Healthcare Systems Engineering

Chapter 1 The Healthcare Delivery System Overview 1.1 Healthcare Delivery Components 1.2 Major Stakeholders 1.3 Global Issues in Health Global Spending Global Outcomes Unique Challenges 1.4 Drivers for Healthcare Systems Financial Population Health and Wellness Equity Quality--First, Do No Harm Electronic Health Records Point of Care Personalized Medicine Questions and Learning Activities References Chapter 2 Complexity and Systems in Healthcare Overview 2.1 Taking a Systems Approach to Healthcare 2.2 Complex Adaptive Systems Defining Characteristics of Complex Adaptive Systems Complexity in Healthcare Case 2a: Complexity in Chronic Kidney Disease 2.3 Systems Thinking and System Dynamics Dimensions of Systems Thinking Linear vs. Feedback Perspectives Methodologies Causal Loop Diagrams Case 2b: Systems Thinking and Causal Loop Diagrams in CKD Stock Flow Model Case 2c: System Dynamics and Stock Flow Diagrams in CKD Questions and Learning Activities References Chapter 3 Patient Flow Overview 3.1 Healthcare Settings and Clinical Workflows Primary Ambulatory Care Specialty Ambulatory Care Emergency Care Outpatient Surgical Center Operating Room Care Inpatient Care Long-Term Care 3.2 Patient Flow through a Hospital Admission and Discharge ED Capacity and Crowding Boarding OR Scheduling Variability 3.3 Care Transitions Transfers within a Hospital Patient Transfer from the ED to Inpatient Primary Care to Specialty Care Inpatient Setting to Long-Term Care Facilities Inpatient Setting to Home 3.4 Process Mapping Benefits of Process Mapping Creating a Process Map 3.5 Queuing 3.6 Case Study: ED Crowding--A Patient Flow Solution Questions and Learning Activities References Chapter 4 Healthcare Financing Overview 4.1 Financing Models for Health Services Insurance and Third-Party Payment Agency Issues Government-Provided Insurance Universal Healthcare 4.2 Compensation Models for Providers Fee for Service Bundled Payments--Diagnostic-Related Groups Pay-for-Performance Plans Shared Savings Plans Capitation 4.3 Cost Allocation and Charges Costs Setting Charges Cost Shifting 4.4 Capital Budgeting Net Present Value Project Selection References Chapter 5 Health Data and Informatics Overview 5.1 Healthcare Data 5.2 Electronic Health Records Computerized Physician Order Entry Clinical Decision Support Systems Meaningful Use 5.3 Health Information Exchange 5.4 Publicly Reported Healthcare Data Hospital Compare Health, United States Medicare Provider Charge Data State Departments of Health 5.5 Case Study Health Informatics at a Hospital--a 10-Year Journey Questions and Learning Activities References Chapter 6 Lean Overview 6.1 Lean Philosophy and Methods 6.2 Drivers for Lean Healthcare Systems Driver 1: Define Value Based on the Voice of the Patient (Customer) Driver 2: Create an Environment That Supports the Staff Driver 3: Eliminate All Forms of Waste Driver 4: Deliver Excellent Clinical Quality 6.3 A Toolset for Eliminating Wastes 6.4 Value Stream Mapping 6.5 A3 6.6 5S 6.7 Kanban 6.8 Lean Implementations 6.9 Lean Thinking Questions and Learning Activities References Chapter 7 Six Sigma Overview 7.1 Six Sigma Philosophy 7.2 Six Sigma Quality Six Sigma Costs and Benefits Six Sigma DMAIC Methodology Define Phase Concepts and Tools Critical to Quality (CTQ) Flowdown SIPOC Measure Phase Concepts and Tools Cause-and-Effect Diagram Pareto Chart Analyze Phase Concepts and Tools Failure Modes and Effects Analysis Improve Phase Concepts and Tools Lean Thinking and Lean Tools Comparative Experiments Design of Experiments Control Phase Concepts and Tools Statistical Process Control Control Plan and Documentation Six Sigma Implementations Leading Change Strategy and Strategic Management Change Management Health Organization Transformation Six Sigma in Translational Research Questions and Learning Activities References Chapter 8 Reliability and Patient Safety Overview 8.1 Human Reliability 8.2 Errors in Healthcare 8.3 Medication Errors Poor Prescription Illegible Handwriting Wrong Medication Administration 8.4 Patient Falls Risk Factors Risk Mitigation Strategies Risk Factor Assessment and Screening Individual Interventions System Redesign (Environmental Interventions) 8.5 Human Factor and Ergonomics for Patient Safety Individuals Situation Awareness Decision-Making Support Methods for Better Medical Decision Making Technology Medical Device Design Organization Communication Questions and Learning Activities References Chapter 9 Health Analytics Overview 9.1 Data Mining Definition and Methodologies Preprocessing Data Mining Interpretation/Evaluation Medical Data Mining Mining Claims Data Mining Clinical Trial Data Mining Adverse Drug Reaction Incidents Mining Healthcare Market Segments Case 9.1: Predicting Parkinson's Disease Using Data Mining Data Acquisition and Preprocessing Data Mining and Knowledge Discovery Results 9.2 Data Visualization Definition and Function of Data Visualization Brief History of Data Visualization Data Visualization Techniques Today The Data Visualization Process Perception Human Factors in Data Visualization Data Visualization in Healthcare Practice Technique 1: Icon Arrays Technique 2: Magnifier Risk Scale Technique 3: Risk Scale Technique 4A: Timeline Technique 4B: Timeline Belt Technique 5: Heatmap Technique 6: Kaleidomaps by Bale et al. Technique 7: Timeline Browser by Cousins and Kahn Technique 8: Glyph Technique 9: Overlaps and Interconnections Case 9.2: Data Visualization in Obesity Counseling Questions and Learning Activities Social Network Analysis Network Representation Descriptive Network Properties Case 9.3: SNA in a Pediatric Intensive Care Unit (PICU) Data Envelopment Analysis DEA Models Model Formulations Case 9.4: Using DEA for Finding Best-in-Class Hospitals in a Network Multicriteria Decision Making MCDM Terms and Concepts Goal Programming Case 9.5: Use of GP to Optimize Helicopter Emplacement at Medical Treatment Facilities Questions and Learning Activities References Chapter 10 Capacity Management Overview 10.1 Capacity Management Challenges 10.2 Managing Nursing Units Boarding Diversion Transferring Patients 10.3 Managing Operating Rooms Determining Block Times Block Scheduling Block Scheduling in Practice 10.4 Managing Diagnostic Units 10.5 Nurse Staffing and Scheduling References Chapter 11 Healthcare Logistics Overview 11.1 Facility Location Basic Location Models Location of Healthcare Facilities Willingness-to-Travel Constraints Choice Constraints Equity Modeling Model Formulation 11.2 Home Healthcare Routing and Scheduling HHC Routing/Allocation HHC Heuristics References Chapter 12 Health Supply Chains Overview 12.1 Forecasting Demand Time Series Models Forecast Error 12.2 Inventory Control Deterministic Models Stochastic Models Newsvendor Model 12.3 Healthcare Distribution Distribution Requirements Planning Transportation Planning Vendor Management Inventory Cold Chains for Healthcare Products 12.4 Coordinating Activities in the Supply Chain Pooling Information Sharing Supply Chain Contracting References Chapter 13 Infection Control Overview 13.1 Historical Perspective 13.2 Infection Control Classification 13.3 Checklists for Infection Control 13.4 The Case of Sepsis 13.5 Mathematical Modeling of Hospital Infection Control Compartment Models Compartment Model Applied to Hand Washing Tuberculosis Infection Control References