SHORTLISTED FOR THE COSTA BIOGRAPHY PRIZE THE SUNDAY TIMES NO.2 BESTSELLER WINNER OF THE BMA PRESIDENT’S AWARD 2017 An incredible memoir from one of the world’s most eminent heart surgeons, recalling some of the most remarkable and poignant cases he’s worked on.
Most of the current literature on healthcare operations management is focused on importing principles and methods from manufacturing. The evidence of success is scattered and nowhere near what has been achieved in other industries. This book develops the idea that the logic of production, and production systems in healthcare is significantly different. A line of thing that acknowledges the ingenious characteristics of health service production is developed. This book builds on a managerial segmentation of healthcare based on fundamental demand-supply constellations. Demand can be classified with the variables urgency, severity, and randomness. Supply is constrained by medical technology (accuracy of diagnostics, efficacy of therapies), patient health behavior (co-creation of health), and resource availability. Out of this emerge seven demand-supply-based operational types (DSO): prevention, emergencies, one-visit, electives, cure, care, and projects. Each of these have distinct managerial characteristics, such as time-perspective, level of co-creation, value proposition, revenue structure, productivity and other key performance indicators (KPI). The DSOs can be envisioned as platforms upon which clinical modules are attached. For example, any Emergency Department (ED) must be managed to deal with prioritization, time-windows, agitated patients, the necessity to save and stabilize, and variability in demand. Specific clinical assets and skill-sets are required for, say, massive trauma, strokes, cardiac events, or poisoning. While representing different specialties of clinical medicine they, when applied in the emergency – context, must conform to the demand-supply-based operating logic. A basic assumption in this book is that the perceived complexity of healthcare arises from the conflicting demands of the DSO and the clinical realms. The seven DSOs can neatly be juxtaposed on the much-used Business Model Canvas (BMC), which postulates the business model elements as value proposition; customer segments, channels and relations; key activities, resources and partners; the cost structure; and the revenue model.
In gripping prose, one of the world's leading cardiac surgeons lays bare both the wonder and the horror of a life spent a heartbeat away from death When Stephen Westaby witnessed a patient die on the table during open-heart surgery for the first time, he was struck by the quiet, determined way the surgeons walked away. As he soon understood, this detachment is a crucial survival strategy in a profession where death is only a heartbeat away. In Open Heart, Westaby reflects on over 11,000 surgeries, showing us why the procedures have never become routine and will never be. With astonishing compassion, he recounts harrowing and sometimes hopeful stories from his operating room: we meet a pulseless man who lives with an electric heart pump, an expecting mother who refuses surgery unless the doctors let her pregnancy reach full term, and a baby who gets a heart transplant-only to die once it's in place. For readers of Atul Gawande's Being Mortal and of Henry Marsh's Do No Harm, Open Heart offers a soul-baring account of a life spent in constant confrontation with death.
This book has been written for those who must work with and give care to the dying. Our discussion is not simple narrative or description; it is a ""rendition of reality,"" informed by a rather densely woven and fairly abstract theoretical scheme. This scheme evolved gradually during the course of our research. The second audience for this volume is social scientists who are less interested in dying than they are in useful substantive theory. Our central concern is with the temporal aspects of work. The theory presented here may be useful to social scientists interested in areas far removed from health, medicine, or hospitals. The training of physicians and nurses equips them for the technical aspects of dealing with illness.Medical students learn not to kill patients through error, and to save lives through diagnosis and treatment. But their teachers put little or no emphasis on how to talk with dying patients; how-or whether-to disclose an impending death; or even how to approach the subject with the wives, husbands, children, and parents of the dying. Students of nursing are taught how to give nursing care to terminal patients, as well as how to give ""post-mortem care."" But the psychological aspects of dealing with the dying and their families are virtually absent from training. Although physicians and nurses are highly skilled at handling the bodies of terminal patients, their behavior to them otherwise is actually outside the province of professional standards. Much, if not most, nontechnical conduct toward, and in the presence of, dying patients and their families is profoundly influenced by ""common sense"" assumptions, essentially untouched by professional or even rational considerations or by current advancement in social-psychological knowledge. The process of dying in hospitals is much affected by professional training and codes, and by the particular conditions of work generated by hospitals as places of work. A third important consideration in int
This book will take you through the improbable, unconventional and entertaining adventures of the author and his family who fled Cuba after Castro took control of their homeland in 1960.The family was led by the author's father, an ordinary man with no college education, no building experience and very little knowledge of the English language. He was a man who was not afraid to dream big and with sheer determination, boundless energy and drive led his family, like many refugees, to experience the American Dream. Their story takes you through an interesting twist of fate of a man and his family that had lost their home and country and recovered to provide affordable housing and create thousands of jobs for so many in a country that graciously welcomed them. Arriving in Miami in 1960 with only a few personal possessions, this story will take you through the family's diverse journey experiencing life in America in this fast-paced autobiography.
Forensic psychiatrist Frank Clevenger returns in this arresting new thriller from bestselling author Keith Ablow. Having achieved celebrity status with his last case, Clevenger is tapped by the FBI to catch an elusive murderer known as the Highway Killer, who has left twelve bodies strewn across twelve states. But the Highway Killer isn't just a serial killer--he's a psychiatrist whose brilliance as a doctor is matched only by his precision as a murderer. When he writes to a national newspaper challenging Clevenger to cure him through an exchange of open letters, a gripping public therapy unfolds. With the Highway Killer's brutality reaching new heights as he confronts his mind's darkest demons, will Clevenger exorcise those demons before they spin completely out of control?