare workers that are of a variety of races, ethnicities and backgrounds.

I believe that this text would not only be useful to students enrolled in healthcare professions involved in direct patient care but would also be useful to students in supporting healthcare disciplines such as health information technology and management, medical billing and coding, etc.

Table of Contents

• Introduction

Case Study #1: Chronic Obstructive Pulmonary Disease (COPD)

• Learning Objectives
• Patient: Erin Johns
• Emergency Room

Case Study #2: Pneumonia

• Day 0: Emergency Room
• Day 1: Emergency Room
• Day 1: Medical Ward
• Day 2: Medical Ward
• Day 3: Medical Ward
• Day 4: Medical Ward

Case Study #3: Unstable Angina (UA)

• Patient: Harj Singh

Case Study #4: Heart Failure (HF)

• Patient: Meryl Smith
• In the Supermarket
• Day 0: Medical Ward

Case Study #5: Motor Vehicle Collision (MVC)

• Patient: Aaron Knoll
• Crash Scene
• Operating Room
• Post Anaesthesia Care Unit (PACU)
• Surgical Ward

Case Study #6: Sepsis

• Patient: George Thomas
• Sleepy Hollow Care Facility

Case Study #7: Colon Cancer

• Patient: Fred Johnson
• Two Months Ago
• Pre-Surgery Admission

Case Study #8: Deep Vein Thrombosis (DVT)

• Patient: Jamie Douglas

Appendix: Overview About the Authors

Ancillary Material

About the book.

Health Case Studies is composed of eight separate health case studies. Each case study includes the patient narrative or story that models the best practice (at the time of publishing) in healthcare settings. Associated with each case is a set of specific learning objectives to support learning and facilitate educational strategies and evaluation.

The case studies can be used online in a learning management system, in a classroom discussion, in a printed course pack or as part of a textbook created by the instructor. This flexibility is intentional and allows the educator to choose how best to convey the concepts presented in each case to the learner.

Because these case studies were primarily developed for an electronic healthcare system, they are based predominantly in an acute healthcare setting. Educators can augment each case study to include primary healthcare settings, outpatient clinics, assisted living environments, and other contexts as relevant.

About the Contributors

Glynda Rees teaches at the British Columbia Institute of Technology (BCIT) in Vancouver, British Columbia. She completed her MSN at the University of British Columbia with a focus on education and health informatics, and her BSN at the University of Cape Town in South Africa. Glynda has many years of national and international clinical experience in critical care units in South Africa, the UK, and the USA. Her teaching background has focused on clinical education, problem-based learning, clinical techniques, and pharmacology.

Glynda‘s interests include the integration of health informatics in undergraduate education, open accessible education, and the impact of educational technologies on nursing students’ clinical judgment and decision making at the point of care to improve patient safety and quality of care.

Faculty member in the critical care nursing program at the British Columbia Institute of Technology (BCIT) since 2003, Rob has been a critical care nurse for over 25 years with 17 years practicing in a quaternary care intensive care unit. Rob is an experienced educator and supports student learning in the classroom, online, and in clinical areas. Rob’s Master of Education from Simon Fraser University is in educational technology and learning design. He is passionate about using technology to support learning for both faculty and students.

Part of Rob’s faculty position is dedicated to providing high fidelity simulation support for BCIT’s nursing specialties program along with championing innovative teaching and best practices for educational technology. He has championed the use of digital publishing and was the tech lead for Critical Care Nursing’s iPad Project which resulted in over 40 multi-touch interactive textbooks being created using Apple and other technologies.

Rob has successfully completed a number of specialist certifications in computer and network technologies. In 2015, he was awarded Apple Distinguished Educator for his innovation and passionate use of technology to support learning. In the past five years, he has presented and published abstracts on virtual simulation, high fidelity simulation, creating engaging classroom environments, and what the future holds for healthcare and education.

Janet Morrison is the Program Head of Occupational Health Nursing at the British Columbia Institute of Technology (BCIT) in Burnaby, British Columbia. She completed a PhD at Simon Fraser University, Faculty of Communication, Art and Technology, with a focus on health information technology. Her dissertation examined the effects of telehealth implementation in an occupational health nursing service. She has an MA in Adult Education from St. Francis Xavier University and an MA in Library and Information Studies from the University of British Columbia.

Janet’s research interests concern the intended and unintended impacts of health information technologies on healthcare students, faculty, and the healthcare workforce.

She is currently working with BCIT colleagues to study how an educational clinical information system can foster healthcare students’ perceptions of interprofessional roles.

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Top 40 Most Popular Case Studies of 2021

Two cases about Hertz claimed top spots in 2021's Top 40 Most Popular Case Studies

Two cases on the uses of debt and equity at Hertz claimed top spots in the CRDT’s (Case Research and Development Team) 2021 top 40 review of cases.

Hertz (A) took the top spot. The case details the financial structure of the rental car company through the end of 2019. Hertz (B), which ranked third in CRDT’s list, describes the company’s struggles during the early part of the COVID pandemic and its eventual need to enter Chapter 11 bankruptcy. 

The success of the Hertz cases was unprecedented for the top 40 list. Usually, cases take a number of years to gain popularity, but the Hertz cases claimed top spots in their first year of release. Hertz (A) also became the first ‘cooked’ case to top the annual review, as all of the other winners had been web-based ‘raw’ cases.

Besides introducing students to the complicated financing required to maintain an enormous fleet of cars, the Hertz cases also expanded the diversity of case protagonists. Kathyrn Marinello was the CEO of Hertz during this period and the CFO, Jamere Jackson is black.

Sandwiched between the two Hertz cases, Coffee 2016, a perennial best seller, finished second. “Glory, Glory, Man United!” a case about an English football team’s IPO made a surprise move to number four.  Cases on search fund boards, the future of malls,  Norway’s Sovereign Wealth fund, Prodigy Finance, the Mayo Clinic, and Cadbury rounded out the top ten.

Other year-end data for 2021 showed:

• Online “raw” case usage remained steady as compared to 2020 with over 35K users from 170 countries and all 50 U.S. states interacting with 196 cases.
• Fifty four percent of raw case users came from outside the U.S..
• The Yale School of Management (SOM) case study directory pages received over 160K page views from 177 countries with approximately a third originating in India followed by the U.S. and the Philippines.
• Twenty-six of the cases in the list are raw cases.
• A third of the cases feature a woman protagonist.
• Orders for Yale SOM case studies increased by almost 50% compared to 2020.
• The top 40 cases were supervised by 19 different Yale SOM faculty members, several supervising multiple cases.

CRDT compiled the Top 40 list by combining data from its case store, Google Analytics, and other measures of interest and adoption.

All of this year’s Top 40 cases are available for purchase from the Yale Management Media store .

And the Top 40 cases studies of 2021 are:

1.   Hertz Global Holdings (A): Uses of Debt and Equity

2.   Coffee 2016

3.   Hertz Global Holdings (B): Uses of Debt and Equity 2020

4.   Glory, Glory Man United!

5.   Search Fund Company Boards: How CEOs Can Build Boards to Help Them Thrive

6.   The Future of Malls: Was Decline Inevitable?

7.   Strategy for Norway's Pension Fund Global

8.   Prodigy Finance

9.   Design at Mayo

10. Cadbury

11. City Hospital Emergency Room

13. Volkswagen

14. Marina Bay Sands

15. Shake Shack IPO

16. Mastercard

17. Netflix

18. Ant Financial

19. AXA: Creating the New CR Metrics

20. IBM Corporate Service Corps

21. Business Leadership in South Africa's 1994 Reforms

22. Alternative Meat Industry

23. Children's Premier

24. Khalil Tawil and Umi (A)

25. Palm Oil 2016

26. Teach For All: Designing a Global Network

27. What's Next? Search Fund Entrepreneurs Reflect on Life After Exit

28. Searching for a Search Fund Structure: A Student Takes a Tour of Various Options

30. Project Sammaan

31. Commonfund ESG

32. Polaroid

33. Connecticut Green Bank 2018: After the Raid

34. FieldFresh Foods

35. The Alibaba Group

36. 360 State Street: Real Options

37. Herman Miller

38. AgBiome

39. Nathan Cummings Foundation

40. Toyota 2010

Thrive On: The Campaign for Utica University → Delays Due to Weather → -->

What Is Healthcare Administration? A Closer Look at the Backbone of Quality Care

February 5, 2024

In the landscape of modern medicine, there is a silent yet foundational force that orchestrates the seamless delivery of quality patient care. Healthcare administration provides the unseen framework that helps ensure medical facilities run smoothly.

This behind-the-scenes discipline has become essential for the optimal functioning of healthcare organizations of all kinds, providing the structure necessary for medical professionals to deliver quality care to patients.

From its fundamental principles to the pivotal role it plays in enhancing patient experiences and optimizing healthcare delivery, join us as we answer the questions “What is healthcare administration and why is it important?”

What is healthcare administration?

Healthcare administration serves as the linchpin that upholds the integrity and efficiency of healthcare systems. At its core, the discipline ensures the smooth operation of medical facilities, orchestrating indispensable tasks that range from financial management to resource allocation.

Administrators manage the business side of healthcare facilities. This involves overseeing daily operations, which can include managing staff, finances, and resources.

Healthcare administrators make strategic decisions to optimize patient care while considering factors like budget constraints and evolving policies. They may work in hospitals, clinics, long-term care facilities, or other healthcare settings, coordinating different departments to promote smooth operations and high-quality care for patients. They can also play a critical role in maintaining regulatory compliance and cross-departmental cooperation for government agencies, insurance companies, and more.

By strategizing and implementing innovative approaches, healthcare administration professionals drive improvements in healthcare delivery, aiming not only for effectiveness, but also for cost-efficiency and accessibility.

Why is healthcare administration important?

Healthcare administrators navigate the complexities of modern healthcare, adapting to ever-evolving technologies, policies, and patient needs. They do this all while maintaining a delicate balance between the human aspect of healthcare and its administrative demands.

The importance of healthcare administration is multifaceted—it optimizes workflows, streamlines processes, and ensures compliance with regulations, ultimately safeguarding the quality of patient care. Let’s take a closer look at the crucial role healthcare administration plays in the healthcare system at large:

• Efficient operations: Administrators manage resources, staff, and facilities to ensure efficient and effective healthcare delivery. They streamline processes, reducing wait times and improving patient care.
• Financial management: They oversee budgets, billing, and the other financial aspects of healthcare organizations, ensuring sustainability while optimizing resources for the best patient outcomes.
• Quality improvement: Healthcare administrators implement strategies to enhance the quality of care provided. They establish protocols, monitor outcomes, and implement improvements to ensure patients receive the best care possible.
• Regulatory compliance: Administrators navigate complex healthcare regulations and policies, ensuring that the organization complies with legal requirements. This is crucial for avoiding penalties and maintaining ethical standards.
• Strategic planning: They develop long-term strategies for the organization’s growth and sustainability. This includes anticipating changes in healthcare policies and technological advancements, while positively impacting patient needs by optimizing resource allocation and enhancing the quality of care delivery.
• Patient satisfaction: Healthcare administrators work to create environments where patients feel cared for, respected, and supported throughout their healthcare journeys. They gauge patient satisfaction through surveys and other feedback mechanisms to identify areas for improvement.

Moreover, healthcare administration serves as a catalyst for change and innovation within the greater healthcare landscape. Administrators are instrumental in fostering collaboration among medical professionals, promoting interdisciplinary communication, and implementing data-driven decisions.

Through their leadership, those who work in healthcare administration empower medical teams to embrace advancements, adopt best practices, and explore novel solutions to address the challenges faced by the industry. Their strategic vision and ability to forecast trends enable medical facilities to adapt proactively, ensuring the sustainability and resilience of healthcare services in an ever-changing world.

Build a meaningful career in healthcare administration

Now that you have a broader understanding of what healthcare administration is, it’s easy to recognize the important, multifaceted role this discipline plays within the greater healthcare landscape. This helps explain why these professionals are in such high demand.

Healthcare administrator jobs are experiencing rapid growth, projected to see a 28 percent boost between 2022 and 2033. That’s more than five times faster than the average for all occupations nationwide. The median annual salary for this role is also notable, at more than double the national average.

If you’re looking for a career path that will provide you with the opportunity to have a positive influence across your entire community, this impactful role could be right for you. To learn more about what it takes, explore our Master of Healthcare Administration program page or visit our article “ How to Become a Healthcare Administrator ."

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by  Juma Sei

A new movie tells the story of Kemba Smith Pradia, race and incarceration

Strange news, meet abby lampe, two-time champion of the cheese-wheel-chasing race, meet abby lampe, two-time champion of the chees-wheel-chasing race, 100 years ago, indigenous people were granted u.s. citizenship by law.

by  Sandhya Dirks

The first professional women's hockey league in the U.S. has a winner

Music interviews, jon lampley, a veteran of stephen colbert's talk show, releases his debut album.

by  D. Parvaz ,  Ayesha Rascoe ,  Ryan Benk

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