Better Ideas
Cultural Health Care Issues
Environmental Issues
General
International
International Initiatives
Last Phase of Life
Leadership
National Initiatives & Organizations
North America
Patient, Family & Consumer Sites
Patient-Centered Care
Professional Associations
Quality Improvement Resources
Regulatory, Legislative & Policy
US Government
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Better Ideas
The Agency for Healthcare Research and Quality (AHRQ) Health Care Innovations Exchange is a web-based resource designed to support health care professionals in sharing and adopting innovations that improve health care quality. The website includes a clearinghouse of innovative ideas and opportunities to learn and share ideas with others. Submissions of innovative approaches to patient care delivery are welcomed.
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Cultural Health Care Issues
The National Center for Cultural Competence (NCCC) is a project of the Georgetown University Center for Child and Human Development and the University Center for Excellence in Development Disabilities. The NCCC offers many products and services to define cultural and linguistic competence as well as to create culturally and linguisticly appropriate service delivery systems.
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Ethnomed provides cultural medicine information from Harborview Medical Center (part of the University of Washington) specific to the ethnic groups living in the Seattle, Washington area. Information about culture, language, health, illness, and community resources is provided as a support for health care providers giving care to this population. Much of the information may also be pertinent and of interest to other geographic regions.
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Following the Institute of Medicine’s report, recommending the health care industry to create a plan to reduce racial and ethnic disparities in medical care, The Kaiser Family Foundation has attempted to put together one single document outlining the activities that should be done as well as programs that are currently underway.
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The Center for Disease Control and Prevention compiled a list of resources for cultural and linguistic competency resources.
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The Cross Cultural Health Care Program (CCHCP) offers many resources that address cultural health care issues. Resources include books, training programs, interpreter information, and research programs. The CCHCP strives to serve as a bridge between communities and health care institutions to ensure that the communities receive the care they need.
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Diversityrx.org is the website of Resources for Cross-Cultural Health Care, a network of individuals and organizations promoting the language and cultural competency for diverse communities. The site provides information about models and practices, legal issues, and policy. The National Conference of State Legislatures (NCSL) and the Henry J. Kaiser Family Foundation also support this site.
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The Provider’s Guide to Quality and Culture is a joint project of Management Sciences for Health, US Department of Health and Human Services, Health Resources and Services Administration, and the Bureau of Primary Health Care. Their goal is to provide health care organizations with the assistance they need to provide service that are of both high quality and culturally competent.
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Environmental Issues
The primary goal of the H2E effort is to educate health care professionals about pollution prevention opportunities in hospitals and health care systems. Through activities, such as the development of best practices, model plans for total waste management, resource directories, and case studies. The project hopes to provide hospitals and health care systems with enhanced tools for minimizing the volumes of waste generated and the use of persistent, bioaccumulative, and toxic chemicals. [USA]
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To transform the health care industry worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment. [USA]
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General
Healthcare 411 is a news series produced by the Agency for Healthcare Research and Quality (AHRQ). Weekly audio and video programs for both consumers and clinicians feature the latest AHRQ research findings as well as informational stories on health care topics to help consumers improve the quality of their health care and navigate the system.
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The SQUIRE Guidelines help authors write excellent, usable articles about quality improvement in health care so that their findings can be easily discovered and widely disseminated, thus spreading improvement work to a broader population. The website contains the Guidelines, a Guidelines Checklist, and other resources.
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The Dartmouth Atlas project brings together researchers in diverse disciplines — including epidemiology, economics, and statistics — and focuses on the accurate description of how medical resources are distributed and used in the United States. Using very large health care claims databases (including Medicare, Blue Cross organizations, and other sources of data), the Dartmouth Atlas project documents remarkable differences in how Americans use health care resources, and the influence of the local supply of resources on the rates of use of those resources. The Dartmouth Atlas project has published a series of books, several of which can be read or downloaded from their website.
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This link to the Associates in Process Improvement's website contains an extensive and periodically updated listing of books, articles, and studies on various topics within the topic of improvement.
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Lean Enterprise Institute (LEI) is a non-profit training, publishing, and a research center founded in 1997 by James P. Womack, author of the best-selling book Lean Thinking. LEI shares and teaches lean principles, tools, and techniques to minimize waste and maximize value in an organization. This is a great site that describes the fundamentals of lean thinking and provides access to support tools, articles, workbooks, events, and training.
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An independent, nonprofit organization, ICSI helps its members (48 medical organizations in Minnesota) identify and accelerate the implementation of best clinical practices for their patients. The ICSI program has four components: improvement commitment, scientific groundwork for health care, support for improvement, and the Minnesota health quality agenda. Some of the most valuable resources on the site include the health care guidelines and protocols.
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The Northern New England Perinatal Quality Improvement Network (NNE PQIN) attempts to improve perinatal health throughout New England through actions such as: making sure consistent quality improvement guidelines are readily available; maintaining a database of reviews; aiding in peer review facilitation; and many other areas.
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This website develops and tests methods to evaluate the quality of mental health care. Funded by the Agency for Healthcare Research and Quality and the Substance Abuse and Mental Health Services Administration, CQAIMH provides a number of mental health quality measures.
User submitted: Richard Hermann, MD, MS
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An excellent resource to develop your storytelling skills and the use of story to change culture, develop leadership, and spread quality improvement efforts. [USA]
User submitted: Susan Edgman-Levitan
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This program was founded by a number of nursing facilities in reaction to managed care. Wellspring's mission is "to provide a leadership structure and process that others can use to support ongoing clinical improvement and business opportunties." [USA]
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Urgent Matters is an initiative of The Robert Wood Johnson Foundation to help hospitals eliminate emergency department crowding and help communities understand the challenges facing the health care safety net. The initiative is housed at the Center for Health Services Research and Policy at The George Washington University Medical Center’s School of Public Health and Health Services. [USA]
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The mission of the Progressive Policy Institute (PPI) is to define and promote a new progressive politics for America in the 21st century. Through its research, policies, and perspectives, PPI is fashioning a new governing philosophy and an agenda for public innovation. [USA]
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The Delmarva Foundation for Medical Care has worked in health care quality work for over 25 years and currently serves as the Medicare Quality Improvement Organization (QIO) for Maryland and the District of Columbia. Delmarva also works with 8 State Medicaid programs as the External Quality Review Organization (EQRO). [USA]
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The National Committee for Quality Assurance (NCQA) is a private, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans. [USA]
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The National Coalition on Health Care is the nation’s largest and most broadly representative alliance working to improve America’s health care. The Coalition, which was founded in 1990 and is non-profit and rigorously non-partisan, is comprised of almost 100 groups, employing or representing approximately 100 million Americans. Members are united in the belief that we need — and can achieve — better more affordable health care for all Americans. [USA]
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Created in 1994 as a focal point for sharing resources, discussions, learning, and research on the Deming philosophy. Currently have more than 1,000 papers, essays, files, and programs.
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Health Care Excel (HCE) is recognized as one of the most experienced health care utilization management and quality improvement organizations in the United States. The company draws upon nearly 30 years experience to provide quality services to health care professionals and consumers. Health Care Excel's success is the result of strategic partnerships, dedicated professionals and an unwavering commitment to improving health care. [USA]
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Associates in Process Improvement (API) develops methods, works with leaders and teams, and provides education and training to help organizations improve their products and services and to build their capability for ongoing improvement. [USA]
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The National Initiative for Children's Healthcare Quality (NICHQ) seeks to make dramatic improvements in the quality of care for children and adolescents. NICHQ seeks to catalyze a national commitment to improve health care for children, as well as to achieve better outcomes in practices that care for children by developing, testing and deploying new methods to provide and improve care.
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A nonprofit organization founded by Dr. W. Edwards Deming. The aim of the Institute is to foster the understanding of The Deming System of Profound Knowledge to advance commerce, prosperity, peace, and to make a difference in the quality of life for everyone. [USA]
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The Center is the locus for a diverse group of scientists and clinician-scholars interested in evaluating some fundamental questions in medicine: how well medical procedures actually work; how to improve the quality of medical and surgical care; how health care resources are distributed and used; and how patients value medical interventions and their consequences. [USA]
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The Baldrige National Quality Program is an award program organization working to enhance the competitiveness, quality, and productivity of US organizations by helping them improve their quality management. Their goal is to increase public awareness of the need for a systems approach to improvement, and sharing quality and performance improvement strategies. [USA]
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The American Society for Quality advances individual, organizational and community excellence worldwide through learning, quality improvement, and knowledge exchange. [USA]
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Allicance of Community Health Plans (ACHP) is a membership organization of leading health plans and provider organizations — promotes the highest standards of health care quality and health improvement through collaborative learning, innovation, and advocacy. [USA]
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International
Commission for Health Improvement (CHI) is the authoritative voice on the state of the NHS in England and Wales. CHI helps the NHS assure, monitor and improve the quality of patient care. CHI addresses unacceptable variations in NHS patient care by identifying notable practice as well as highlighting areas for improvement. [UK]
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International Initiatives
This resource provides services to guide health professionals, providers, researchers, agencies, policy makers and consumers, to achieve excellence in health care delivery to all people, and to continuously improve the quality and safety of care.
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The World Health Organization (WHO), the United Nations specialized agency for health, is governed by 192 states. WHO’s objective is the attainment by all peoples of the highest possible level of health. Health, defined under the WHO constitution, is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. [SWITZERLAND]
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Last Phase of Life
These Clinical Practice Guidelines for Quality Palliative Care have been developed by the National Consensus Project for Quality Palliative Care (NCP), a group of five leading palliative care organizations in the US. The Guidelines form a national concensus of what the standard of good palliative care should be.
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This site from the Washington Home Center for Palliative Care Studies offers support and resources to hospitals, nursing homes, health systems, hospices, and other organizations that serve individuals nearing the end of life and their families.
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Leadership
The Health Resources and Services Administration (HRSA) Bureau of Primary Health Care (BPHC), in partnership with the Institute for Healthcare Improvement, has embarked on a nationwide initiative to improve care for people with chronic conditions. The Health Disparities Collaboratives strive to achieve excellence through goals such as building strategic partnerships, transforming clinical practice through models of care, improvement, and learning, developing infrastructure, and generating/documenting improved health outcomes. The website includes training manuals, tools and resources, and upcoming opportunities to get involved.
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National Initiatives & Organizations
The Commonwealth Fund is a private foundation that supports independent research on health and social issues and makes grants to improve health care practice and policy. The Fund is dedicated to helping people become more informed about their health care, and improving care for vulnerable populations such as children, elderly people, low-income families, minority Americans, and the uninsured.
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North America
The Clinical Toolbox for Geriatric Care, developed by the Society of Hospital Medicine Geriatric Task Force, provides hospitalists with a compendium of resources to facilitate and improve inpatient care of the elderly. Resources include practice guidelines; assessment tests for mental status, mobility, and pain; tools for predicting and preventing pressure ulcers; and more.
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The Centers for Medicare & Medicaid Services (CMS)/Premier Inc. Hospital Quality Incentive Demonstration (HQID) pay-for-performance project is the first national pay-for-performance project of its kind, designed to determine if financial incentives are effective at improving the quality of inpatient hospital care. More than 260 hospitals are voluntarily participating in the project. Reported results thus far indicate that patients treated at hospitals participating in the project are living longer and receiving recommended treatments more frequently.
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Patient, Family & Consumer Sites
The Institute for Family-Centered Care, a non-profit organization, provides leadership to advance the understanding and practice of patient- and family-centered care. By promoting collaborative, empowering relationships between providers and consumers, the Institute facilitates patient- and family-centered change in all settings where individuals and families receive care and support. Guidance for creating patient and family advisory councils, supporting family participation on committees and task forces (e.g., patient safety, pain management, quality improvement, and patient and family education), collaborative design planning, and involving patients and families in staff orientation and the education of students and trainees is available from the Institute.
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Patient-Centered Care
The Survey Users Network is a website which contains detailed information about the CAHPS survey project. CAHPS is a multi-year project which uses survey tools to measure the experiences of consumers and patients. The goal is to allow patients to make decisions which promote improved health and health care.
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The National CAHPS Benchmarking Database (NCBD) is the national warehouse of data collected by the CAHPS patient surveys to assess patient care. All organizations that administer their surveys according to CAHPS specifications may participate in the national database free of charge.
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Patients and health care meet in small living, adapting "front line" systems called microsystems — small, interdependent groups of people who work together regularly to provide care for specific groups of patients. This website, developed by Dartmouth-Hitchcock Medical Center and the Institute for Healthcare Improvement, features concrete ways to further understand, develop, assess, and improve clinical microsystems.
In addition, the site has information on the 2003 Microsystem Fall Invitational Film Festival. The Film Festival explored ways to use film to share experiences, teaching methods, knowledge, emotions, and collaborative practice to improve clinical microsystems and improve health care.
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Foundation for Accountability (FACCT) is a not-for-profit organization dedicated to consumer input into health care. Quality tools that focus on consumer input are available at this site. [USA]
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Obtaining deeper information about your patients can be difficult. Use HowsYourHealth website to have all the practice staff complete the survey to gain insight into the process for patients and for the practice to see how aggregate data about a group can help develop plans of care. Choose the "For Health Professionals" link on the home page to learn about features of this program and how to customize it for your setting. [USA]
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Professional Associations
The American College of Physicians quality improvement website focuses on pay-for-performance, performance measures and practice redesign, and includes a number of informational resources for internists.
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The National Association for Healthcare Quality is dedicated to improving the quality of health care and to supporting the development of professionals in health care quality. [USA]
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The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) is the nation's largest medical specialty society. Its mission is to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine. [USA]
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The AMA strives to serve as the voice of the American medical profession, which includes the development and promotion of standards in medical practice, research, and education, and the commitment to providing timely information on matters important to the health of America. [USA]
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The national organization that represents and serves all types of hospitals, health care networks, and their patients and communities. AHA provides education for health care leaders and is a source of information on health care issues and trends. [USA]
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American Academy of Family Physicians, the national association of family doctors, is committed to preserving and promoting quality, cost-effective health care by family physicians. [USA]
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Quality Improvement Resources
This free resource from The Commonwealth Fund is for health care professionals interested in tracking performance on various measures of health care quality. It enables organizations to compare their performance against that of peer organizations, against a range of benchmarks, and over time. Case studies and improvement tools spotlight successful improvement strategies of the nation’s top performers.
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"Physicians in Their Own Voices" is a motivational documentary developed by Putting Quality into Practice, a joint research effort of the American Board of Internal Medicine (ABIM) Foundation and The Commonwealth Fund. The DVD features physicians describing in their own words how they implemented quality improvement principles and simple, yet effective solutions in their practices to improve the quality of care for patients. These stories demonstrate that small group and solo practitioners can implement modern management and improvement principles at the front line to improve care as well as to increase patient, staff, and physician satisfaction. The DVD may be obtained from ABIM via their website.
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This first-of-its-kind portrait of the state of health care quality in the United States documents serious gaps in quality on many crucial dimensions of care: Lack of preventive care, medical mistakes, substandard care for chronic conditions, and health care disparities. The chartbook is based on more than 150 published studies and reports about quality of care.
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Regulatory, Legislative & Policy
This semi-annual journal strives to publish high-quality articles covering the entire spectrum of health policy issues and is designed to appeal to audiences with different degrees of familiarity with the subjects of health care and health policy. [USA]
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The Agency for Healthcare Research and Quality (AHRQ) research provides evidence-based information on health care outcomes; quality; and cost, use, and access. Information from AHRQ’s research helps people make more informed decisions and improve the quality of health care services. AHRQ was formerly known as the Agency for Health Care Policy and Research. [USA]
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The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) evaluates and accredits nearly 17,000 health care organizations and programs in the United States. An independent, not-for-profit organization, JCAHO is the nation's predominant standards-setting and accrediting body in health care. Since 1951, JCAHO has developed state-of-the-art, professionally based standards and evaluated the compliance of health care organizations against these benchmarks. Its mission is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. In support of this mission, in 2002, JCAHO introduced Shared Visions-New Pathways, an initiative that focuses accreditation on operational systems that are critical to the safety and quality of patient care.
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US Government
The 2005 NHQR includes 179 performance measures that can be used to monitor the United State's progress toward improved health care quality for all Americans. The report focuses on four components of quality: effectiveness, patient safety, timeliness, and patient-centeredness. It also presents data on a group of 46 "core" measures representing the most important and scientifically sound measures of quality.
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The 2005 NHDR tracks disparities in both quality of and access to health care in the United States for both the general population and for designated priority populations. The report focuses on four components of quality—effectiveness, patient safety, timeliness, and patient-centeredness—and two components of access—facilitators and barriers to health care and health care utilization.
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QualityTools is a website sponsored by the Agency for Healthcare Research and Quality that has a number of tools to help improve the quality of health care.
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The Office for Civil Rights ensures that all people have equal access, without discrimination, to all health services provided by the US Department of Health and Human Services. This site includes a Fact Sheet on Protecting the Privacy of Patients’ Health Information as well as resources addressing the concern of health disparities.
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The Advisory Commission on Consumer Protection and Quality in the Health Care Industry was created by President Clinton to "advise the President on changes occurring in the health care system and recommend such measures as may be necessary to promote and assure health care quality and value, and protect consumers and workers in the health care system." [USA]
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The world's largest medical library and creator of MEDLINE/PubMed. [USA]
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The mission of the Institute of Medicine is to advance and disseminate scientific knowledge to improve human health. The Institute provides objective, timely, authoritative information and advice concerning health and science policy to government, the corporate sector, the professions and the public. [USA]
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The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau provides technical assistance (TA) and training to help CARE Act programs in providing care for people living with HIV. [USA]
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The Centers for Disease Control and Prevention (CDC) is recognized as the lead federal agency for protecting the health and safety of people — at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. [USA]
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