In a personal communication with Janet practitioners, provide merely an exciting and
Maronde, Executive Director of the Health- glamorous location and justification for the BOOK REVIEWS care Quality Certification Board, she in- drama—but in the manner, for instance, in formed me that since 1984 the CPHQ exam- which director Peter Brook uses it in his work ination has been taken by 13 000 people and with Oliver Sacks, or American doctor/writer 9500 have been certified. For the first time in Frank Huyler in his wonderful Blood of Stran- The Healthcare Quality Handbook: the year 2000 it has become international. It gers, a review of which, incidentally, also A Professional Resource and Study is given in many locations around the world appears in the journal. Guide. 15th Annual Edition. Janet A and the content specific to the USA has been There’s plenty to fascinate the novelist in Brown. (Pp 800; $125 for NAHQ members, nearly eliminated. Maronde was careful to say this new journal—interesting ideas on sick- $140 for non-members, yearly updates avail- that her Board does not recommend any par- ness or health and, of course, Chekhov. As a able for additional fee). California: Managed writer in residence at a medical school I ticular textbook to prepare for the CPHQ Care Consultants, 2000. (Also available found papers on the relationship between arts examination, but that many people use Janet through the National Association for Health- and medicine, and its current state of play in care Quality (NAHQ), P O Box 3781, Brown’s handbook for this purpose. No errors of commission were found in the medical schools, invaluable. Oakbrook, Illinois 60522, USA.) What is more interesting, though, is that, to handbook. Although the pages are not num- bered, the chapters and paragraphs are. This, someone on the humanities side, there appears Revised yearly since 1986, this is an 800 page loose leaf handbook in a ring binder and is and the lack of an index, make inserted revi- to be something unnecessarily deferential used by some readers to prepare for the sions easier. Given the size and density of the about the approach medicine makes to the International Certified Professional in handbook, it seems unfair to ask for more. arts, like poor old peasant-stock Lopahin, cap- Healthcare Quality (CPHQ) examination of This reviewer would like to have seen more in-hand, before he bought the cherry orchard. the Healthcare Quality Certification Board Imagine this if you can. A bunch of English on statistical process control. Perhaps Euro- which is associated with the National Associ- Literature lecturers, concerned about the pean readers would like more on ISO 9000 ation for Health Quality (NAHQ). teaching of the subject in the country’s and its updates, even though this approach is Imagine a classmate of yours known for tak- universities, in particular the sort of narrow not widely used in USA health care. The sec- ing meticulous notes for all her classes and visioned students, lecturers, novels, plays, etc tion on reduction in medical errors will no homework. Imagine that she kept such notes it is producing, decide to introduce a Special doubt be expanded in future revisions, but for the equivalent of a master’s degree in health Study Module in Science and Medicine into this literature in health care is just beginning. the degree. DiYcult isn’t it? care quality and she kept reading and updating This unique handbook should be available Roll on the well rounded doctor. Let’s hope these notes for 15 years. This may give you an idea of what Janet Brown has written. The to every health care quality professional who and pray, for all our sakes, they don’t start result is a book too heavy to hold in your hands wishes to recognise and have access to the requiring the same of writers. for long. There are lots of definitions, lists, and large body of ideas and methods now bullet points summarising the literature. These available for improvement. It should become CAROL CLEWLOW references are cited. Brown’s outline approach available on computer disk in the future. Writer in Residence, allows a lot of densely packed information to Department of Epidemiology & Public Health, D NEUHAUSER School of Health Sciences, be included; there are proportionally few full paragraphs. Three hundred and fifty multiple Case Western Reserve University, The Medical School, choice questions are included to test your Cleveland, Ohio 44106-4945, USA University of Newcastle, Newcastle upon Tyne NE2 4HH, UK knowledge and prepare for the CPHQ exam- ination. Medical Humanities David Greaves, Mar- About 20% of the content is specific to tyn Evans, Editors. Published twice yearly in laws and institutions in the USA such as the requirements of the Joint Commission on the June and December as a special edition of the Accreditation of Healthcare Organizations Journal of Medical Ethics. Personal subscrip- tion: £21.00 (US$33.00). London: BMJ Corrections (JCAHO). Some of this may be of interest to experts outside the USA. The other 80% is Publishing Group. quality theory and principles and is applica- ble anywhere. The template is Chekhov. Or maybe the DARTS study The book is divided into sections on qual- patron saint. Call him the lode star, anyway, ity concepts, strategic leadership, quality sys- for those who want to bring medicine and the In the Viewpoint article entitled “The poten- tem management, performance improve- humanities together. tial use of decision analysis to support shared ment, information management, people Picture the scene. There he is, late one decision making in the face of uncertainty: the management, and USA federal legislation night, any night, deep into The Three Sisters, example of atrial fibrillation and warfarin anti- related to quality. Here is a haphazard or Uncle Vanya, or The Seagull and there’s a coagulation” by A Robinson and R G Thom- sampling of concepts to be found in the book: knock at the door which, opened up by the son on behalf of the Decision Analysis in Rou- factors aVecting utilisation, Deming’s 14 housekeeper, reveals a scruVy urchin who tine Treatment Study (DARTS) team which points, risk management, benchmarking, says those magic words “Can the doctor appeared on page 238 of the December 2000 team leadership skills, clinical pathways, case come...?” issue of Quality in Health Care, the following management, medical records review, medi- And so Chekhov the writer lays down his acknowledgement should have appeared: cal staV appointment process, quality indica- pen and drags himself away from the “The DARTS project was commissioned by tors, the European Foundation for Quality Prozorov’s drawing room, or Vanya’s oYce, the West Midlands Regional NHS Executive Management award criteria, aYnity dia- or Arkadin’s dining table, and rises from his R&D programme and Eli Lilly Ltd”. The grams, the “five whys”, FOCUS-PDCA, and desk. And Chekhov the doctor goes out into authors apologise for this omission. the list goes on. The density of information in the night. It’s a story to strike shame in the this practical handbook is such that it makes heart of any precious writer, trust me. Chek- any other book on health care quality EQuiP statement published in the last decade seem undernour- hov, naturally enough, figures in the first issue ished and anaemic. The most similar book of Medical Humanities. A paper on Chekhov’s In the Viewpoint article entitled “Improving known to this reviewer is the 778 page short story A Case History considers, among the interface between primary and secondary textbook by Goetsch and David entitled other things, the polyphonic nature of care: a statement from the European Working Quality Management: Introduction to Total doctor-patient communications—a perfect Party on Quality in Family Practice (EQuiP)” Quality Management for Production, Processing example of how naturally fiction and medi- by O J Kvamme et al which appeared on page and Service, 3rd edition, published in 2000 by cine fuse together. Just how inherently 33 of the March 2001 issue of Quality in Health Prentice Hall. This is a basic general class dramatic is the business of medicine is some- Care, the name of the last author was room textbook for management students and thing instantly recognisable to the novelist— incorrectly spelt. The correct spelling is M is a companion more than a competitor to not in the sense of ER or Casualty in which Samuelson. The publishers apologise for this Brown’s handbook. medicine and all things medical, including its error.
Arthur M. Nezu, George F. Ronan, Elizabeth A. Meadows, Kelly S. McClure (Editors) - Practitioner's Guide To Empirically Based Measures of Depression (AABT Clinical Assessment Series) (2000)