Healthcare Systems Engineering

Apply engineering and design principles to revitalize the healthcare delivery system Healthcare Systems Engineering is the first engineering book to cover this emerging field, offering comprehensive coverage of the healthcare system, healthcare delivery, and healthcare systems modeling. Written by leading industrial engineering authorities and a medical doctor specializing in healthcare delivery systems, this book provides a well-rounded resource for readers of a variety of backgrounds. Examples, case studies, and thoughtful learning activities are used to thoroughly explain the concepts presented, including healthcare systems, delivery, quantification, and design. You'll learn how to approach the healthcare industry as a complex system, and apply relevant design and engineering principles and processes to advance improvements. Written with an eye toward practicality, this book is designed to maximize your understanding and help you quickly apply toward solutions for a variety of healthcare challenges. Healthcare systems engineering is a new and complex interdisciplinary field that has emerged to address the myriad challenges facing the healthcare industry in the wake of reform. This book functions as both an introduction and a reference, giving you the knowledge you need to move toward better healthcare delivery. Understand the healthcare delivery context Use appropriate statistical and quantitative models Improve existing systems and design new ones Apply systems engineering to a variety of healthcare contexts Healthcare systems engineering overlaps with industrial engineering, operations research, and management science, uniting the principles and practices of these fields together in pursuit of optimal healthcare operations. Although collaboration is focused on practitioners, professionals in information technology, policy and administration, public health, and law all play crucial roles in revamping health care systems. Healthcare Systems Engineering is a complete and authoritative reference for stakeholders in any field.

Apply engineering and design principles to revitalize the healthcare delivery system Healthcare Systems Engineering is the first engineering book to cover this emerging field, offering comprehensive coverage of the healthcare system, healthcare delivery, and healthcare systems modeling. Written by leading industrial engineering authorities and a medical doctor specializing in healthcare delivery systems, this book provides a well-rounded resource for readers of a variety of backgrounds. Examples, case studies, and thoughtful learning activities are used to thoroughly explain the concepts presented, including healthcare systems, delivery, quantification, and design. You'll learn how to approach the healthcare industry as a complex system, and apply relevant design and engineering principles and processes to advance improvements. Written with an eye toward practicality, this book is designed to maximize your understanding and help you quickly apply toward solutions for a variety of healthcare challenges. Healthcare systems engineering is a new and complex interdisciplinary field that has emerged to address the myriad challenges facing the healthcare industry in the wake of reform. This book functions as both an introduction and a reference, giving you the knowledge you need to move toward better healthcare delivery. Understand the healthcare delivery context Use appropriate statistical and quantitative models Improve existing systems and design new ones Apply systems engineering to a variety of healthcare contexts Healthcare systems engineering overlaps with industrial engineering, operations research, and management science, uniting the principles and practices of these fields together in pursuit of optimal healthcare operations. Although collaboration is focused on practitioners, professionals in information technology, policy and administration, public health, and law all play crucial roles in revamping health care systems. Healthcare Systems Engineering is a complete and authoritative reference for stakeholders in any field.

It has been almost 20 years since the Institute of Medicine released the seminal report titled, Crossing the Quality Chasm. In it, the IoM identified six domains of care quality (safe, timely, effective, efficient, equitable, and patient-centric) and noted a huge gap between the current state and the desired state. Although this report received a great deal of attention, sadly there has been little progress in these areas. In the U.S., healthcare still has huge disparities, is inefficient, and is fragmented with delays in care that are often unsafe. Most U.S. citizens are expected to suffer from a diagnostic error sometime during their lifetime, not receive a large fraction of recommended care, and pay for one of the most expensive systems in the world. Much has been written about quality improvement over the years but many prominent quality and safety experts. Yet progress has been slow. Some have called on the healthcare professions to look outside of healthcare to other industries using examples in nuclear power and airlines for safety, the hotel and entertainment industry for a ‘customer’ focus, and the automotive industry, particularly Toyota for efficiency (Lean). This book by Dr. Oppenheim on lean healthcare systems engineering (LHSE) is a fresh approach that brings forth concepts that systems engineers have used in huge national defense projects. What’s unique in this book is that these powerful system engineering tools are modified to be able to address smaller sized healthcare problems that still involve similar problems in fragmentation and poor communication and coordination. This book is an invaluable reference for a new powerful process named Lean Healthcare Systems Engineering (LHSE) for managing workflow and care improvement projects in all clinical environments. The book applies to ambulatory clinics and hospitals of all types including operating rooms, emergency departments, and ancillary departments, clinical and imaging laboratories, pharmacies, and population health. The book presents a generic rigorous but not mathematical step-by-step process of integrated healthcare, systems engineering and Lean. The book also contains the first major product created with the LHSE process, namely tabularized summaries of representative projects in healthcare delivery applications, called Lean Enablers for Healthcare Projects. Each full-page enabler table lists the challenges and wastes, powerful improvement goals, risks, and expected benefits, and some useful descriptions of the healthcare system of interest. The book provides user-friendly solutions to major problems in healthcare delivery operations in all clinical environments, addressing fragmentation, wastes, wrong incentives, ad-hoc and stove-piped management, lack of optimized processes, hierarchy gradient, lack of systems thinking, “blaming and shaming culture”, burnout of providers and many others.

In a joint effort between the National Academy of Engineering and the Institute of Medicine, this books attempts to bridge the knowledge/awareness divide separating health care professionals from their potential partners in systems engineering and related disciplines. The goal of this partnership is to transform the U.S. health care sector from an underperforming conglomerate of independent entities (individual practitioners, small group practices, clinics, hospitals, pharmacies, community health centers et. al.) into a high performance "system" in which every participating unit recognizes its dependence and influence on every other unit. By providing both a framework and action plan for a systems approach to health care delivery based on a partnership between engineers and health care professionals, Building a Better Delivery System describes opportunities and challenges to harness the power of systems-engineering tools, information technologies and complementary knowledge in social sciences, cognitive sciences and business/management to advance the U.S. health care system.

Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.

With rapidly rising healthcare costs directly impacting the economy and quality of life, resolving improvement challenges in areas such as safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity has become paramount. Using a system engineering perspective, Handbook of Healthcare Delivery Systems offers theoretical foundations, methodologies, and case studies in each main sector of the system. It explores how system engineering methodologies and their applications in designing, evaluating, and optimizing the operations of the healthcare system could improve patient outcomes and cost effectiveness. The book presents an overview of current challenges in the healthcare system and the potential impact of system engineering. It describes an integrated framework for the delivery system and the tools and methodologies used for performance assessment and process improvement with examples of lean concept, evidence-based practice and risk assessment. The book then reviews system engineering methodologies and technologies and their applications in healthcare. Moving on to coverage of the design, planning, control and management of healthcare systems, the book contains chapters on 12 services sectors: preventive care, telemedicine, transplant, pharmacy, ED/ICU, OR, decontamination, laboratory, emergency response, mental health, food and supplies, and information technology. It presents the state-of-the-art operations and examines the challenges in each service unit. While system engineering concepts have been broadly applied in healthcare systems, most improvements have focused on a specific segment or unit of the delivery system. Each unit has strong interactions with others and any significant improvement is more likely to be sustained over time by integrating the process and re-evaluating the system design from a holistic viewpoint. By providing an overview of individual operational sectors in the extremely complex healthcare system and introducing a wide array of engineering methods and tools, this handbook establishes the foundation to facilitate integrated system thinking to redesign the next generation healthcare system.

This Briefs Series book illustrates in depth a concept of healthcare management engineering and its domain for hospital and clinic operations. Predictive and analytic decision-making power of management engineering methodology is systematically compared to traditional management reasoning by applying both side by side to analyze 26 concrete operational management problems adapted from hospital and clinic practice. The problem types include: clinic, bed and operating rooms capacity; patient flow; staffing and scheduling; resource allocation and optimization; forecasting of patient volumes and seasonal variability; business intelligence and data mining; and game theory application for allocating cost savings between cooperating providers. Detailed examples of applications are provided for quantitative methods such as discrete event simulation, queuing analytic theory, linear and probabilistic optimization, forecasting of a time series, principal component decomposition of a data set and cluster analysis, and the Shapley value for fair gain sharing between cooperating participants. A summary of some fundamental management engineering principles is provided. The goal of the book is to help to bridge the gap in mutual understanding and communication between management engineering professionals and hospital and clinic administrators. The book is intended primarily for hospital/clinic leadership who are in charge of making managerial decisions. This book can also serve as a compendium of introductory problems/projects for graduate students in Healthcare Management and Administration, as well as for MBA programs with an emphasis in Healthcare.

An argument that understanding healthcare delivery as a complex adaptive system will help us design a system that yields better health outcomes. Breakthroughs in medical science, innovations in medical technologies, and improvements in clinical practices occur today at an increasingly rapid rate. Yet because of a fragmented healthcare delivery system, many Americans are unable to benefit from these developments. How can we design a system that can provide high-quality, affordable healthcare for everyone? In this book, William Rouse and Nicoleta Serban introduce concepts, principles, models, and methods for understanding, and improving, healthcare delivery. Approaching the topic from the perspectives of engineering and statistics, they argue that understanding healthcare delivery as a complex adaptive system will help us design a system that is more efficient, effective, and equitable. The authors use multilevel simulation models as a quantitative tool for evaluating alternate ways of organizing healthcare delivery. They employ this approach, for example, in their discussions of affordability, a prevention and wellness program, chronic disease management, and primary care accessibility for children in the Medicaid program. They also consider possible benefits from a range of technologies, including electronic health records and telemedicine; data mining as an alternative to randomized trials; conceptual and analytical methodologies that address the complexity of the healthcare system; and how these principles, models, and methods can enable transformational change.