Threatened by sharp cuts in state government support and stagnant federal research funding, US public research universities are becoming fragile ecosystems. By charting flows of research dollars through a leading public research university-the University of California, San Francisco (UCSF)-this book illuminates how such schools work to cope with these funding threats and how the challenges and coping strategies affect organization and direction of research. Academic leaders, faculty, administrators, and students will learn how a complex academic health center manages its revenues, expenses, and diverse academic cultures. For the first time, they can begin to understand arcane mysteries of indirect cost recovery, sponsored funds, capital investment, endowments, debt, and researchers' salaries.

This is an unmistakable time of crisis and confusion about the purpose, value, and sustainability of higher education in the United States. Data continues to show substantial benefits for students who complete a four-year degree, yet Americans from all backgrounds are losing confidence in the nation's institutions of higher learning, and political and economic challenges for colleges and universities seem greater than ever. How can faculty, administrators, governing boards, and other stakeholders address these challenges effectively? Holden Thorp and Buck Goldstein draw on interviews with higher education thought leaders and their own experience inside and outside the academy to address these problems head on. Now in paperback with a new preface by the authors, Our Higher Calling presents a forceful case for the enduring value of higher education along with pragmatic recommendations for how campus leaders can engage in constructive dialogue about necessary change.

Academic medical centers provide cutting edge acute care, train tomorrow's physicians, and carry out research that will expand the range of treatable and curable illnesses. But these centers themselves may need urgent care—experts generally agree that many are suffering acute—even life-threatening—financial distress. Many academic medical centers are suffering for several reasons: in-patient admissions are down, as many procedures that once required a hospital stay are now performed on an out-patient basis or in a physician's office ; managed care plans have negotiated discounted fees that cut hospital operating margins; the Balanced Budget Act of 1997 curtailed Medicare reimbursements, lowered margins and pushed some into the red; the revolution in information technology is imposing large new capital costs; and the character of medical education is receiving its most thorough review in decades. While there is a general consensus that medical centers are under pressure, experts disagree about the depth and pervasiveness of the current financial distress. Are they whining about financial pressures other, less-favored sectors find routine; or is the high quality American teaching hospital becoming an endangered species—that could face extinction if nothing is done. Because academic medical centers perform such important jobs, it is critical to determine the true nature and depth of their current financial problems—and then fashion analytically sound and politically sustainable solutions. This book brings together chief executive officers of major medical centers, university presidents, senior members of Congressional and executive office staffs, and leading analysts. These experts address the key issues and prescribe remedies both regulatory and legislative to ensure that the teaching hospital remains a picture of financial health. Contributors include Nancy Kane (Harvard School of Public Health), Jamie Reuter (Institute for Health Care Research P

In Making Room in the Clinic, Julie Fairman examines the context in which the nurse practitioner movement emerged, how large political and social movements influenced it, and how it contributed to the changing definition of medical care. Drawing on primary source material, including interviews with key figures in the movement, Fairman describes how this evolution helped create an influential foundation for health policies that emerged at the end of the twentieth century, including health maintenance organizations, a renewed interest in health awareness and disease prevention, and consumer-based services.

Health services research is "the multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care and the quality and cost of health care." Since the 1960s, health services research has provided the foundation for progress, effectiveness, and value in health care. Ironically, at a time in which appreciation has never been higher for both the need and potential from health services research, the political and financial support for sustenance and growth appear to be weakening. With funding support from AcademyHealth, the American Association of Colleges of Nursing, the American Board of Family Medicine, the American Society of Anesthesiologists, the Association of American Medical Colleges, the Federation of American Hospitals, and the Robert Wood Johnson Foundation, this National Academy of Medicine Special Publication identifies the range of issues that health services research must consider, address, and potentially overcome to transform the field to meet the needs of a 21st-century health care system. These issues are broad, multidisciplinary, and will require a coordinated effort to address?as well as dedicated and sustainable funding. Federal support for health services research has never been more critical. Now is a critical time for the field to articulate its priorities, demonstrate its utility, and transform to meet the needs of a 21st-century health care system. The physical and financial health of the nation is at stake.

2014 AJN BOOK OF THE YEAR AWARD! 2014 DOODY’S CORE TITLE Now in its third edition, this highly acclaimed text remains the leading comprehensive textbook and professional reference for Clinical Nurse Specialist (CNS) education and practice. Supported by theory, research, and current literature, the book focuses on CNS roles and scope of practice; expanding opportunities in primary and home care settings; and outcomes of CNS practice throughout the care continuum and across the three spheres of impact. The third edition is updated to reflect current trends affecting CNS practice, with several new chapters that focus on telehealth, home care, and quality improvement. The text begins with an overview of the evolution, attributes, philosophical underpinnings, and key outcomes of CNSs in the United States. It then addresses nursing interventions, quality, and care delivery, as well as the business side of CNS practice—consultation, mentoring, project management, and entrepreneurship. It features examples of CNS practice in a variety of settings and specialty areas. This resource provides students and professionals with the guidance required to achieve core competencies and improve patient outcomes. NEW TO THE THIRD EDITION: Updated to reflect current practices and the latest core competencies Features a new section—Creating a Culture of Quality—that addresses patient safety, high-reliability organizations, Big Data, and efficiency Highlights emerging areas of CNS practice such as telehealth, pediatric palliative care, wound care, and home care KEY FEATURES: Emphasizes the importance of the CNS practitioner as expert clinician, consultant, researcher, and educator Written and edited by more than 40 individuals representing the “Who’s Who” of CNS nursing Highlights core competencies and practice outcomes identified in NACNS’s 2019 Statement on Clinical Nurse Specialist Practice and Education Presents models of CNS specialty care and CNS practice with outcomes Includes discussion questions, ethical considerations, analysis and synthesis exercises, and clinical application considerations Instructor’s PowerPoint slides included

In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.